Effect of aspirin on hacmostasis in the horse

Suspected aspirin resistance in individual healthy adult warmblood horses

The reasons for this prospective experimental study were to determine a dosing scheme with loading and maintenance dose of aspirin inducing inhibition of platelet function measured by whole blood impedance aggregometry. Ten horses received aspirin orally in the morning with one loading dose of 4.7-5 mg/kg and maintenance doses of 1-1.3 mg/kg daily the following 4 days. Aggregometries (COLtest, ASPItest, ADPtest) and serum salicylic acid were measured. ASPItest showed significant difference in inhibition at 24 and 48 hr (p < .05) and 96 hr (p < .01). Significant change for ADPtest and COLtest couldn't be detected. Serum salicylic acid concentrations were significantly (p < .01) increased at 6 and 12 hr. Despite this, three horses failed any inhibitory effect of platelet function, suspecting an aspirin resistance. Regarding the other seven horses platelet aggregation induced by ASPItest was reduced between 37% and 100% from baseline at 6 and 12 hr and between 0 and 98% during the next 4 days. Correlations of serum concentration of salicylic acid and aggregometries couldn't be detected. It can be presumed that equine platelets are less susceptible to aspirin what may compromise eventually the anticoagulatory effects and efficacy in preventing and treating diseases with increased platelet activation as endotoxaemia or laminitis.

Assessment of a platelet function analyser in horses: reference range and influence of a platelet aggregation inhibitor

The objective of this study was to assess whether a new human platelet function analyser (the PFA-100) could be used to evaluate platelet function in horses and detect acetylsalicylic acid (ASA)-induced platelet dysfunctions. Citrated blood samples from 40 healthy horses were processed to obtain reference values for closure time (CT) using cartridges with collagen-ADP (CT-ADP) and collagen-epinephrine (CT-EPI) as platelet agonists. In addition, CT-ADP and CT-EPI were also measured before and 24 h after oral ASA administration in another 12 healthy horses. The sensitivity and specificity of the test were also determined. In normal horses, means+/-SD value for CT-ADP was 85.1+/-13.1 s (median, 82 s), and CT-EPI ranged from 158 to >300 s (median 291 s). Calculated reference ranges were 60.5-115.9 s and 158.5->300 s for CT-ADP and CT-EPI, respectively. Administration of ASA significantly (P<0.001) prolonged CT-ADP values from 91.0+/-13 to 113.5+/-14.4 s, and CT-EPI values were also significantly (P<0.008) prolonged after ASA administration. Sensitivity and specificity results for ADP cartridges showed that a prolonged CT value would be highly suggestive of a platelet aggregation inhibition. In conclusion, ADP cartridges can be used in horses to assess primary haemostasis and may be a valuable test for the detection of platelet aggregation inhibition.

Effects of intravenous administration of formaldehyde on platelet and coagulation variables in healthy horses

OBJECTIVES

To assess safety and determine effects of IV administration of formaldehyde on hemostatic variables in healthy horses.

ANIMALS

7 healthy adult horses.

PROCEDURE

Clinical signs and results of CBC, serum biochemical analyses, and coagulation testing including template bleeding time (TBT) and activated clotting time (ACT) were compared in horses given a dose of 0.37% formaldehyde or lactated Ringer's solution (LRS), IV, in a 2-way crossover design. In a subsequent experiment, horses received an infusion of 0.74% formaldehyde or LRS. In another experiment, horses were treated with aspirin to impair platelet responses prior to infusion of formaldehyde or LRS.

RESULTS

Significant differences were not detected in any variable measured between horses when given formaldehyde or any other treatment. Infusion of higher doses of formaldehyde resulted in adverse effects including muscle fasciculations, tachycardia, tachypnea, serous ocular and nasal discharge, agitation, and restlessness.

CONCLUSIONS AND CLINICAL RELEVANCE

Intravenous infusion of formaldehyde at doses that do not induce adverse reactions did not have a detectable effect on measured hemostatic variables in healthy horses.

Equine cardiac disease. Clinical pharmacology and therapeutics

Cardiac disease is often life-threatening and challenging to treat. Prolonged therapy is indicated in many cases, which can lead to problems with treatment costs, owner compliance, and potential drug toxicity. Many therapies are empirical or based on data from other species because of a lack of well-designed prospective clinical trials in horses. This article reviews the clinical pharmacology and therapeutics of heart failure, cardiac arrhythmias, myocardial disease, endocarditis, and pericardial disease.

