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Effects of a selective 5-HT4 agonist and an alpha-2 adrenoceptor antagonist on etorphine-induced impairment across the oxygen cascade in immobilised sheep (Ovis aries): a randomised, prospective, and controlled trial

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  • Published: 07 August 2026
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Effects of a selective 5-HT4 agonist and an alpha-2 adrenoceptor antagonist on etorphine-induced impairment across the oxygen cascade in immobilised sheep (Ovis aries): a randomised, prospective, and controlled trial
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  • Hathaipat Rattanathanya  ORCID: orcid.org/0000-0002-0664-28001,2,
  • Anna Binetti  ORCID: orcid.org/0000-0002-4042-91063,
  • Friederike Pohlin  ORCID: orcid.org/0000-0002-4236-58471,
  • Susana C.M. Ferreira  ORCID: orcid.org/0000-0003-0265-02101,
  • Christina Braun  ORCID: orcid.org/0000-0002-4547-62783,
  • Johannes Schramel  ORCID: orcid.org/0000-0002-3254-370X3,
  • Leith C.R. Meyer  ORCID: orcid.org/0000-0002-5122-24694,5,6,
  • Anna Haw  ORCID: orcid.org/0000-0002-5904-27531,6,
  • Marja Raekallio  ORCID: orcid.org/0000-0002-2653-003X7,
  • Stefan Böhmdorfer  ORCID: orcid.org/0000-0003-1400-33958,
  • Szilvia Kalogeropoulu  ORCID: orcid.org/0000-0002-3689-63691,
  • Martina Mosing  ORCID: orcid.org/0000-0002-6190-56423 na1 &
  • …
  • Gabrielle Stalder  ORCID: orcid.org/0000-0002-8901-11811 na1 
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Abstract

Background

Etorphine, a highly potent opioid, disrupts multiple steps of the oxygen cascade, including alveolar ventilation, pulmonary gas exchange, systemic oxygen transport, and tissue-level oxygen utilisation, resulting in hypoxaemia and cellular hypoxia during immobilisation of wild ungulates. To evaluate potential mitigating agents, a randomised, prospective, controlled crossover design was used in etorphine-immobilised sheep (0.05 mg·kg−1, intramuscularly, n = 6). After etorphine administration, animals received either the serotonergic agonist BIMU-8 (1.5 mg·kg−1), the alpha-2 adrenoceptor antagonist vatinoxan (0.15 mg·kg−1), or sterile water (control) intravenously with a four-week washout period. Immobilisation was reversed with naltrexone 19 min after treatment administration. Sequential steps of the oxygen cascade were assessed using thoracic electrical impedance-derived variables (respiratory rate (RREIT) and tidal impedance variation (TIV)) for ventilation, blood gas analysis and venous admixture for pulmonary gas exchange, oxygen delivery (DO2) for oxygen transport, and oxygen extraction ratio (ER) for tissue oxygen utilisation. Measurements were obtained at baseline, after etorphine administration, at five-minute intervals following treatment, and after naltrexone. Data was analysed using linear mixed-effects models.

Results

Etorphine induced respiratory depression, characterised by reduced RREIT (p < 0.001) and TIV (p = 0.01), and impaired gas exchange, indicated by increased venous admixture (p < 0.001) compared with baseline, causing hypercapnia and hypoxaemia in all treatments. Neither BIMU-8 nor vatinoxan improved these variables compared with the control. Consequently, progressive decreases in arterial partial pressure of oxygen (F3,90 = 104.82, p < 0.001) were observed across treatments during immobilisation, resulting in persistently reduced DO2 (F3,84 = 51.55, p < 0.001) and increased ER (F3,90 = 8.09, p < 0.001) at similar levels in all treatments. All variables normalised after naltrexone administration.

Conclusions

Etorphine profoundly impaired multiple sequential steps of the oxygen cascade in sheep, resulting in hypoxaemia, reduced DO2, and compensatory increases in ER. BIMU-8 and vatinoxan did not effectively mitigate these disturbances at any level of the cascade compared with the control. Future research is needed to develop targeted strategies that address the key mechanisms underlying the disruptions in the oxygen cascade during etorphine immobilisation.

