Can Trazodone Help With Horse Sedation?

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Trazodone and Horse Sedation

The study investigated the use of oral trazodone for sedation in horses, particularly in conjunction with xylazine for procedural or preanesthetic sedation. The findings can be summarized as follows: 

Sedation Efficacy: Oral trazodone led to increased sedation in horses, with a dose-dependent effect. Both low (LD) and high doses (HD) of trazodone improved sedation scores, but LD trazodone led to an increase in xylazine requirements to achieve adequate sedation for anesthetic induction compared to the control and HD groups. 

Behavioral Effects: Trazodone was effective in reducing stress-related behaviors in horses undergoing stall confinement. It decreased stall walking, circling, pacing, and violent behaviors. 

Sedative and Anesthetic Interactions: Horses treated with trazodone showed quantifiable sedation and a lowering of the head, but LD trazodone required more xylazine to reach the sedation level deemed adequate for anesthetic induction. This is contrary to findings in other veterinary species where trazodone reduced the need for other anesthetics. 

Adverse Effects: Minor, self-limiting adverse effects were observed, such as second-degree atrioventricular block and mild tremors. One horse became cast in a stall corner, but this was not definitively linked to trazodone or xylazine treatment. 

Limitations: The study had limitations including the potential inaccuracy of the EquiSed scoring system for trazodone sedation, the impact of baseline temperament, and the limited generalizability due to the specific teaching herd used. The study's experimental nature also limits the applicability of results to clinical practice. 

Conclusion: Oral trazodone can be a useful adjunct for sedation in horses, showing increased sedation with minimal adverse effects. However, LD trazodone may increase the need for xylazine, and further research in a clinical setting is needed to better understand its effects and optimize its use. 

Swanton, W. E., Johnson, R., Zhao, Q., & Schroeder, C. (2024). Oral trazodone results in quantifiable sedation but does not result in a xylazine-sparing effect in healthy adult horses. American Journal of Veterinary Research https://doi.org/10.2460/ajvr.24.07.0185 

Bottom Line - It can be helpful.

High Dose Cytopoint for Non Responders

Lokivetmab (Cytopoint) is a monoclonal antibody used to treat canine atopic and allergic dermatitis (AD) at a standard dose of 2 mg/kg. However, some dogs show little to no response at this dosage. Since the effect of lokivetmab is dose-dependent, researchers hypothesized that increasing the dose to 4 mg/kg (HDL) might improve outcomes in dogs that were nonresponsive or partially responsive at the standard dose. This retrospective study analyzed the medical records of 36 dogs with AD who had previously shown suboptimal responses. The results showed that at 30 days post-injection, the median verbal numeric scale (VNS) score for pruritus dropped significantly from a pre-treatment score of 5.0 to 2.75. Additionally, 52.7% of dogs experienced a ≥50% reduction in VNS score, while 63.8% had at least a two-point reduction in their score. The study concludes that increasing the lokivetmab dose to 4 mg/kg may be more effective in some dogs, though further research is needed to validate these findings. 

D. R. Tulloss^1,2; E. M. Tulloss³; A. Trimmer⁴; D. N. Wyatt¹¹Dermatology Clinic for Animals, Lacey, WA, USA; ²Public Health Activity – Fort Lewis, US Army, Joint Base Lewis-McChord, WA, USA; ³LaSalle High School, Yakima, WA, USA; ⁴Animal Allergy and Dermatology Specialists, Las Vegas, NV, USA A retrospective study on the use of a high-dose (4 mg/kg) of lokivetmab in 36 dogs with allergic dermatitis 

Bottom Line — something to remember for challenging cases.

Fecal Transplants to Treat Epilepsy

Epilepsy is a common neurological disorder in both humans and dogs, often accompanied by behavioral comorbidities such as attention deficit hyperactivity disorder (ADHD)-like behaviors, fear, anxiety, and cognitive dysfunctions. These comorbidities significantly impact the quality of life for affected individuals and their caregivers. Traditional treatment with antiseizure drugs (ASDs) is not always effective; in dogs, approximately two-thirds of epilepsy cases are classified as drug-resistant epilepsy (DRE), where behavioral issues are more pronounced. 

Recent research suggests a link between these behavioral comorbidities and the microbiota-gut-brain axis (MGBA)—a complex communication network between the gastrointestinal microbiota (GIM) and the brain. Fecal microbiota transplantation (FMT) emerges as a potential method to recalibrate the GIM by introducing fecal material from a healthy donor to the affected individual. Previous studies in animals have shown that behaviors such as depression and anxiety can be transferred via FMT. 

In this pilot study, the effects of FMT on dogs with DRE were examined, focusing on behavioral comorbidities and cognitive dysfunctions. The results indicated that FMT has the potential to improve ADHD-like behaviors, fear, and anxiety in recipient dogs. Owners reported enhanced quality of life for both their pets and themselves. Objective measures, including validated behavioral tests and computational analyses, supported these findings by showing that dogs were calmer and exhibited less impulsivity post-FMT. 

The study also observed changes in the GIM after FMT. There was a decrease in the abundance of certain bacteria associated with stress and anxiety, such as those in the family Peptococcaceae and the species Blautia_A_sp900541345. Conversely, there was an increase in unidentified bacteria within the genus Ruminococcus_B. These microbial shifts may contribute to behavioral improvements, although the exact mechanisms remain unclear. The study used the Genome Taxonomy Database (GTDB) for microbial classification, which differs from traditional taxonomies but offers a standardized approach based on genomic data. 

Moreover, FMT appeared to influence neurotransmitter levels. There was a reduction in excitatory neurotransmitters (aspartate and glutamate) and an increase in the inhibitory neurotransmitter GABA in urine samples. This shift could potentially explain the behavioral improvements, as imbalances in glutamate and GABA are implicated in ADHD and anxiety disorders. However, the relationship between peripheral neurotransmitter levels and central nervous system activity is not fully understood, and further research is needed to clarify this connection. 

While the findings are promising, the study acknowledges limitations, including its open-label design, small sample size, and the potential for placebo effects. The results should be interpreted cautiously, and larger, controlled studies are necessary to confirm the benefits of FMT in treating behavioral comorbidities associated with DRE. 

In conclusion, this pilot study provides preliminary evidence that FMT could be a valuable procedure for improving behavioral comorbidities in dogs with DRE. The observed enhancements in behavior and quality of life suggest that FMT may offer a novel therapeutic avenue. Future research with larger sample sizes and control groups is essential to validate these findings and explore their potential relevance to human epilepsy treatment.

Watanangura A, Meller S, Farhat N, Suchodolski JS, Pilla R, Khattab MR, Lopes BC, Bathen-Nöthen A, Fischer A, Busch-Hahn K, Flieshardt C, Gramer M, Richter F, Zamansky A, Volk HA. Behavioral comorbidities treatment by fecal microbiota transplantation in canine epilepsy: a pilot study of a novel therapeutic approach. Front Vet Sci. 2024 Jun 21;11:1385469. doi: 10.3389/fvets.2024.1385469. 

Bottom Line — This therapy shows some promise.

Just putting things in perspective …