Results of the Megavertebrate Analgesia Survey: Elephants and Rhino

Abstract

An online survey utilizing Survey Monkey linked through the American Association of Zoo Veterinarians listserve examined current practices in megavertebrate analgesia. Data collected included drugs administered, dosing regimens, ease of administration, efficacy, and adverse events. Fifty-nine facilities (38 housing elephants, 33 housing rhinoceroses) responded. All facilities administered nonsteroidal anti-inflammatory drugs (NSAIDs), with phenylbutazone (0.25-10 mg/kg) and flunixin meglumine (0.2-4 mg/kg) being most common. Efficacy was reported as "good" to "excellent" for these medications. Opioids were administered to elephants (11 of 38) and rhinoceroses (7 of 33), with tramadol (0.5-3.0 mg/kg) and butorphanol (0.05-1.0 mg/kg) being most common. Tramadol efficacy scores were highly variable in both elephants and rhinoceroses. While drug choices were similar among institutions, substantial variability in dosing regimens and reported efficacy between and within facilities indicates the need for pharmacokinetic studies and standardized methods of analyzing response to treatment to establish dosing regimens and clinical trials to establish efficacy and safety.

Relationships between housing and management factors and clinical health events in elephants in North American zoos

“…Musculoskeletal disorders are also more prevalent in older elephants (this study and [17, 25, 43]), resulting in the administration of NSAIDs that can be prolonged [77]. One of the known side-effects of long-term NSAID use is GI irritation [78–81], and the prophylactic use of GI protectants was common in this study, especially in older elephants. These data suggest that management practices that involve distributing food throughout the elephants’ habitat, as opposed to limiting feedings to a smaller number of areas, may be beneficial to digestive health, again possibly due to increased exercise facilitating good GI mobility.…”

Zoo elephant research: contributions to conservation of captive and free‐ranging species

“…The enormous body size and dissimilar physiologic metabolism of elephants compared with other species, such as horses and cattle, complicate estimation of dosing requirements based on metabolic scaling calculations (Sedgwick, 1993;Mortenson & Sierra, 1998). A recent online survey exploring use of analgesics in elephants and rhinoceros in human care found a 'substantial variability in dosing regimens and reported efficacy between and within facilities, indicating the need for pharmacokinetic studies' (Kottwitz et al, 2016).…”

“…Drugs to treat non-specific disease manifestations have focused on non-steroidal anti-inflammatories (NSAIDs), and phenylbutazone and flunixin meglumine are most commonly prescribed (Kottwitz et al, 2016). Pharmacokinetic studies conducted with NSAIDs in elephants (Table 2) include ibuprofen (Bechert & Christensen, 2007), ketoprofen (Hunter et al, 2003), phenylbutazone (Bechert et al, 2008), and trials with flunixin meglumine and firocoxib are currently under way.…”

Operant conditioning facilitates safe induction and appropriate positioning for molar extraction under general anaesthetic in an Asian elephant (Elephas maximus)

“…Keepers were advised to modify its diet to include chaff (short‐stemmed hay and chopped silage), and the possibility of veterinary intervention was discussed if clinical signs did not resolve. The elephant was slow in accepting the dietary modifications and no improvement in clinical signs was noted after NSAID treatment, which was subsequently modified to ibuprofen (4 mg/kg orally twice a day ibuprofen 400 mg, Fourrts (UK) Pharmacare, UK)9 10, for seven days without further effect.…”