Necrotizing enterocolitis in horses: a retrospective study

The clinical and clinicopathologic characteristics of fatal necrotizing enterocolitis were examined in 16 horses (age 4 months to 12 years). At initial presentation, 8 of 16 horses were pyrexic (median temperature, 38.4 degrees C; range, 33.8 to 40.6 degrees C); all 16 were tachycardic (median heart rate, 93 bpm, range, 66 to 138 bpm); 13 of 16 were tachypneic (median heart rate, 36 bpm, range, 16 to 80 bpm), dehydrated, and had discolored mucous membranes. All horses that were pyrexic were also tachycardic and tachypneic. PCV was high (> 45%) in 14 horses. Six horses were leukopenic (< 5,000 cells/microL); 12 were neutropenic (< 2,300 cells/microL), and 14 had > 100 band neutrophils/microL. Twelve horses were acidemic (pH < 7.37; range, 6.88 to 7.33) and the venous bicarbonate concentration was low (< 23 mEq/L) in 14 horses. Median anion gap in 16 horses was 31.5 mEq/L (> 15 mEq/L in 15 horses). Eleven of 16 horses were hyponatremic (< 137 mEq/L), 1 horse was hypernatremic (> 143 mEq/L), 3 were hypokalemic (< 3.2 mEq/L), 6 were hyperkalemic (> 4.5 mEq/L), and 14 were hypochloremic (< 98 mEq/L). Serum creatinine concentrations were high (> 1.4 mg/dL) in 15 horses. Abdominal fluid was examined in 12 horses 4 had total protein concentrations > 2.5 g/dL and 6 had nucleated cell counts > 5,000/ microL and < 10,000/microL; none had > 10,000/microL. Eight of 12 samples revealed a nondegenerate neutrophilia (> 50%). Abdominal fluid collected from 4 horses immediately before death was normal in 2 horses and indicative of suppurative inflammation in 2. All 8 horses tested had low or nonexistent serum immunofluorescent antibody titers to Ehrlichia risticii. Four of 16 horses had Salmonella spp isolated from feces or tissues. All 16 horses either died (5 of 16; 31%) or were euthanized because of a grave prognosis. Median time to death was 45.5 hours (range, 7 to 113 hours) from the time of admission. Death was preceded by severe abdominal pain in 14 horses. Fatal necrotizing enterocolitis of horses is characterized by a brief course, profound dehydration, electrolyte derangements, acid-base abnormalities, and terminally, severe abdominal pain. Abdominal fluid analysis was frequently not indicative of the severity of disease.

Hematology and hemostasis in the horse: normal functions and common abnormalities

In diseased animals, laboratory evaluations of erythrocytes, leukocytes, and hemostasis provide important information that contributes to either narrowing the list of potential diagnoses or to determining a specific diagnosis. To adequately interpret the results of these evaluations, normal erythrocyte and leukocyte kinetics and normal hemostatic function must be understood. In addition, knowledge of common diseases resulting in abnormalities of these laboratory tests and of typical changes in these tests caused by these diseases is vital. This article has reviewed normal erythrocyte and leukocyte kinetics and normal hemostatic functions that are clinically significant and has described the laboratory abnormalities expected in common diseases affecting these functions.

Antithrombotic actions of aspirin in the horse

The antithrombotic effects of aspirin at two dose rates (4 mg/kg and 11 mg/kg bodyweight [bwt] were evaluated in normal, healthy ponies by measuring template bleeding time. Inhibition of platelet aggregation in response to adenosine diphosphate (ADP) and collagen was evaluated and cyclo-oxygenase activity was monitored by radioimmunoassay of thromboxane B2 (TXB2), the stable metabolite of thromboxane A2 (TXA2). TXB2 was measured in serum and platelet rich plasma. Bleeding time was prolonged significantly until 48 h after treatment at 12 mg/kg bwt and until 4 h at the lower dose rate. Synthesis of TXB2 and collagen induced aggregation were diminished for much greater periods with similar results at each of the dose rates. The prolonged effects of aspirin on platelet function occurred in spite of a very short plasma half-life of aspirin, because of its irreversible action on platelet cyclo-oxygenase. The results show that low dose aspirin has a potential role in antithrombotic therapy in horses although the relationship between skin bleeding time in normal horses and improvement of clinical conditions requires further research and evaluation in clinical trials. TXB2 measurement appears to overestimate the duration of antithrombotic effects of aspirin in vivo.

The treatment of laminitis in horses

The structural and vascular anatomy of the healthy equine foot is compared with the pathologic changes in the foot of horses with acute and chronic laminitis. The structural and vascular abnormalities present in the foot of horses with laminitis are demonstrated in order to explain the abnormal manner in which their feet grow. The medical, surgical, dietary, and endocrine management of acute and chronic laminitis is discussed. Various forms of hoof trimming beneficial to the reestablishment of normal digital perfusion, normal hoof growth, and normal spatial orientation among the distal phalanx, hoof wall, and sole are described. Guidelines for the provision of frog support provided by adjustable heart-bar shoes are presented.

Equine hemostasis. Description, evaluation, and alteration

This is a review of equine hemostasis and is divided into three sections. The initial portion describes the normal hemostatic system and includes platelet function, coagulation, fibrinolysis and control processes. The second phase is devoted to laboratory tests of hemostasis, and the last section provides information on specific alterations.

Clinical pharmacology and therapeutic uses of non-steroidal anti-inflammatory drugs in the horse

Weak organic acids possessing anti-inflammatory, analgesic and antipyretic properties--commonly known as aspirin-like drugs--have been used in equine medicine for almost 100 years. These non-steroidal anti-inflammatory drugs (NSAIDs) may be classified chemically into two groups; the enolic acids such as phenylbutazone and carboxylic acids like flunixin, meclofenamate and naproxen. All NSAIDs have similar and possibly identical modes of action accounting for both their therapeutic and their toxic effects. They block some part of the cyclo-oxygenase enzyme pathway and thereby suppress the synthesis of several chemical mediators of inflammation, collectively known as eicosanoids. The available evidence indicates that some of the newer NSAIDs have a reasonable safety margin but further studies are required. The toxicity of phenylbutazone in the horse has been investigated very thoroughly in recent years and it has been shown to cause renotoxicity and, most significantly, ulceration of the gastrointestinal tract when relatively high doses are administered. Several factors may predispose towards phenylbutazone toxicity in the horse, including breed and age, but high dosage is considered to be particularly important. The absorption into, and fate within, the body of NSAIDs are considered and particular attention is drawn to the ways in which these pharmacokinetic properties relate to the drugs' toxicity and clinical efficacy. In reviewing current knowledge of the clinical pharmacology of this important group of drugs, it is hoped to provide the clinician with a rational, scientific basis for their safe and effective use in equine practice.