Perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy

Am J Vet Res. 2020 Sep;81(9):699-707. doi: 10.2460/ajvr.81.9.699.

Abstract

Objective: To determine perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy.

Animals: 43 healthy female dogs.

Procedures: Dogs were randomly assigned to receive the methadone-fluconazole-naltrexone formulation at 1 of 2 dosages (0.5 mg/kg, 2.5 mg/kg, and 0.125 mg/kg, respectively, or 1.0 mg/kg, 5.0 mg/kg, and 0.25 mg/kg, respectively, PO, q 12 h, starting the evening before surgery; n = 15 each) or methadone alone (0.5 mg/kg, SC, q 4 h starting the morning of surgery; 13). Dogs were sedated with acepromazine, and anesthesia was induced with propofol and maintained with isoflurane. A standard ovariohysterectomy was performed by experienced surgeons. Sedation and pain severity (determined with the Glasgow Composite Pain Scale-short form [GCPS-SF]) were scored for 48 hours after surgery. Rescue analgesia was to be provided if the GCPS-SF score was > 6. Dogs also received carprofen starting the day after surgery.

Results: None of the dogs required rescue analgesia. The highest recorded GCPS-SF score was 4. A significant difference in GCPS-SF score among groups was identified at 6:30 am the day after surgery, but not at any other time. The most common adverse effect was perioperative vomiting, which occurred in 11 of the 43 dogs.

Conclusions and clinical relevance: Oral administration of a methadone-fluconazole-naltrexone formulation at either of 2 dosages every 12 hours (3 total doses) was as effective as SC administration of methadone alone every 4 hours (4 total doses) in dogs undergoing routine ovariohysterectomy. Incorporation of naltrexone in the novel formulation may provide a deterrent to human opioid abuse or misuse.

MeSH terms

  • Administration, Oral
  • Analgesia* / veterinary
  • Analgesics, Opioid / therapeutic use
  • Animals
  • Dog Diseases* / drug therapy
  • Dogs
  • Female
  • Fluconazole
  • Humans
  • Hysterectomy / veterinary
  • Methadone / therapeutic use
  • Naltrexone / therapeutic use
  • Ovariectomy / veterinary
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Pain, Postoperative / veterinary

Substances

  • Analgesics, Opioid
  • Naltrexone
  • Fluconazole
  • Methadone