BOOK
Therapeutics, An Issue of Veterinary Clinics of North America: Exotic Animal Practice, E-Book
(2018)
Additional Information
Book Details
Abstract
This issue of Veterinary Clinics of North America: Exotic Animal Practice focuses on Therapeutics, with topics including: Metabolic scaling and other methods used to extrapolate drug dosages for exotics; Update on antiviral therapies in birds; Multiresistant bacteria in exotic animal medicine: fact or faux?; Emergency drugs and fluid therapy in exotics; Guidelines for treatment of toxicities in exotic animals; Nutraceuticals in exotic animal medicine; Pharmacokinetic/pharmacodynamics modelling of analgesic drugs; Psychoactive drugs in avian medicine; Cardiovascular drugs in avian and small mammal medicine; Gastrointestinal drugs in small mammal medicine; Update on cancer treatment in exotics; Drug delivery methods with emphasis on low stress handling while medicating exotic animal; and Compounding and extra-label use of drugs in exotic animal medicine.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Therapeutics\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Therapeutics | vii | ||
| Translating Pharmacokinetic and Pharmacodynamic Data into Practice | vii | ||
| The Educated Guess: Determining Drug Doses in Exotic Animals Using Evidence-Based Medicine | vii | ||
| Compounding and Extralabel Use of Drugs in Exotic Animal Medicine | vii | ||
| Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations | viii | ||
| Low-Stress Medication Techniques in Birds and Small Mammals | viii | ||
| Techniques for Monitoring Drug Efficacy | viii | ||
| Group Treatment Strategies for Animals in a Zoologic Setting | viii | ||
| Considerations for Treatment of Large Zoologic Collections: Fish | ix | ||
| Therapeutic Contraindications in Exotic Pets | ix | ||
| Prudent Use of Antimicrobials in Exotic Animal Medicine | ix | ||
| Antifungal Therapy in Birds: Old Drugs in a New Jacket | ix | ||
| Avian Vaccination: Current Options and Strategies | x | ||
| Cardiovascular Drugs in Avian, Small Mammal, and Reptile Medicine | x | ||
| Gonadotrophin-Releasing Hormone Agonists and Other Contraceptive Medications in Exotic Companion Animals | x | ||
| Update on Cancer Treatment in Exotics | xi | ||
| Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals | xi | ||
| VETERINARY CLINICS OF\rNORTH AMERICA: EXOTIC\rANIMAL PRACTICE\r | xii | ||
| FORTHCOMING ISSUES | xii | ||
| September 2018 | xii | ||
| January 2019 | xii | ||
| May 2019 | xii | ||
| RECENT ISSUES | xii | ||
| January 2018 | xii | ||
| September 2017 | xii | ||
| May 2017 | xii | ||
| Preface:\rTherapeutics | xiii | ||
| Translating Pharmacokinetic and Pharmacodynamic Data into Practice | 169 | ||
| Key points | 169 | ||
| INTRODUCTION | 169 | ||
| BUILDING CONFIDENCE IN INTERPRETING PHARMACOKINETIC OR PHARMACODYNAMIC PAPERS | 170 | ||
| What Was the Number, Gender, and Age of Animals Used in the Study? | 170 | ||
