Influence of Long-Term Furosemide Use on Bone Mineral Content, Bone Metabolism Markers, and Water Weight Loss in Horses

Comparison of Bone Mineral Content of the Equine Third Metacarpal to Total Radiographic Bone Aluminum Equivalents From Unprocessed Digital Radiographs

Digital radiographs are common for estimating bone mineral content (BMC) in horses with radiographic bone aluminum equivalents (RBAE). Processing algorithms are used to produce clearer images of digital radiographs in clinical settings, but this distorts RBAE. This study compared RBAE from digital radiographs to BMC from bone ash, and physical and digital morphology measurements. Digital radiographs were taken of six third metacarpals (MCIII) from equine cadavers with an aluminum step wedge penetrometer. A 2-cm transverse section of bone was digitally analyzed and excised from each MCIII. For each image, a linear regression was created using the step wedge thicknesses (R² > 0.99) and used to obtain total and individual RBAE. Outer and inner diameters of both dorsal-palmar (DP) and lateral-medial (LM) aspects, as well as cortical thicknesses, were measured physically and digitally. Bone samples were ether-extracted, oven-dried, and ashed. Statistics were analyzed as correlations between variables. Physical and digital measurements of dorsal, medial, and lateral cortices, as well as DP outer diameter, tended to be similar (r > 0.74, P < .09) but palmar cortex measurements did not (r = 0.41, P = .42). The LM outer and DP/LM inner diameters were similar between the two methods (r > 0.95, P < .05). Total RBAE was strongly correlated to BMC (r > 0.93, P < .01). These results suggest that using digital radiographs to make morphological measurements is accurate and confirm the strong relationship between total RBAE and bone ash. However, this study emphasizes the need to use unprocessed radiographs for analysis.

Furosemide administration results in a transient alteration in calcium balance in mature horses

Previous research documented that furosemide negatively impacted calcium balance for 3 days but did not determine when calcium balance returned to baseline. This study hypothesized that furosemide's impact on calcium would return to control values before 7 days post-administration. Ten mature geldings were assigned to either control (CON, n = 5) or treatment (FUR, n = 5) for the first of two 8-day total collections in crossover design. Treatment horses received one administration of furosemide (1 mg/kg, IV). A 10% sample of pooled faeces and urine from each day was kept. Calcium concentrations in hay, faeces and urine were determined by an atomic absorption spectrophotometer. Data were analysed using mixed-model-repeated measures ANOVA to determine influence of day and treatment. For urine output, FUR urinated twice as much during the 24 hr after administration than CON (p < .001). Horses in FUR excreted more urinary calcium 24-hr post-administration as compared to CON (9.3 ± 1.0 and 4.2 ± 1.0 g, respectively; p < .001). Calcium balance in FUR was more negative on day 1 than day 3 (p < .05). Faecal calcium concentrations remained the same from day 1 to day 7 in CON (6.3 ± 1.3 and 5.5 ± 1.3 g/kg, respectively; p > .10) but were lower in FUR on day 7 as compared to day 1 (4.8 ± 1.3 and 7.3 ± 1.3 g/kg, respectively; p < .001), indicating a potential mechanism to restore calcium balance. These findings corroborate previous studies on furosemide and calcium balance and provide evidence for a possible mechanism to recover net calcium losses after furosemide administration. Since calcium balance returns to baseline in 3 days and previous results have examined frequent, long-term use, furosemide may not negatively impact bone mineral content even if used over long periods.