Incidence of Post-Sedation Emesis in Cynomolgus (Macaca fascicularis) and Rhesus (Macaca mulatta) Macaques, and Evaluation of Prophylactic Antiemetic Efficacy

Emesis is one of the most common side effects of ketamine sedation; however, predictors like species and sex have not been studied in macaques. This study aimed to determine the incidence and predictors of emesis in macaques undergoing ketamine sedation and to assess the efficacy of orally administered antiemetics in preventing emesis. A retrospective analysis was performed using medical records from rhesus and cynomolgus macaques who received ketamine sedation for veterinary examination events from August 2023 to April 2024. Among the 70 sedations performed using IM ketamine, the overall incidence of emesis was 26%. Cynomolgus macaques had a significantly higher risk of emesis (odds ratio (OR) 46.14, 95% confidence interval (CI): 7.08-493.9; <i>p</i> < 0.0001), with an emesis incidence of 55%. Females showed a higher incidence of emesis (75%) with an odds ratio of 3.72 (95% CI: 0.55-17.91; <i>p</i> = 0.24), though this difference was not statistically significant. In a prospective, randomized study, we compared the prophylactic use of oral maropitant citrate at a dose of 2 mg/kg or oral ondansetron at a dose of 1 mg/kg versus placebo for the prevention of emesis in cynomolgus macaques undergoing veterinary examination. Emesis was reduced from 58% in the control group to 50% in the maropitant group and 33% in the ondansetron group. However, the reduction in relative risk with either treatment did not reach statistical significance. Prophylactic oral administration of maropitant appears ineffective in preventing emesis in cynomolgus macaques. In contrast, prophylactic oral ondansetron is a more effective alternative in preventing emesis in these animals.