Intra-articular concentration of gentamicin administered by intravenous regional limb perfusion in healthy horses / Concentração intra-articular de gentamicina administrada por perfusão regional intravenosa em membros de equinos sadios

Intravenous regional limb perfusion (IRLP) is an efficient method to treat horses with synovial infections. However, information on the dose, volume, and intervals of administration is lacking. The aim of this study was to evaluate the intra-articular concentration of gentamicin administered by IRLP in horses over 24 h post-administration and evaluate the influence of the total perfused volume. Twenty horses were assigned to two treatment groups. Gentamicin 60 group (G60, n=10) and Gentamicin 250 group (G250, n=10) received IRLP of 6.6 mg/kg of gentamicin diluted in Ringers lactate for a total volume of 60 ml (G60) and 250 ml (G250), respectively. Synovial fluid harvests were performed in the metacarpophalangeal joint before (0) and 4, 8, 12, 16, 20, and 24 hours after IRLP. Agar diffusion was the assay for measuring gentamicin concentrations. Four hours after IRLP, the intra-articular concentration of gentamicin was 47.58±49.21 g/ml in G60 and 10.92±6.11 g/ml in G250. During the 24 h of harvest, the intra-articular concentration of gentamicin remained above the minimum inhibitory concentration for horses (MIC; 2 g/ml) in both experimental groups. In G60, the concentration of gentamicin in synovial fluid reached the maximal concentration and remained 8 to 10-fold higher than the MIC (Cmax: 16 to 20 g/ml) during 12 h after IRLP. These findings support that IRLP with 6.6 mg/kg of gentamicin diluted to a volume of 60 ml promotes intra-articular concentrations higher than 250 ml, remaining above the MIC for 24 h and at the maximum concentration for 12 h.(AU)

A perfusão regional intravenosa (PRI) em membros de equinos é um método comprovadamente eficiente para o tratamento de infecções sinoviais, porém ainda existem lacunas quanto à dose, volume e intervalos de administração a serem utilizados. Neste estudo, objetivou-se avaliar a concentração intra-articular da gentamicina administrada por PRI em equinos, ao longo de 24 horas pós-administração, bem como avaliar a influência do volume total perfundido. Vinte equinos foram distribuídos em dois grupos experimentais, Grupo Gentamicina 60 (G60) e Grupo Gentamicina 250 (G250), representados por 10 equinos em cada grupo que receberam, por PRI, 6,6 mg/kg de gentamicina diluída em Ringer lactato para um total de 60 ml (G60) ou 250 ml (G250). As colheitas de líquido sinovial foram realizadas, na articulação metacarpo-falangeana, antes do início do experimento e após 4, 8, 12, 16, 20, e 24 horas. Difusão em ágar foi o método para doseamento das concentrações de gentamicina. Quatro horas após a PRI, a concentração intra-articular da gentamicina era de 47,58±49,21 µg/ml no G60 e 10,92±6,11 µg/ml no G250. Durante as 24 horas de colheita, a concentração intra-articular de gentamicina permaneceu acima da concentração inibitória mínima (CIM) (2 g/ml) em ambos os grupos experimentais. No G60, as concentrações de gentamicina no líquido sinovial atingiram a concentração máxima e mantiveram-se 8 a 10 vezes mais elevadas que a CIM (Cmáx: 16 a 20 g/ml) durante 12 horas após a PRI. Conclui-se que a PRI em membros, com 6,6 mg/kg de gentamicina diluída para o volume de 60 ml, promove concentrações intra-articulares mais elevadas que o volume de 250 ml, permanecendo acima da CIM durante 24 horas e em concentração máxima durante 12 horas.(AU)

Bypass ileal seguido de tiflostomia no tratamento de abdomen agudo em equino / Ileal bypass followed by tiflostomy to treat acute abdomen in a horse

Background: Equine gastrointestinal colic cases represent one of the diseases with higher morbidity and mortality. Short and long term survivals are commonly correlated with the colic causes, being considered 50 % the survival rate of horses referred to surgery because of small intestine strangulative causes. The jejuno-caecostomy technique is recommended in cases of ileum necrosis or ischemia that indicates ileum removal. The survival rate after this procedure is low, being even lower than others common terminal-terminal enteroanastomoses. This study reports a case of jejuno-caecostomy followed by tiflopexy and tiflostomy performed in a colic horse. Case: A 12-year-old mare, mangalarga breed, with a history of acute abdomen during 18 h was referred to the FZEA-USP equine hospital. According to the owner, the animal suffered previous episodes of colic that had been solved without treatment. On this occasion, the owner, without veterinary advice, had administered 10 mL of flunixin meglumine, but the animal did not show improvement. During the examination, the patient presented tachycardia, tachypnea, toxemic mucosa, a large amount of enterogastric reflux, and it was possible to observe distended small intestine during rectal palpation. The horse was referred to surgery; it was possible to identify necrosis of the ileum and 30 cm of the aboral segment of the jejunum, caused by strangulation due to a pedunculated lipoma localized in the medial band of the caecum. Latero-lateral jejuno-caecostomy was performed between the medial and dorsal bands of the caecum, using polyglactin 910, nº 2.0, potassium penicillin 30.000 IU / kg, every 6 h, gentamicin 6.6 mg / kg, every 24 h, flunixin meglumine 1.1 mg / kg, every 12 h and maintenance fluid therapy were performed post operatively. The animal had ileus and severe enterogastric reflux for five days postoperatively, showing severe signs of endotoxemia, and parenteral hydration seemed to be not enough. So it was...

