Investigation of pulmonary deposition of a nebulized radiopharmaceutical agent in awake cats

Schulman, Rhonda L.; Crochik, Sonia S.; Kneller, S. K.; McKiernan, Brendan C.; Schaeffer, David J.; Marks, Steven L.

doi:10.2460/ajvr.2004.65.806

Cited by 26 publications

(20 citation statements)

References 9 publications

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“…1,2,5,23 Because IGC have essentially replaced OGC in human medicine owing to their efficacy and minimal systemic adverse effects, these drugs have been more recently advocated for use in cats. 6,25 Use of a spacer with a tight-fitting facemask facilitates delivery of IGC to the distal airways. Nebulized pharmaceuticals delivered into a spacer and inhaled by use of a tightly fitting facemask allow diffuse pulmonary distribution in healthy, spontaneously breathing cats.…”

Section: Discussionmentioning

confidence: 99%

Inhaled Flunisolide Suppresses the Hypothalamic-Pituitary-Adrenocortical Axis, but Has Minimal Systemic Immune Effects in Healthy Cats

Reinero¹,

Brownlee²,

Decile³

et al. 2006

J Vet Int Med

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Feline bronchial disease is commonly treated with oral glucocorticoids (OGC), which might be contraindicated in cats with certain infectious, endocrine, renal, or cardiac diseases. Inhalant GC (IGC) maximize local efficacy and minimize systemic bioavailability. We evaluated systemic endocrine and immune effects of IGC (flunisolide, 250 mg/puff q12h) versus OGC (prednisone, 10 mg/d PO) and placebo. Six healthy cats received each drug for 2 weeks followed by a 1-month washout. Testing included determination of single early morning cortisol concentration, results of ACTH stimulation, the urine cortisol-to-creatinine ratio (UC : Cr), lymphocyte phenotype, lymphocyte blastogenesis, serum total IgA and IgM concentrations, and cytokine profiles. Significant differences between treatments were not apparent for serum immunoglobulin concentrations, or expression (mRNA) for the cytokines, interleukin (IL-) 2, IL-4, and IL-10, or gamma interferon. Single early morning cortisol concentration was lower for IGC (0.68 6 0.74 mg/dL), compared with that associated with placebo (2.82 6 1.94 mg/dL; P 5 .033). The ACTH-stimulated peak cortisol concentrations were lower after treatment in cats receiving IGC (before, 8.5 6 50.2 mg/dL; after, 2.9 6 3.3 mg/dL, P 5 .0004), but not OGC (before, 8.0 6 6.1 mg/dL; after, 6.0 6 4.5 mg/dL, P 5 .07). Similarly, UC : Cr (0.8 6 0.8) before IGC was lower than the value (5.02 6 3.62; P 5 .019) after IGC. Compared with placebo, cats given OGC, but not IGC, had significantly lower total percentages of T and B cells. Lymphocyte proliferation was decreased in cats receiving OGC, but not IGC, in comparison with placebo (6.9 6 3.3; 24.0 6 6.5; 18.8 6 14.0, respectively). Significantly more IL-10 mRNA transcription was detected in cats administered OGC or IGC, compared with placebo. Although IGC suppress the hypothalamic-pituitary-adrenocortical axis, IGC had minimal effects on the systemic adaptive immune system.

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Section: Discussionmentioning

confidence: 99%

Inhaled Flunisolide Suppresses the Hypothalamic-Pituitary-Adrenocortical Axis, but Has Minimal Systemic Immune Effects in Healthy Cats

Reinero¹,

Brownlee²,

Decile³

et al. 2006

J Vet Int Med

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“…Despite the increasing use of aerosol therapies in small animals, there are few scientific studies assessing their efficacy. Studies assessing deposition of aerosol therapies in conscious small animals are limited to a single report describing scintigraphic imaging of nebulized 99m technetium ( 99m Tc) delivered via a spacer and face mask apparatus in conscious cats . Reports of scintigraphic assessment of aerosol deposition in dogs have been restricted to research studies in the medical field in which anesthetized and intubated dogs are used as models for people .…”

mentioning

confidence: 99%

Scintigraphic Assessment of Deposition of Radiolabeled Fluticasone Delivered from a Nebulizer and Metered Dose Inhaler in 10 Healthy Dogs

