Pharmacological treatment in behavioural medicine: the importance of neurochemistry, molecular biology and mechanistic hypotheses.

Psychopharmacology has become a popular, and sometimes mandatory addition to treatment regimes for canine and feline patients with behavioural problems; however, clients and practitioners should be dissuaded that behavioural drugs are 'quick fixes'. Veterinarians should only prescribe psychotropic medication when they have a specific idea of how the mechanism of action of the drug will affect the target behaviours associated with a specific diagnosis. The diagnosis must be treated rather than non-specific signs. Newer psychotropic medications demonstrate the extent to which truly abnormal behaviours are dysfunctions of neurochemistry; synaptic or cellular metabolism; or genetic encoding and 'learning', or LTP, hence there is a clear role for the interaction of neuropharmacology and behavioural and environmental modification.Future advances in treatment in behavioural medicine will be pharmacological and neurophysiological. As the field of behavioural medicine expands, its paradigm will enlarge to include combination therapy and the implementation of neuropharmacological intervention as a diagnostic tool. At present, the veterinary practitioner can effectively aid many common behavioural problems using extant drugs to treat animals with true behavioural pathology.Rational pharmacological therapy requires complete medical and behavioural histories, requisite laboratory work, complete client understanding and compliance, and an honest and ongoing dialogue between the client and veterinarian that includes frequent follow-ups and re-examinations. Copyright Harcourt Publishers Ltd.     

Medical Management of Recurrent Seizures in Dogs and Cats

The problem of recurrent seizures is a common and challenging one in veterinary medical practice. The pathophysiology and pharmacologic suppression of focal seizure activity have been studied extensively in basic research settings, yet little is known of the genesis, modulation, and termination of generalized seizures, the most common form of seizures noted to occur in companion animals. Knowledge concerning the pharmacokinetic fate of anticonvulsant drugs currently used in veterinary medicine is adequate, though prospective clinical studies of the efficacy of these drugs in the treatment of various types of seizures are lacking. This study will review the available literature regarding the pharmacology, use, and side effects of anticonvulsant drugs currently available for control of recurrent seizures in companion animals. Alternative anticonvulsant drugs will also be described.     

Current research in canine and feline pheromones.

Pheromonotherapy seems to be a new therapeutic approach allowing practitioners to tackle the treatment of behavioral disorders in a natural, specific, and safe way. Although the efficacy of pheromones has been assessed in some specific behavioral problems, it seems that their range of action could cover the wide field of reduction of stress. Therefore, the use of pheromones should not be reduced to treatment of behavioral disorders (potentially associated with psychotropes or a behavioral modification program) but should be included in a strategy of improving the welfare of pets in veterinary structures (during examination and hospitalization) and in breeding networks (separation from the mother and transport). Moreover, further studies may allow the veterinary practitioner to use pheromone analogues in the field of diagnostics to determine the behavioral status of a pet (e.g., anxious or not, dominant or not). Pheromonotherapy is at its beginning, and the use of pheromones in various fields of medicine is heartening.     

The pharmacologic spectrum of furosemide

Objective: To review the clinical spectrum and mechanisms of action of furosemide in human and small animal veterinary patients. Data sources: Review of human and veterinary literature. Data synthesis: Furosemide is used primarily for its properties as a loop diuretic; however, it has many other actions that may be clinically applicable. Furosemide has a vasodilatory effect that precedes diuresis that may confer its immediate benefit in patients with volume overload. Furosemide can be inhaled to relieve dyspnea in patients with bronchospasm. Furosemide also shows promise as an adjunct to antiseizure therapy to help control epilepsy, status epilepticus, and acute ischemic damage related to seizures. It has activity as an antioxidant, iodine depletive, and may increase thoracic lymph duct flow. Reported furosemide side effects include altered drug metabolism, electrolyte depletion, ototoxicity, mucociliary impairment, endocrine and exocrine pancreatic effects, delayed wound healing, sulfonamide toxicity, and thyroid binding interference. It is worthwhile to consider the implications of these effects when using furosemide either alone or in combination with other drugs. Conclusions: Despite the research in animal models that demonstrates a wide spectrum of pharmacologic activity, furosemide has not been widely recognized or used clinically in veterinary medicine except as a loop diuretic.     