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Abbreviations

PBC:

Pre-Bötzinger complex

PaO2 :

Arterial partial pressure of oxygen

CO:

Cardiac output

DO2 :

Oxygen delivery

VO2 :

Oxygen consumption

ER:

Oxygen extraction ratio

5-HT4:

5-hydroxytryptamine 4

CaO2 :

Arterial oxygen content

EIT:

Electrical impedance tomography

RREIT :

Respiratory rate

TIV:

Tidal impedance variation

BL:

Baseline

PE:

Post-etorphine

PT:

Post-treatment

PN:

Post-naltrexone

AU:

Arbitrary units

TIVMIN :

Minute tidal impedance variation

PaCO2 :

Arterial partial pressure of carbon dioxide

△Z:

Total impedance change

Qs/Qt:

Venous admixture

SaO2 :

Arterial oxygen saturation

SvO2 :

Mixed venous oxygen saturation

CvO2 :

Mixed venous oxygen content

Acknowledgements

We would like to thank Dr. Giovannini and Boehringer Ingelheim for the generous provision of the protocol for the synthesis of BIMU-8, and the Institute of Chemistry of Renewable Resources, BOKU University, Vienna for providing the infrastructure required for the synthesis of BIMU-8 and Magdaléna Labíková for synthesis BIMU-8. We would also like to thank Vetcare Ltd, Finland for providing vatinoxan; and the Equine University Clinic of the Vetmeduni Vienna for providing the infrastructure for the experiments and Manuela Habe, Peter Steiger and Viola Bouvier for their animal training and animal husbandry; We furthermore thank Lisa Ebenhofer, Cosima Gösele and Lisa Stahl for their contribution to the experimental work in the course of their diploma theses. We would also like to thank Felix Knauer for his statistical support.

Funding

This work was funded by a scholarship of the Chulabhorn Royal Academy, Bangkok, Thailand. The funding institution played no role in the study design or reporting of the study.

Author information

Author notes
  1. Martina Mosing and Gabrielle Stalder shared last authors.

Authors and Affiliations

  1. Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria

    Hathaipat Rattanathanya, Friederike Pohlin, Susana C.M. Ferreira, Anna Haw, Szilvia Kalogeropoulu & Gabrielle Stalder

  2. Chulabhorn Royal Academy, Bangkok, Thailand

    Hathaipat Rattanathanya

  3. Anaesthesiology and Intensive Care, Clinical Centre for Small Animal Health and Research, Clinical Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria

    Anna Binetti, Christina Braun, Johannes Schramel & Martina Mosing

  4. Department of Production Animal Studies and Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa

    Leith C.R. Meyer

  5. Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, New Zealand

    Leith C.R. Meyer

  6. Brain Function Research Group, Department of Physiology, School of Biomedical Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Leith C.R. Meyer & Anna Haw

  7. Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland

    Marja Raekallio

  8. Institute of Chemistry of Renewable Resources, BOKU University, Vienna, Austria

    Stefan Böhmdorfer

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  1. Hathaipat Rattanathanya
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Corresponding author

Correspondence to Gabrielle Stalder.

Ethics declarations

Ethics approval and consent to participate

All procedures were approved by the Ethics and Animal Welfare Committee of the University of Veterinary Medicine, Vienna in accordance with the University’s guidelines for Good Scientific Practice and authorized by the Austrian Federal Ministry of Education, Science and Research (BMBWF 2023 − 0.276.137) in accordance with current legislation. The study was conducted and reported in accordance with the ARRIVE (2.0) guidelines.

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The authors declare no competing interests.

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Rattanathanya, H., Binetti, A., Pohlin, F. et al. Effects of a selective 5-HT4 agonist and an alpha-2 adrenoceptor antagonist on etorphine-induced impairment across the oxygen cascade in immobilised sheep (Ovis aries): a randomised, prospective, and controlled trial. BMC Vet Res (2026). https://doi.org/10.1186/s12917-026-05790-4

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  • Received: 07 April 2026

  • Accepted: 29 July 2026

  • Published: 07 August 2026

  • DOI: https://doi.org/10.1186/s12917-026-05790-4

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Keywords

  • BIMU-8
  • Etorphine
  • Hypoxaemia
  • Opioid
  • Vatinoxan

Profiles

  1. Hathaipat Rattanathanya View author profile
  2. Friederike Pohlin View author profile
  3. Susana C.M. Ferreira View author profile
  4. Johannes Schramel View author profile
  5. Stefan Böhmdorfer View author profile

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  • Can BIMU-8 or vatinoxan mitigate etorphine-induced oxygen cascade disruptions?
  • How does etorphine affect sequential steps of the oxygen cascade in mammals?
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