| Is the Study Designed as a Cross-Over, Parallel, or Single-Route Study? | 170 | ||
| Is the Washout Period Long Enough? | 171 | ||
| Was the Study Randomized and Blinded? | 171 | ||
| Was the Drug Used in the Study an Approved Formulation or a Compounded Product? | 171 | ||
| DETERMINANTS OF PLASMA DRUG CONCENTRATION | 171 | ||
| Absorption | 172 | ||
| Distribution | 175 | ||
| Metabolism | 176 | ||
| Excretion | 176 | ||
| Steady State Concentrations | 177 | ||
| Pharmacokinetic Parameters: From Paper to Practice | 177 | ||
| PHARMACODYNAMICS | 178 | ||
| Integrating Pharmacokinetics and Pharmacodynamics for Antimicrobial Selection | 178 | ||
| SUMMARY | 179 | ||
| REFERENCES | 179 | ||
| The Educated Guess | 183 | ||
| Key points | 183 | ||
| EVIDENCE-BASED VETERINARY MEDICINE | 183 | ||
| FOUR PRINCIPLES OF DRUG MOVEMENT | 185 | ||
| ALLOMETRIC SCALING | 186 | ||
| DOSE SELECTION ALGORITHM | 188 | ||
| Pharmacokinetic Data in a Related Species | 188 | ||
| Plasma Protein Binding | 188 | ||
| Evaluating the Risk of Adverse Events | 189 | ||
| Challenges of Polypharmacy | 190 | ||
| Titrating a Drug | 190 | ||
| SUMMARY | 191 | ||
| REFERENCE | 192 | ||
| Compounding and Extralabel Use of Drugs in Exotic Animal Medicine | 195 | ||
| Key points | 195 | ||
| INTRODUCTION | 195 | ||
| WHAT IS EXTRALABEL DRUG USE? | 196 | ||
| WHAT IS DRUG COMPOUNDING? | 196 | ||
| INDICATIONS FOR DRUG COMPOUNDING IN VETERINARY MEDICINE | 196 | ||
| INDICATIONS FOR DRUG COMPOUNDING IN EXOTIC ANIMAL MEDICINE | 198 | ||
| STANDARDS AND REGULATIONS FOR EXTRALABEL DRUG USE AND DRUG COMPOUNDING | 198 | ||
| United States Pharmacopeia Standards | 198 | ||
| Drug Compounding Laws and Regulations | 199 | ||
| EXTRALABEL DRUG USE AND DRUG COMPOUNDING LAWS AND REGULATIONS FOR SPECIAL CIRCUMSTANCES | 200 | ||
| Extralabel Drug Use and Drug Compounding in Food Animal Species | 200 | ||
| Compounding of Controlled Substances | 201 | ||
| Compounded Medications Prepared for Office Use in the Veterinary Practice | 201 | ||
| RISKS AND ADVERSE EVENTS ASSOCIATED WITH EXTRALABEL DRUG USE AND DRUG COMPOUNDING | 201 | ||
| Risks Associated with Compounded Therapies for Animals | 201 | ||
| Adverse Event Reporting for Veterinary Compounds | 202 | ||
| CHEMICAL CONSIDERATIONS FOR DRUGS AND COMPOUNDED FORMULATIONS | 203 | ||
| Effects of Chemical Composition and Chemical Interactions | 203 | ||
| Drug Stability Over Time | 204 | ||
| ACTIVE PHARMACEUTICAL INGREDIENTS | 204 | ||
| WORKING WITH THE COMPOUNDING PHARMACIST AND PHARMACY | 204 | ||
| DRUG COMPOUNDING IN THE VETERINARY HOSPITAL | 205 | ||
| Compounding Formulas and Component Selection | 206 | ||
| IN-HOUSE COMPOUNDED DRUG PRESCRIPTION LABELING | 208 | ||
| NOVEL DRUG DELIVERY METHODS FOR EXOTIC ANIMALS | 209 | ||
| SUMMARY | 210 | ||
| ACKNOWLEDGMENTS | 210 | ||
| REFERENCES | 210 | ||
| Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations | 215 | ||
| Key points | 215 | ||
