A comparison of anesthesia induction by two different administration routes and doses of ketamine and medetomidine in red-eared sliders (Trachemys scripta elegans)

Abstract

This study aimed to assess the efficiency of ketamine and medetomidine by two different doses and routes on anesthesia depth and cardiac stability in red-eared sliders. Each turtle was anesthetized two times, with seven days wash-out period. Induction of anesthesia consisted of a bolus combination of ketamine (10 mg/kg) and medetomidine (0.2 mg/kg) administered in the left brachial biceps in the intramuscular protocol, or a bolus combination of ketamine (20 mg/kg) and medetomidine (0.2 mg/kg) administered in subcarapacial sinus after clear blood presence confirmation in the intravenous protocol. Vital signs, reaction on the skin palpation, manual mouth opening for endotracheal intubation, palpebral and cloacal reflex, and the withdrawal reflex of the front and hind limbs were measured and recorded every 5 minutes for 60 minutes after anesthesia injection. Atipamezole (1 mg/kg) was administered in the right brachial biceps one hour after ketamine and medetomidine administration. Needle insertion and possible painful reactions to drug administration were also evaluated and recorded. Obtained data were analyzed for normality and paired t-tests, Wilcoxon, or McNamar tests were performed where appropriate. The values of P≤0.05 were considered significant. A significantly less pronounced decrease in heart rate was observed with intravenous anesthesia protocol. Both protocols recorded complete anesthesia recovery 60 minutes after intramuscular atipamezole administration. A ketamine-medetomidine dose combination administered intravenously provides a more stable and consistent anesthetic plane in red-eared sliders than ketamine-medetomidine administered intramuscularly.

Keywords

• intravenous
• ketamine
• medetomidine.
• Red-eared slider

Ethical Statement

The study was conducted at the Veterinary Faculty – University of Sarajevo, following approval by the Institutional Ethics Committee under approval number 01-02-153-2/21, dated: 12.02.2021.

Thanks

The article is summarized from the first author’s Ph.D. thesis. The authors are grateful to Majda Beslija, MSc Organizational, and Social Psychology for statistical analysis.

References

1. Alves-Júnior JRF, Bosso ACS, Andrade BS, et al (2012): Association of midazolam with ketamine in giant Amazon River turtle Podocnemis expansa breed in captivity. Acta Cirúrgica Brasileira, 27, 144-147.
2. Bailey JE, Pablo LS (1998): Anaesthetic monitoring and monitoring equipment in small exotic pet practice. Seminars in Avian and Exotic Medicine, 7, 53-60.
3. Bennett RA (1991): A review of anesthesia and chemical restraint in reptiles. J Zoo Wildl Med, 22, 282-303.
4. Bouts T, Gasthuys F (2002): Anesthesia in Reptiles. Part 1: Injection anesthesia. Vlaams Diergeneeskundig Tijdschrift, 71, 183-194.
5. Cermakova E, Ceplecha V, Knotek Z (2017): Efficacy of two methods of intranasal administration of anesthetic drugs in red-eared terrapins (Trachemys scripta elegans). Veterinarni Medicina, 62, 87-93.
6. Dennis PM, Heard DJ (2002): Cardiopulmonary effects of a medetomidine-ketamine combination administered intravenously in gopher tortoises. JAVMA, 220, 1516-1519.
7. Došenović M, Radaković M, Vučićević M, et al (2020): Evaluation of the effects of two anesthetic protocols on oxidative status and DNA damage in red-eared sliders (Trachemys scripta elegans) undergoing endoscopic colectomy. Acta Veterinaria Hungarica, 4, 337-344.
8. Faul F, Erdfelder E, Lang AG, et al (2007): G*power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175-191.