Urolitíase obstrutiva em equino / Obstructive urolithiasis in horse

Background: Obstructive urinary tract disease in horses is a rare and low prevalence pathology in the species, but potentially severe. It is an emergency condition that presents variable clinical signs and depends on the anatomical locationof the obstruction. The bladder calculus are the most common followed by the urethra and less commonly seen are thekidney or ureteral. The main crystalloid component of uroliths in horses is calcium carbonate. The higher prevalence ofurolithiasis in male horses is justified by some anatomical differences between genders. The urethra of males is narrowerand longer than that of females. The tissue injury is the most important factor for the development of uroliths in horses.Desquamation of epithelial cells, presence of leukocyte and necrotic cell debris are relevant contributors to crystal growth.Urinary stasis favors nucleation by increasing the chance of contact between crystalloid material and urinary epithelium.Once crystal growth has begun, the urine alkalinity of the equines favors the crystallization and further deposition of othercomponents, especially calcium carbonate. Typical clinical signs of urolithiasis include tenesmus, dysuria, strangury andpolaquiuria. Hematuria is often present, mainly observed after exercise and at the end of urination. In addition signs ofcolic are quite frequent in the acute bladder and urethral urolithiasis due to bladder distension. Upper urinary tract surgerymay be technically challenging due to limited structural exposure, especially in adult horses The prognosis for horses withurolithiasis depends on the location of the urolith and the degree of renal injury that occurred.Case: This report aims to describe a rare case of obstructive urolithiasis in a 8-year-old castrated male horse with 24 hevolution. The horse was expressing signs of abdominal pain and during the transretal examination through palpation...

Bypass ileal seguido de tiflostomia no tratamento de abdomen agudo em equino / Ileal bypass followed by tiflostomy to treat acute abdomen in a horse

Background: Equine gastrointestinal colic cases represent one of the diseases with higher morbidity and mortality. Short and long term survivals are commonly correlated with the colic causes, being considered 50 % the survival rate of horses referred to surgery because of small intestine strangulative causes. The jejuno-caecostomy technique is recommended in cases of ileum necrosis or ischemia that indicates ileum removal. The survival rate after this procedure is low, being even lower than others common terminal-terminal enteroanastomoses. This study reports a case of jejuno-caecostomy followed by tiflopexy and tiflostomy performed in a colic horse. Case: A 12-year-old mare, mangalarga breed, with a history of acute abdomen during 18 h was referred to the FZEA-USP equine hospital. According to the owner, the animal suffered previous episodes of colic that had been solved without treatment. On this occasion, the owner, without veterinary advice, had administered 10 mL of flunixin meglumine, but the animal did not show improvement. During the examination, the patient presented tachycardia, tachypnea, toxemic mucosa, a large amount of enterogastric reflux, and it was possible to observe distended small intestine during rectal palpation. The horse was referred to surgery; it was possible to identify necrosis of the ileum and 30 cm of the aboral segment of the jejunum, caused by strangulation due to a pedunculated lipoma localized in the medial band of the caecum. Latero-lateral jejuno-caecostomy was performed between the medial and dorsal bands of the caecum, using polyglactin 910, nº 2.0, potassium penicillin 30.000 IU / kg, every 6 h, gentamicin 6.6 mg / kg, every 24 h, flunixin meglumine 1.1 mg / kg, every 12 h and maintenance fluid therapy were performed post operatively. The animal had ileus and severe enterogastric reflux for five days postoperatively, showing severe signs of endotoxemia, and parenteral hydration seemed to be not enough. So it was...(AU)

Urolitíase obstrutiva em equino / Obstructive urolithiasis in horse

Background: Obstructive urinary tract disease in horses is a rare and low prevalence pathology in the species, but potentially severe. It is an emergency condition that presents variable clinical signs and depends on the anatomical locationof the obstruction. The bladder calculus are the most common followed by the urethra and less commonly seen are thekidney or ureteral. The main crystalloid component of uroliths in horses is calcium carbonate. The higher prevalence ofurolithiasis in male horses is justified by some anatomical differences between genders. The urethra of males is narrowerand longer than that of females. The tissue injury is the most important factor for the development of uroliths in horses.Desquamation of epithelial cells, presence of leukocyte and necrotic cell debris are relevant contributors to crystal growth.Urinary stasis favors nucleation by increasing the chance of contact between crystalloid material and urinary epithelium.Once crystal growth has begun, the urine alkalinity of the equines favors the crystallization and further deposition of othercomponents, especially calcium carbonate. Typical clinical signs of urolithiasis include tenesmus, dysuria, strangury andpolaquiuria. Hematuria is often present, mainly observed after exercise and at the end of urination. In addition signs ofcolic are quite frequent in the acute bladder and urethral urolithiasis due to bladder distension. Upper urinary tract surgerymay be technically challenging due to limited structural exposure, especially in adult horses The prognosis for horses withurolithiasis depends on the location of the urolith and the degree of renal injury that occurred.Case: This report aims to describe a rare case of obstructive urolithiasis in a 8-year-old castrated male horse with 24 hevolution. The horse was expressing signs of abdominal pain and during the transretal examination through palpation...(AU)