| INTRODUCTION | 215 | ||
| DRUG ADMINISTRATION VIA INJECTABLE ROUTES | 216 | ||
| Intramuscular, Subcutaneous, Intraperitoneal, and Intracoelomic Drug Administration | 216 | ||
| Subcutaneous route | 216 | ||
| Intramuscular route | 216 | ||
| Portal systems in nonmammalian species | 216 | ||
| Intraperitoneal/intracoelomic route | 223 | ||
| Comparison of the different routes of injection | 224 | ||
| Intravenous, Intraosseous, and Intracardiac Drug Administration | 224 | ||
| Intravenous route | 231 | ||
| Intraosseous route | 231 | ||
| Intracardiac route | 233 | ||
| Vascular access ports | 233 | ||
| Extended Release Devices and Intralesional Drug Administration | 233 | ||
| DRUG ADMINISTRATION IN THE DIGESTIVE AND RESPIRATORY SYSTEMS | 235 | ||
| Oral Drug Administration | 235 | ||
| Oral drug administration via food or drinking water | 235 | ||
| Intraoral administration by syringe and gavage feeding | 236 | ||
| Long-term oral drug administration: feeding tube placement | 238 | ||
| Transmucosal Drug Administration | 239 | ||
| Intranasal route | 240 | ||
| Oral transmucosal route | 240 | ||
| Intrarectal or intracloacal routes | 241 | ||
| Administration of Medications into the Respiratory Tract | 241 | ||
| Intranasal and intrasinusal routes | 242 | ||
| Intratracheal route | 242 | ||
| Intrapneumonic and air sac delivery routes | 243 | ||
| Nebulization | 243 | ||
| DRUG ADMINISTRATION VIA TOPICAL ROUTES | 244 | ||
| Transcutaneous Absorption | 244 | ||
| Topical Treatments | 246 | ||
| SUMMARY | 248 | ||
| REFERENCES | 248 | ||
| Low-Stress Medication Techniques in Birds and Small Mammals | 261 | ||
| Key points | 261 | ||
| INTRODUCTION | 261 | ||
| CAPTURE AND RESTRAINT | 262 | ||
| THE ABCS OF DESCRIBING BEHAVIOR | 264 | ||
| BODY LANGUAGE: WHAT IT IS AND WHAT IT IS NOT | 265 | ||
| IDENTIFY FEAR AND EMPLOY DESENSITIZATION AND COUNTERCONDITIONING | 265 | ||
| THE APPROPRIATE USE OF CONSCIOUS SEDATION | 270 | ||
| MEDICATION TRAINING | 271 | ||
| FOOD VEHICLES | 275 | ||
| TEACHING ANIMALS TO TAKE MEDICATION FROM A SYRINGE | 276 | ||
| IN-PATIENT MANAGEMENT | 277 | ||
| FINDING TIME | 278 | ||
| EXAMINATION ROOM AND OUTPATIENT MANAGEMENT | 278 | ||
| FORAGING AND ENRICHMENT | 279 | ||
| THE POTENTIAL FOR INFLUENCE OF DRUG THERAPIES ON MEMORY AND LEARNING | 281 | ||
| SUPPLEMENTARY DATA | 283 | ||
| REFERENCES | 283 | ||
| Techniques for Monitoring Drug Efficacy | 287 | ||
| Key points | 287 | ||
| INTRODUCTION | 287 | ||
| DRUG EFFICACY | 288 | ||
| Dose-Response Relationship | 288 | ||
| Establishment of the Therapeutic Window | 288 | ||
| WHAT CONSTITUTES DRUG EFFICACY MONITORING? | 290 | ||
| THERAPEUTIC DRUG MONITORING | 291 | ||
| Interpretation of Therapeutic Drug Monitoring Results | 292 | ||
| Example Problem | 293 | ||
| DETERMINING THE EFFICACY OF COMPOUNDED MEDICATIONS | 293 | ||
| SUMMARY | 294 | ||
| REFERENCES | 294 | ||
| Group Treatment Strategies for Animals in a Zoologic Setting | 297 | ||