9. Frische S, Fago A, Altimiras J (2000): Respiratory response to short-term hypoxia in the snapping turtle, Chelydra serpentine. Comp Biochem Phys A, 126, 223-231.
10. Frye FL (1981): Anesthesia. 241-246. In: FL Frye (Ed), Biomedicine and surgical aspects of captive reptile husbandry. Veterinary Medicine Publishing.
11. Greer LL, Jenne KJ, Diggs HE (2001): Medetomidine-Ketamine Anesthesia in Red-Eared Slider Turtles (Trachemys scripta elegans). American Association for Laboratory Animal Science, 40, 9-11.
12. Hammer Ø, Harper DAT, Ryan PD (2001): PAST: Paleontological statistics software package for education and data analysis. Palaeontologia Electronica, 4, 9.
13. Harcourt-Brown F (2002): Anaesthesia and analgesia. 121-139. In: F Harcourt-Brown (Ed), Textbook of Rabbit Medicine. Oxford.
14. Haskins SC (2015): Monitoring Anesthetized Patients. 86-113. In: KA Grimm, LA Lamont, WJ Tranquilli, et al (Eds), Veterinary Anesthesia and Analgesia: the fifth edition of Lumb and Jones. John Wiley and Sons, Inc.
15. Heatley J, Russell KE (2019): Hematology. 301-318. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
16. Hirshman CA, McCullough RE, Cohen PJ, et al (1975): Hypoxic ventilatory drive in dogs during thiopental, ketamine, or pentobarbital anesthesia. Anesthesiology, 43, 628-34.
17. Holz P, Holz RM (1994): Evaluation of ketamine, ketamine/xylazine and ketamine/midazolam anesthesia in red-eared sliders (Trachemys scripta elegans). J Zoo Wildl Med, 25, 531-537.
18. Jackson DC (2000): Living without oxygen: lessons from the fresh-water turtle. Comp Biochem Phys A, 125, 299-315.
19. Jackson DC, Crocker CE, Ultsch GR (2001): Mechanisms of homeostasis during long-term diving and anoxia in turtles. Zoology, 103, 150-156.
20. Knotek Z, Divers SJ (2019): Pulmonology. 786-804. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
21. Lock BA, Heard DJ, Dennis P (1998): Preliminary evaluation of medetomidine/ketamine combinations for immobilization and reversal with atipamezole in three tortoise species. Bulletin of the Association of Reptilian and Amphibian Veterinarians, 8, 6-9.
22. Longley L (2008): Reptile anesthesia. 185-210. In: Anaesthesia of exotic pets. Saunders.
23. Maginnis LA, Ekelund SA, Ultsch GR (2004): Blood Oxygen Transport in Common Map Turtles during Simulated Hibernation. Physiological and Biochemical Zoology, 77, 232-241.
24. Mans C, Sladky KK, Schumacher J (2019): General Anesthesia. 447-464. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
25. McArthur S (2004): Anaesthesia, analgesia and Euthanasia. 379-401. In: S McArthur, R Wilkinson, J Meyer (Eds), Medicine and Surgery of Tortoises and Turtles. Blackwell Publishing.
26. Meredith A (2015): Appendix II: Protocols. 315-322. In: BSAVA Small Animal Formulary, 9th ed.
27. Norton TM (2005): Chelonian Emergency and Critical Care. Topics in Medicine and Surgery. Seminars in Avian and Exotic Pet Medicine, 14, 106-130.
28. Perry SM, Mitchell MA (2019): Routes of Administration. 1130-1138. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
29. Plumb DC (2011): Medetomidine HCL. 3823-3834. In: Plumb's Veterinary Drug Handbook, 7th ed. PharmaVet, Inc.
30. Posner LP, Burns P (2009a): Injectable anesthetic agents. 729-834. In: JE Riviere, MG Papich (Eds), Veterinary Pharmacology, 9th edition. Wiley-Blackwell.
31. Posner LP, Burns P (2009b): Sedative agents: Tranquilizers, alpha-2 agonists, and related agents. 933-1067. In: JE Riviere, MG Papich (Eds), Veterinary Pharmacology, 9th edition. Wiley-Blackwell.
32. Quesada RJ, Aitken-Palmer C, Conley K, et al (2010): Accidental submeningeal injection of propofol in gopher tortoises (Gopherus polyphemus). The Veterinary Record, 167, 494.
33. Schenllbacher RW, Shepard M (2019): Sedation. 441-446. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
34. Schilliger L, Girling S (2019): Cardiology. 669-698. In: SJ Divers, SJ Stahl (Eds), Mader’s Reptile and Amphibian Medicine and Surgery, 3rd edition. Elsevier.
35. Schumacher J, Yelen T (2006): Anesthesia and analgesia. 442-452. In: DR Mader (Ed), Reptile Medicine and Surgery, 2nd ed. Saunders Elsevier, Missouri.
36. Sleeman JM, Gaynor J (2000): Sedative and cardiopulmonary effects of medetomidine and reversal with atipamezole in desert tortoises (Gopherus agassizii). J Zoo Wildl Med, 31, 28-35.
37. Soliman MG, Brindle GF, Kuster G (1975): Response to hypercapnia under ketamine anesthesia. Canad Anaesth Soc J, 22, 486-494.
38. Tatli ZB, Sen ZB, Gulaydin A (2016): Aural abscess in a red-eared slider turtle (Trachemys scripta elegans). Harran Üniversitesti Veteriner Fakültesi Dergisi, 5, 170-172.
39. Thurmon JC, Tranquilli WJ, Benson GJ (1996): Preanesthetics and anesthetics adjuvants. 183-209. In: JC Thurmon, WJ Tranquilli, GJ Benson (Eds), Lumb and Jones' veterinary anesthesia, 3rd ed. Baltimore.
40. Verstegen J, Fargetton X, Donnay I, et al (1991): An evaluation of medetomidine/ketamine and other drug combinations for anesthesia in cats. Vet Rec, 128, 32-35.
41. Vigani A (2015): Cardiac Output Measurement. 473-482. In: KA Grimm, LA Lamont, WJ Tranquilli, et al (Eds), Veterinary Anesthesia and Analgesia: the fifth edition of Lumb and Jones. John Wiley and Sons, Inc.
42. White PF, Way WL, Trevor AJ (1982): Ketamine – its pharmacology and therapeutic uses. Anesthesiology, 56, 119-136.
43. Wright M (1982): Pharmacologic effects of ketamine and its use in veterinary medicine. J Am Vet Med Assoc, 180, 1462-1471.