Thrombolytic Therapy in Dogs and Cats

Objective: To review the thrombolytic agents most commonly used in humans, their mechanisms of action, potential uses, adverse effects, and reports of their use in dogs and cats.
Human data synthesis: Thrombolytic agents avaliable in human medicine include streptokinase, urokinase, tissueplasminogen activator (t-PA), single-chain urokinase plasma activator (scu-PA) and anisoylated plasminogen-strep-tokinase activator complex (APSAC). These agents were originally used for the management of proximal deep vein thrombosis and severe pulmonary embolism but more recently, use of these drugs has been extended to include the treatment of acute peripheral arterial disease, cerebrovascular disease (stroke) and acute coronary thrombosis. The most predictable side effect associated with the use of thrombolytic therapy is hemorrhage.
Veterinary data synthesis: Clinical experience with thrombolytic agents in small animals is limited to streptokinase and t-PA. It is possible, that as in humans, canine and feline patients with PTE and right ventricular dysfunction may benefit from thrombolytic therapy but there are no veterinary studies to support this theory to date. Successful use of streptokinase has been documented in a small number of canine patients with systemic thromboembolism. ⁶³ Thrombolytic therapy is relatively efficacious in cats with aortic thromboemboli but is associated with a high mortality rate. ^59,60,64 With regard to use of t-PA in veterinary medicine, the small number of animals treated with varying protocols makes it impossible to provide safe and effective dose recommendations at this time.
Conclusions: Future goals for thrombolytic therapy in veterinary medicine include determination of more specific clinical indications, as well as design of effective protocols that minimize mortality and morbidity.     

Diagnosis and management of patients presenting with behavior problems

Behavior problems are among the most common concerns for veterinary clients, and veterinarians need to be comfortable diagnosing and treating these conditions. Knowledge of animal behavior by veterinarians is critical for effective treatment of behavior problems, recognition and diagnosis of medical conditions for which behavior signs prevail, proper handling of veterinary patients, prevention of abandonment and euthanasia, preservation of the companion animal-human bond, and prevention of mental suffering. Successful patient management requires taking a thorough behavioral history, understanding the mechanisms underlying behavior changes, developing appropriate treatment interventions, and, in some cases, pharmacologic therapy.     

Overview of the use of antimicrobials for the treatment of bacterial infections in horses

Use of antimicrobial drugs is central to the treatment of primary and secondary bacterial infection in horses. When selecting an antimicrobial to treat confirmed or suspected bacterial infection multiple factors should be considered, including: the likely infectious agent; distribution and dosage of selected drugs; mechanisms of action; and potential side effects. Many of these issues will be covered in subsequent articles in this series. The aim of this paper is to aid the clinician in the rational selection of antimicrobials by reviewing the mode of action, spectrum of activity, pharmacokinetics, pharmacodynamics, indications and potential side effects of the main classes of antimicrobial drugs. Extralabel use of drugs is common in veterinary medicine due to a lack of licensed products. This increases the importance of a thorough understanding of antimicrobials and their possible adverse effects.     

Management of atrial fibrillation.

Atrial fibrillation (AF) is the most common clinically important arrhythmia in veterinary medicine. Electrical cardioversion of AF to sinus rhythm is feasible, but pharmacologic rate control is an effective and achievable treatment strategy for most veterinary patients. Recent human trials suggest that rate control and rhythm control are almost equally beneficial. Nevertheless, AF can be a challenging arrhythmia to manage, because most affected animal shave numerous other concurring problems associated with the underlying heart disease that dictate or influence the clinician's choice of treatment and monitoring strategy for each patient.     

促胃肠动力药物研究现状

胃肠动力迟缓类疾病由于发病特征的不显著,在动物身上并未引起足够的重视,但随着近几年畜牧业的不断发展,其发病率不断升高,对国家已造成了不可估量的损失。从药物机制、临床研究等方面对比阐述了人用及兽用促胃肠动力药物的应用现状,旨在为兽用促胃肠动力药物的研发及兽医临床中的使用提供参考。     

The use of IV lipid emulsion for lipophilic drug toxicities

IV lipid emulsion (ILE) therapy is emerging as a potential antidote for lipophilic drug toxicities in both human and veterinary medicine. ILE has already gained acceptance in human medicine as a treatment of local anesthetic systemic toxicity, but its mechanism of action, safety margins, and standardized dosing information remains undetermined at this time. Experimental and anecdotal use of ILE in the human and veterinary literature, theorized mechanisms of action, current dosing recommendations, potential adverse effects, and indications for use in human and veterinary emergency medicine are reviewed herein.     

