Abstract

Intranasal ketamine has recently gained interest in human medicine, not only for its sedative, anaesthetic or analgesic properties, but also in the management of treatment resistant depression, where it has been shown to be an effective, fast acting alternative treatment. Since several similarities are reported between human psychiatric disorders and canine anxiety disorders, intranasal ketamine could serve as an alternative treatment for anxiety disordered dogs. However, to the authors knowledge, intranasal administration of ketamine and its pharmacokinetics have never been described in dogs. Therefore, this study aimed to examine the pharmacokinetics, absolute bioavailability and tolerability of intranasal ketamine administration compared with intravenous administration. Seven healthy, adult laboratory Beagle dogs were included in this randomized crossover study. The dogs received 2 mg/kg body weight ketamine intravenously (IV) or intranasally (IN), with a two-week wash-out period. Prior to ketamine administration, dogs were sedated intramuscularly with dexmedetomidine. Venous blood samples were collected at fixed times until 480 min post-administration and ketamine plasma concentrations were determined by liquid chromatography-tandem mass spectrometry. Cardiovascular parameters and sedation scores were recorded at the same time points. Non-compartmental pharmacokinetic analysis revealed a rapid (Tmax = 0.25 ± 0.14 h) and complete IN bioavailability (F = 147.65 ± 49.97%). Elimination half-life was similar between both administration routes (T1/2el IV = 1.47 ± 0.24 h, T1/2el IN = 1.50 ± 0.97 h). Heart rate and sedation scores were significantly higher at 5 and 10 min following IV administration compared to IN administration, but not at the later time-points.

Highlights

  • Ketamine is a dissociative anesthetic commonly used in veterinary medicine, mainly for induction and maintenance of anesthesia, and for pain management in the peri- and postoperative period [1,2]

  • Compared with intramuscular administration of the same ketamine-midazolam combination, there were no differences in the measured parameters associated with sedation except for time to sternal recumbency, which was more rapid in the intranasal group

  • No significant differences in pharmacokinetic parameters were found between the two administration routes

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Summary

Introduction

Ketamine is a dissociative anesthetic commonly used in veterinary medicine, mainly for induction and maintenance of anesthesia, and for pain management in the peri- and postoperative period [1,2]. Intranasal ketamine has been successfully used for sedation and premedication of pediatric patients [5,6,7] and in pain management of both children and adults [8,9,10,11,12,13]. Since anxiety disorders in dogs show several similarities with human mood disorders [17,18,19,20,21,22,23], intranasal ketamine could be a valuable alternative treatment for certain canine behavioural disorders. The tolerability of a single intranasal ketamine administration was assessed

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