| Key points | 297 | ||
| INTRODUCTION | 297 | ||
| AMPHIBIANS | 298 | ||
| BIRDS | 302 | ||
| MAMMALS | 304 | ||
| SUMMARY | 306 | ||
| REFERENCES | 306 | ||
| Considerations for Treatment of Large Zoologic Collections | 311 | ||
| Key points | 311 | ||
| INTRODUCTION | 311 | ||
| PATIENT EVALUATION AND DIAGNOSTICS | 312 | ||
| TREATMENT | 314 | ||
| NONPHARMACOLOGIC TREATMENT OPTIONS: ENVIRONMENTAL AND NUTRITIONAL MANAGEMENT | 314 | ||
| PHARMACOLOGIC TREATMENT OVERVIEW | 318 | ||
| TREATMENT CHALLENGES | 321 | ||
| Parasite Management in Large Mixed Species Exhibits | 321 | ||
| Degradation of Praziquantel and Formalin in Recirculating Systems | 323 | ||
| Mycobacterial Infections | 323 | ||
| SUMMARY AND DISCUSSION | 324 | ||
| REFERENCES | 324 | ||
| Therapeutic Contraindications in Exotic Pets | 327 | ||
| Key points | 327 | ||
| INTRODUCTION | 327 | ||
| ANTIPARASITIC MEDICATIONS | 328 | ||
| Ivermectin | 328 | ||
| Fipronil | 328 | ||
| Benzimidazoles | 329 | ||
| ANTI-INFLAMMATORY MEDICATIONS | 330 | ||
| Glucocorticoids | 330 | ||
| Ibuprofen in Ferrets | 333 | ||
| Ketoprofen in Rats | 335 | ||
| CONTRAINDICATED ANTIBIOTICS IN HERBIVOROUS RODENTS AND RABBITS | 335 | ||
| ITRACONAZOLE IN AFRICAN GRAY PARROTS (PSITTACUS ERITHACUS) | 336 | ||
| REFERENCES | 337 | ||
| Prudent Use of Antimicrobials in Exotic Animal Medicine | 341 | ||
| Key points | 341 | ||
| INTRODUCTION | 341 | ||
| MONITORING OF ANTIMICROBIAL USE | 342 | ||
| RECOMMENDATIONS AND POLICIES | 344 | ||
| ANTIMICROBIAL STEWARDSHIP | 345 | ||
| CHALLENGES FOR RESPONSIBLE ANTIMICROBIAL USE IN EXOTIC ANIMALS | 346 | ||
| GUIDELINES FOR RESPONSIBLE ANTIMICROBIAL USE IN EXOTICS | 347 | ||
| RECOMMENDATIONS | 350 | ||
| ACKNOWLEDGMENTS | 350 | ||
| REFERENCES | 350 | ||
| Antifungal Therapy in Birds | 355 | ||
| Key points | 355 | ||
| INTRODUCTION | 355 | ||
| MECHANISM OF ACTION | 356 | ||
| TOXICITY | 357 | ||
| DRUG RESISTANCE | 363 | ||
| DRUG FORMULATION | 363 | ||
| Administration Route | 365 | ||
| Systemic Treatment | 365 | ||
| Topical Treatment | 370 | ||
| SUMMARY | 373 | ||
| REFERENCES | 373 | ||
| Avian Vaccination | 379 | ||
| Key points | 379 | ||
| INTRODUCTION | 379 | ||
| MODERN VACCINE TECHNOLOGY | 380 | ||
| DNA VACCINES | 380 | ||
| AVIAN DISEASES OF CONCERN AND VACCINE INFORMATION | 381 | ||
| Circoviruses | 381 | ||
| Avian Polyoma Virus | 381 | ||
| Herpesviruses | 384 | ||
| Pigeon Herpesvirus | 385 | ||
| Psittacine Bornaviruses | 385 | ||
| Picornaviruses | 385 | ||
| Duck hepatitis virus | 385 | ||
| West Nile Virus | 386 | ||
| Commercially available equine vaccines | 386 | ||
| Inactivated vaccines | 386 | ||
| Recombinant virus vaccines | 387 | ||
| Chimeric virus vaccines | 387 | ||
| Comparative testing | 387 | ||
| Non–commercially available vaccines | 388 | ||
| Tembusu virus | 389 | ||
| Viral encephalitides | 389 | ||
| Avian influenza | 390 | ||
| Newcastle Disease Virus | 391 | ||