Comments on the Guidelines for the prudent use of antibacterial veterinary pharmaceuticals (guidelines for antibiotics)

In 2010 the German Bundestier?rztekammer (Federal Chamber of Veterinarians) and the AGTAM (Working Group "Veterinary Pharmaceuticals") published the Guidelines for the prudent use of antibacterial veterinary pharmaceuticals in an updated version. Within the limits of therapeutic freedom, veterinarians are committed to take into account the latest scientific findings in veterinary medicine. These findings may, however, include conflicting interpretations if such an approach is expressed by an accredited university or anywhere else in the field of science. Hence, the state of science in veterinary medicine is not only defined by the Guidelines for Antibiotics, rather, the complete recognized scientific literature has to be considered. The Guidelines for Antibiotics are not legally-binding rules. They define the best approach and not the minimum standard for the use of antibiotics. The clinical examination provides the basis for medical treatment in each specific case. Further laboratory diagnostics represent an additional supportive instrument that is used by the veterinarian at his discretion depending on the necessity. Laboratory tests of bacterial sensitivity (identification of pathogens and antibiogram) may become necessary within the framework of diagnostics. As examples demonstrate, laboratory tests of bacterial sensitivity cannot be performed in every clinical case. It appears to be desirable to further discuss the use of antibacterial veterinary pharmaceuticals in the species-specific attachments in more concrete and specific terms, taking into consideration the standards of evidence-based medicine.     

Future directions in reptile medical education

Reptile medicine has emerged as a specialty area within the broader field of zoological medicine. It encompasses the medical needs of approximately 7,500 vertebrate species. This vertebrate class is highly diversified, having biological and medical peculiarities that differ both between and within major groups. Historically, veterinarians who have become recognized specialists with reptiles have had limited formal training in their medical management. The pet reptile trade is a multi-million-dollar business, and the popularity of reptiles as pets has resulted in a need for more veterinarians with training in their medical management. While few private practices have high volumes of reptile cases, many small-animal practices will have the opportunity to see a significant number of reptiles on an annual basis. Most practitioners with reptile medical expertise have merged their experiences as reptile pet owners with the principles of veterinary medicine taught in veterinary college. Several North American veterinary colleges have reptile medicine courses, and most have didactic and clinical courses in exotic and zoo animal medicine that include lectures and practical experience. Most accredited zoological medicine residency training programs include training in reptile medicine. The case load and interest in reptile medicine will probably never be sufficient to lead the average veterinary college to develop much more than what is currently offered. Consequently, those few colleges having more extensive course offerings, both didactic and clinical, will serve as educational centers for this discipline. Future Web-based teaching programs in reptile medicine will allow students nationally and internationally to have access to instructional material that can be continually updated.     

Research Process on Design of Liposomes as Drug Delivery System and Its Application in the Field of Veterinary Medicine

As an excellent pharmaceutical carrier,liposomes exhibit characteristics of wide drug loading range,high efficiency and low toxicity.Besides increasing stability and solubility of loading drugs,liposomes can ascribe targeting and sustained release features to loading drugs.Meanwhile,it can improve bioavailability of loading drugs.Based on the above characteristics,liposomes is becoming hot spot of research and application.This article reviewed construction methods of liposomes based on structure,particle design and chosen of preparation method.Combined with application and demands of veterinary medicine,research progress on application of liposome in the field of veterinary medicine was submitted.It is expected that this article will provide reference for the development of new drug delivery systems used in the field of veterinary medicine.     

脂质体递药系统设计思路及其兽药应用研究进展

脂质体作为一种优良的药物载体,具有载药范围广、高效、低毒等特点,能增加包载药物的稳定性和溶解度,赋予药物靶向和缓释的递药特性,并能有效提高药物的生物利用度,是近年来多领域研究和应用的热点。作者从脂质体的结构、粒径设计及制备方法筛选层面总结脂质体的构建思路,结合兽药应用特点和用药需求归纳脂质体递药系统在兽药领域的研究进展,以期为新型递药系统在兽药领域的研发应用提供参考。     

Effects of pharmacological agents on gastrointestinal motility

The control mechanisms of gastrointestinal motility are complex. Extrinsic neurohormonal effects modulate an intrinsic system, often called the "gut brain," composed of nervous and neuropeptide components. To exert pharmacologic influence on GI motility, use is made of agents that mimic the external control system. Agents that stimulate opioid receptors, block adrenoceptors, block or facilitate acetylcholine action, or antagonize the action of prostaglandins are used to effect changes in GI motility. The major indications for pharmacologic intervention are to increase motility in constipation, to reduce it in most cases of diarrhea, and to restore propulsive coordination in postoperative ileus. In cases of clinical colic the primary requirement is control of pain. Agents used for this purpose may adversely affect motility, and choice requires knowledge of their actions in this respect. In addition, drugs used for other purposes, anthelmintics for instance, may also influence gut motility. A synopsis of the actions of the agents commonly employed in GI motility control and some associated drugs are displayed in Table 3. Recent advances in the understanding of drug action on the gut should help in the selection of drugs for clinical use.     