Encarceramento em forame epiplóico em equino: relato de caso / The epiploic incarceration in horses: case report / Encarcelamiento en forame epiplóico en equinos: estúdio de caso

O encarceramento em forame epiplóico em equinos é observado em 2-10% das cólicas encaminhadas para a cirurgia, causando um comprometimento vascular que pode levar a necessidade de ressecção do segmento de alça intestinal afetado ou, até mesmo, eutanásia do animal. Um equino, macho, castrado, 400 kg, 5 anos de idade, da raça Mangalarga foi admitido com sinais de cólica, que tinha duração de 24 horas. Após os exames pertinentes, foi indicada a cirurgia, a qual foi negada pelo proprietário. Após tentativa de manutenção da vida do animal, foi indicada a eutanásia, sendo diagnosticado encarceramento de íleo no forame epiplóico na necropsia. Foi avaliado que o animal possuiria um bom prognóstico caso a laparotomia fosse realizada.

The epiploic incarceration in horses is observed in 2-10% of the cramps referred for surgery, causing vascular impairment that may lead to the need for resection of the affected intestinal segment or even euthanasia of the animal. A horse, 400 kg, male, 5-year-old, Mangalarga was admitted with signs of colic, which lasted 24 hours. After the pertinent examinations, the surgery was indicated, which was denied by the owner. After trying to maintain the life of the animal, euthanasia was indicated, being diagnosed incarceration of ileus in the epiploic foramen at necropsy. It was evaluated that the animal would have a good prognosis if the laparotomy was performed.

El encarcelamiento en foramen epiplóico en equinos se observa en el 2-10% de los cólicos derivados a la cirugía, generando un compromiso vascular que puede llevar a la necesidad de resección del segmiento de las asas intestinales afectadas o, y incluso, la eutanasia del animal. Un equino, macho, castrado, 400 kg, 5 anos de edad, de la raza Mangalarga fue admitido con seriales de cólico, que tenía una duración de 24 horas. Después de los exámenes pertinentes, fue indicada la cirugía, la cual fue negada por el propietario. Después de un intento de mantenimiento de la vida del animal, fue indicada la eutanasia, siendo diagnosticado encarcelamiento de íleo en el foramen epiplóico en la necropsia. Se evaluó que el animal tendría un buen pronóstico si se realizaba la laparotomía.

Encarceramento em forame epiplóico em equino: relato de caso / The epiploic incarceration in horses: case report / Encarcelamiento en forame epiplóico en equinos: estúdio de caso

O encarceramento em forame epiplóico em equinos é observado em 2-10% das cólicas encaminhadas para a cirurgia, causando um comprometimento vascular que pode levar a necessidade de ressecção do segmento de alça intestinal afetado ou, até mesmo, eutanásia do animal. Um equino, macho, castrado, 400 kg, 5 anos de idade, da raça Mangalarga foi admitido com sinais de cólica, que tinha duração de 24 horas. Após os exames pertinentes, foi indicada a cirurgia, a qual foi negada pelo proprietário. Após tentativa de manutenção da vida do animal, foi indicada a eutanásia, sendo diagnosticado encarceramento de íleo no forame epiplóico na necropsia. Foi avaliado que o animal possuiria um bom prognóstico caso a laparotomia fosse realizada.(AU)

The epiploic incarceration in horses is observed in 2-10% of the cramps referred for surgery, causing vascular impairment that may lead to the need for resection of the affected intestinal segment or even euthanasia of the animal. A horse, 400 kg, male, 5-year-old, Mangalarga was admitted with signs of colic, which lasted 24 hours. After the pertinent examinations, the surgery was indicated, which was denied by the owner. After trying to maintain the life of the animal, euthanasia was indicated, being diagnosed incarceration of ileus in the epiploic foramen at necropsy. It was evaluated that the animal would have a good prognosis if the laparotomy was performed.(AU)

El encarcelamiento en foramen epiplóico en equinos se observa en el 2-10% de los cólicos derivados a la cirugía, generando un compromiso vascular que puede llevar a la necesidad de resección del segmiento de las asas intestinales afectadas o, y incluso, la eutanasia del animal. Un equino, macho, castrado, 400 kg, 5 anos de edad, de la raza Mangalarga fue admitido con seriales de cólico, que tenía una duración de 24 horas. Después de los exámenes pertinentes, fue indicada la cirugía, la cual fue negada por el propietario. Después de un intento de mantenimiento de la vida del animal, fue indicada la eutanasia, siendo diagnosticado encarcelamiento de íleo en el foramen epiplóico en la necropsia. Se evaluó que el animal tendría un buen pronóstico si se realizaba la laparotomía.(AU)