Chow

Tyrrell

Yang

et al. 2017

Veterinary Internal Medicne

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BackgroundAerosolized medications are increasingly being used to treat respiratory diseases in dogs. No previous studies assessing respiratory tract deposition of radiolabeled aerosols have been performed in conscious dogs.Hypothesis/ObjectivesAssess respiratory tract deposition of radiolabeled, inhalant corticosteroid (fluticasone propionate labeled with 99mTc) delivered from a nebulizer and metered dose inhaler (MDI) to healthy dogs.AnimalsTen healthy Foxhounds.MethodsProspective, randomized, cross‐over pilot study. Initial inhalation method (nebulizer or MDI) was randomly assigned. Treatments were crossed over after a 7‐day washout period. Treatments initially were performed using sedation. Dogs were imaged using 2‐dimensional planar scintigraphy, with respiratory tract deposition quantified by manual region‐of‐interest analysis. Deposition calculated as percentage of delivered dose. Six of 10 dogs were randomly selected and reassessed without sedation.ResultsInhalation method had significant effect on respiratory tract deposition (P = 0.027). Higher deposition was achieved by nebulization with mean deposition of 4.2% (standard deviation [SD], 1.4%; range, 1.9–6.1%); whereas MDI treatment achieved a mean of 2.3% (SD, 1.4%; range, 0.2–4.2%). Nebulization achieved higher respiratory tract deposition than MDI in 7 of 10 dogs. No statistical difference (P = 0.68) was found between mean respiratory tract deposition achieved in dogs when unsedated (3.8%; SD, 1.5%) or sedated (3.6%; SD, 1.7%).Conclusions and Clinical ImportanceStudy confirms respiratory tract deposition of inhalant medications delivered from a nebulizer and MDI in healthy dogs, breathing tidally with and without sedation. Respiratory tract deposition in these dogs was low compared to reported deposition in adult humans, but similar to reported deposition in children.

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“…In veterinary medicine, the literature on inhalant therapy is extremely sparse, and what does exist focuses more on aerosol drug delivery to horses than to small pet animal or exotic species. There are only single published studies in conscious, unsedated cats and rats demonstrating the ability to deliver particles to the lower airways by means of ultrasonic nebulization [18,19]. Regardless, aerosol delivery of medication has become popular for treatment of dogs, cats, small mammals, and birds with respiratory disease.…”

Section: Nebulizationmentioning

confidence: 98%

“…The ultrasonic nebulizer can be purchased for a low cost ($150/unit); therefore it is affordable for both veterinarians, and in special circumstances, by owners for continued home therapy. Some ultrasonic nebulizers have been designed specifically for the veterinary market (DVM Pharmaceuticals, Inc., IVAX Corp, Miami, Florida) [18,19].…”

Section: Nebulizationmentioning

confidence: 99%

Emergency and Critical Care of Pet Birds

Bowles¹,

Lichtenberger

Lennox

2007

Veterinary Clinics of North America: Exotic Animal Practice

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Investigation of pulmonary deposition of a nebulized radiopharmaceutical agent in awake cats

Abstract: Awake cats that were not used to the application of a facemask did inhale substances from such a device. Aerosolization of medications may be a feasible route of administration for cats with lower airway disease.

Cited by 26 publications

References 9 publications

Inhaled Flunisolide Suppresses the Hypothalamic-Pituitary-Adrenocortical Axis, but Has Minimal Systemic Immune Effects in Healthy Cats

Inhaled Flunisolide Suppresses the Hypothalamic-Pituitary-Adrenocortical Axis, but Has Minimal Systemic Immune Effects in Healthy Cats

Scintigraphic Assessment of Deposition of Radiolabeled Fluticasone Delivered from a Nebulizer and Metered Dose Inhaler in 10 Healthy Dogs

Emergency and Critical Care of Pet Birds

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