Nontraditional approaches to pain management.

The word nontraditional in the context of this article implies those modalities not normally taught in veterinary medical schools. This word has the same definition of Complementary and Alternative Medicine (CAM) as put forth by the Harvard medical school. CAM is a field of medicine that has enjoyed a recent increase in popularity in both human and equine medicine, particularly in regard to pain management. Some of the more recognized modalities include acupuncture, herbalism, and homeopathy. A brief discussion regarding the theory, scientific evidence and use of these therapies in the treatment of pain will be discussed.     

Pharmacologic considerations in the management of peripartum conditions in the cow.

As is true with the use of drugs in veterinary medicine in general, there are many controversial issues in the management of peripartum conditions in the cow. For example, the use of PG versus antibacterial drugs in the management of postpartum uterine infections has advocates for the use of either approach. Intrauterine versus systemic administration of antibacterial drugs for the prophylaxis or treatment of postpartum metritis is another area of debate. Clearly, more research is needed in this area. Equally clearly, however, the research results that are available are being disregarded on a daily basis. In considering this discussion of the use of drugs in the peripartum period, one is struck by the frequency that optimum drug therapy of a condition relies on the extralabel use of nonapproved preparations. What guidelines are available to the practitioner in this regard? One example is lack of availability of appropriate dosage regimens or withdrawal times for food derived from treated animals. Unfortunately, pharmacokinetic and residue studies that would aid in establishing guidelines generally are not available and, in most instances, are not forthcoming. Extrapolation of data from other species to the ruminant or extrapolation of information from one drug to a related compound (such as prediction of residue and withdrawal data from an approved aminoglycoside, dihydrostreptomycin, to another unapproved drug, gentamicin) is fraught with difficulties. The need for research in this area is obvious, and lack of such information is one of the major dilemmas in trying to establish rational drug therapy in the food-producing animal. Recent developments in drug therapy have led to innovative approaches for the management of peripartum and other diseases in cattle. The use of PG in the treatment of reproductive disorders, so commonplace and widely accepted in contemporary veterinary practice, is a relatively recent approach that continues to be refined with the development of new, more potent, more specific PG analogs. What will be the role of ceftiofur, a potent, third-generation cephalosporin that currently is approved only for the treatment of respiratory infections in cattle, in the management of reproductive tract infections? The fluoroquinolones, which represent a novel approach to the control of infectious diseases, are being increasingly used in veterinary and human medicine, and one may predict that these powerful antimicrobial drugs will find application in bovine practice, including for the treatment of peripartum infections. Pharmacologic manipulation of immune and defense mechanisms also is an approach with some promise.(ABSTRACT TRUNCATED AT 400 WORDS)     

New perspectives in cardiovascular medicine: the calcium channel blocking drugs

Calcium channel blocking drugs reduce the influx of calcium (Ca++) through cell membrane passageways in excitable tissues. This unique pharmacodynamic action represents an important new addition to cardiovascular therapeutics. Clinically available members of this diverse group of compounds are verapamil, nifedipine, and diltiazem. Beneficial responses to these drugs can be explained by vasodilatation and resulting hemodynamic improvement in tissue perfusion-oxygen demand relationships, by suppression of Ca++-dependent arrhythmogenic mechanisms, by direct reduction of pathologic Ca++ overload in ischemic injured cells, or by a combination of these effects. Calcium channel blockade already has become a therapeutic mainstay in human medicine for management of ischemic heart disease and some forms of cardiac dysrhythmias. Relative to veterinary medicine, Ca++ channel blocking drugs may provide a clinical option for controlling supraventricular tachyarrhythmias. Other indications might include obstructive cardiomyopathies, shock-trauma, and congestive heart failure. Importantly, however, essential issues about adverse cardiovascular side effects of Ca++ channel blocking drugs remain unresolved and controversial. Recent studies especially have raised questions about the tendency for Ca++ channel blockade to exacerbate preexisting or occult myocardial contractile failure. Such pharmacodynamic complexities should be assessed judiciously as the Ca++ channel blocking drugs are appraised for entry into veterinary internal medicine.