| Pox Viruses | 392 | ||
| CONSIDERATIONS FOR VACCINATION STRATEGIES IN NONPOULTRY AVIAN SPECIES | 393 | ||
| SUMMARY | 393 | ||
| REFERENCES | 393 | ||
| Cardiovascular Drugs in Avian, Small Mammal, and Reptile Medicine | 399 | ||
| Key points | 399 | ||
| INTRODUCTION | 399 | ||
| CONGESTIVE HEART FAILURE AND RELATED CONDITIONS | 400 | ||
| Diuretics | 407 | ||
| Furosemide | 407 | ||
| Other diuretics | 413 | ||
| Vasodilators | 413 | ||
| Angiotensin-converting enzyme inhibitors | 413 | ||
| Other vasodilators | 414 | ||
| Positive Inotropes | 414 | ||
| Digoxin | 415 | ||
| Pimobendan | 416 | ||
| Other positive inotropes | 416 | ||
| Negative Inotropes | 417 | ||
| β-Blockers | 417 | ||
| Calcium channel blockers | 419 | ||
| Treatment of Related Conditions | 420 | ||
| Hypertrophic cardiomyopathy | 420 | ||
| Systemic hypertension | 421 | ||
| Pulmonary hypertension | 421 | ||
| Pulmonary Vasodilators | 421 | ||
| Other Treatment Options | 422 | ||
| Arrhythmias | 423 | ||
| Treatment of Tachyarrhythmias | 424 | ||
| Treatment of Bradyarrhythmias | 424 | ||
| Supportive Care and Husbandry Considerations | 425 | ||
| Supportive care | 425 | ||
| Fluid therapy challenges | 425 | ||
| Exercise restriction and housing | 426 | ||
| Diet and lifestyle | 426 | ||
| Other | 426 | ||
| PERICARDIAL EFFUSION/CARDIAC TAMPONADE | 427 | ||
| ATHEROSCLEROTIC DISEASE | 428 | ||
| Vasodilation | 428 | ||
| Isoxsuprine | 428 | ||
| Angiotensin-converting enzyme inhibitors | 429 | ||
| Sildenafil | 429 | ||
| Other Medical Managements | 429 | ||
| Pentoxifylline | 429 | ||
| Statins | 429 | ||
| Supportive Care and Husbandry Considerations | 430 | ||
| Supportive care | 430 | ||
| Exercise restriction versus promotion of exercise | 430 | ||
| Dietary management | 430 | ||
| Other | 430 | ||
| SUMMARY | 430 | ||
| REFERENCES | 431 | ||
| Gonadotrophin-Releasing Hormone Agonists and Other Contraceptive Medications in Exotic Companion Animals | 443 | ||
| Key points | 443 | ||
| INTRODUCTION | 443 | ||
| GONADOTROPHIN-RELEASING HORMONE AGONIST SLOW RELEASE IMPLANT | 444 | ||
| Mode of Action of a Gonadotrophin-Releasing Hormone Agonist Slow Release Implant | 445 | ||
| SMALL MAMMALS | 445 | ||
| Ferret | 446 | ||
| Location and technique of placement of the gonadotrophin-releasing hormone agonist slow-release implant in ferrets | 446 | ||
| Male | 446 | ||
| Female | 447 | ||
| Other contraceptives used in ferrets | 448 | ||
| Rabbit | 449 | ||
| Location and technique of placement of the gonadotrophin-releasing hormone agonist slow-release implant in rabbits | 449 | ||
| Male | 449 | ||
| Female | 450 | ||
| Other contraceptives used in rabbits | 450 | ||
| Guinea Pig | 450 | ||
| Location and technique of placement of the gonadotrophin-releasing hormone agonist slow-release implant in guinea pigs | 451 | ||
| Male | 451 | ||
| Female | 451 | ||
| Other contraceptives used in guinea pigs | 452 | ||
| Rat | 452 | ||
| Location and technique of placement of the gonadotrophin-releasing hormone gonadotrophin-releasing hormone agonist slow-rel ... | 452 | ||
| Male | 452 | ||
| Female | 452 | ||
| Other contraceptives used in rats | 453 | ||
| Mouse | 453 | ||
| BIRDS | 453 | ||
| Location and Technique of Placement of the Gonadotrophin-Releasing Hormone Agonist Slow-Release Implant in Birds | 454 | ||
| Male | 454 | ||
| Female | 455 | ||
| Other Contraceptives Used in Birds | 456 | ||
| REPTILES | 456 | ||
| Location and Technique of Placement of the Gonadotrophin-Releasing Hormone Agonist Slow-Release Implant in Reptiles | 457 | ||
| Lizards | 457 | ||
| Turtles | 457 | ||
| SUMMARY | 459 | ||
| REFERENCES | 459 | ||
| Update on Cancer Treatment in Exotics | 465 | ||
| Key points | 465 | ||
| INTRODUCTION | 465 | ||
| TUMOR STAGING | 466 | ||
| TM Approach | 467 | ||
| CLINICAL PATHOLOGY | 468 | ||
| Complete Blood Cell Count | 468 | ||
| Biochemistry | 468 | ||
| IMAGING MODALITIES | 468 | ||
| TREATMENT MODALITIES | 469 | ||
| TRANSLATING CANCER THERAPIES TO EXOTICS | 470 | ||
| Metabolism | 470 | ||
| Vascular Support, Renal/Hepatic Excretion | 470 | ||
| Risks of Corticosteroids and Immunosuppressive Agents | 470 | ||
| CHEMOTHERAPY | 471 | ||
| EMERGING MOLECULARLY TARGETED AGENTS | 471 | ||
| Tyrosine Kinase Inhibitors | 482 | ||
| Tumor Vaccines | 488 | ||
| RADIATION THERAPY IN EXOTIC SPECIES | 488 | ||
| External Beam Radiation | 488 | ||
| Definitive versus palliative protocols | 489 | ||
| Side effects and tolerance | 489 | ||
| Strontium 90 | 490 | ||
| OTHER/MISCELLANEOUS THERAPY TYPES | 490 | ||
| Hormonal/Steroidal Therapies | 490 | ||
| Cryotherapy | 490 | ||
| Other Types of Therapy | 491 | ||
| TREATMENT STRATEGIES FOR TUMORS | 491 | ||
| NUTRITION/SUPPORTIVE CARE FOR EXOTIC CANCER PATIENTS | 493 | ||
| PATIENT MONITORING AND SIDE EFFECTS | 494 | ||
| Adverse Events | 494 | ||
| Assessing Response to Therapy | 495 | ||
| FUTURE DIRECTIONS | 496 | ||
| REFERENCES | 496 | ||
| Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals | 511 | ||
| Key points | 511 | ||
| INTRODUCTION | 511 | ||
| INTRODUCTION TO TRADITIONAL CHINESE VETERINARY MEDICINE | 512 | ||
| Explanation of Traditional Chinese Veterinary Medicine Pattern Diagnosis | 513 | ||
| Explanation of Acupuncture | 514 | ||
| Explanation of Traditional Chinese Veterinary Medicine Food Therapy | 517 | ||
| Explanation of Traditional Chinese Veterinary Medicine Herbal Therapy | 517 | ||
| Cases That Could Benefit from Traditional Chinese Veterinary Medicine | 518 | ||
| Treatment Protocols | 519 | ||
| Side Effects, Precautions, and Contraindications | 519 | ||
| INTRODUCTION TO CHIROPRACTIC | 520 | ||
| Explanation of Chiropractic | 522 | ||
| Cases That Could Benefit from Chiropractic | 523 | ||
| Treatment Protocols | 524 | ||
| Side Effects, Precautions, and Contraindications | 524 | ||
| SUMMARY | 526 | ||
| REFERENCES | 526 |