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Grotowska M, Gozdzik W. Intraoperative intravenous infusion of lidocaine increases total and small vessel densities of sublingual microcirculation: a randomized prospective pilot study. J Int Med Res 2023; 51:3000605231209820. [PMID: 37940618 PMCID: PMC10637181 DOI: 10.1177/03000605231209820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE Multiple organ failure can occur as a result of postoperative complications. Research has indicated that the underlying mechanism of organ dysfunction is a microcirculation disorder. Because of its antioxidant and anti-inflammatory properties, lidocaine has the potential to improve microvascular blood flow. This study was performed to assess the effect of intraoperative intravenous lidocaine infusion on the microcirculation and determine the incidence of postoperative complications. METHODS In this prospective randomized double-blind pilot study, 12 patients scheduled for abdominal surgery were randomly allocated to receive an intraoperative infusion of either 1% lidocaine or the same volume of 0.9% sodium chloride solution. The microcirculation was monitored using sidestream dark-field imaging and the vascular occlusion test combined with near-infrared spectroscopy. RESULTS Lidocaine significantly increased the total vascular density and small vessel density after 2 hours of infusion, with preservation of 99% to 100% of the capillary perfusion in both groups. No patients developed organ failure. CONCLUSIONS An increase in vessel density may be beneficial in major abdominal surgeries because it is associated with better tissue perfusion and oxygen delivery. However, this finding requires further investigation in patients with increased surgical risk. Overall, this study indicates that lidocaine has potential to improve microvascular perfusion.Research Registry number: 9549 (https://www.researchregistry.com/browse-the-registry#home/registrationdetails/650ffd27b3f547002bd7635f/).
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Affiliation(s)
- Małgorzata Grotowska
- Clinical Department of Anesthesiology and Intensive Therapy, University Hospital in Wroclaw, Wroclaw Medical University, Wroclaw, Poland
| | - Waldemar Gozdzik
- Clinical Department of Anesthesiology and Intensive Therapy, University Hospital in Wroclaw, Wroclaw Medical University, Wroclaw, Poland
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2
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Ruíz-López P, Cuypers C, Schauvliege S. Xylazine Infusion during Equine Colic Anesthesia with Isoflurane and Lidocaine: A Retrospective Study. Animals (Basel) 2023; 13:2902. [PMID: 37760302 PMCID: PMC10525755 DOI: 10.3390/ani13182902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This retrospective study investigated the effect of a xylazine infusion on heart rate; mean arterial pressure; blood gases; anesthetic and dobutamine requirements; recovery quality and duration; percentage of death/survival; and days to die/discharge in horses after colic surgery under partial intravenous anesthesia with isoflurane and lidocaine infusion. Anesthetic records of equine colic surgery were reviewed from similar periods in 2020-2021 and 2021-2022. In both groups, after sedation with xylazine 0.7 mg/kg intravenously (IV) and induction with ketamine 2.2 mg/kg and midazolam 0.06 mg/kg IV, anesthesia was maintained with isoflurane and lidocaine (bolus 1.5 mg/kg IV, infusion 2 mg/kg/h). Group L (2020-2021, n = 45) received xylazine 0.2 mg/kg IV before recovery, group XL (2021-2022, n = 44) received xylazine 0.5 mg/kg/h IV intraoperatively. In group XL, minimal (p = 0.04) and average (p = 0.04) heart rate, intraoperative hematocrit (p = 0.001), minimal (p = 0.002) and maximal (p = 0.04) dobutamine administration rate, animals requiring ketamine top-ups (p = 0.04), and the number of days to discharge (p = 0.02), were significantly lower compared to group L. During recovery in group XL, the time to sternal recumbency (p = 0.03) and time to first attempt (p = 0.04) were significantly longer. This retrospective study suggests that a xylazine infusion may have beneficial effects on horses undergoing colic surgery. Further prospective studies are necessary.
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Affiliation(s)
- Patricia Ruíz-López
- Department of Large Animal Surgery, Anesthesia and Orthopedics, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium;
| | | | - Stijn Schauvliege
- Department of Large Animal Surgery, Anesthesia and Orthopedics, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium;
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3
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Wood F, Loomes K. Suspected lidocaine toxicity and the use of metoclopramide and neostigmine to treat post‐operative small intestinal ileus in a donkey. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Kate Loomes
- Rainbow Equine Hospital Malton North Yorkshire UK
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4
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Yau K, Halleran J, Boileau M, Foster D. Retrospective study on the use of lidocaine constant rate infusions for the treatment of ileus in ruminants and camelids. J Vet Intern Med 2021; 35:2933-2936. [PMID: 34514646 PMCID: PMC8692198 DOI: 10.1111/jvim.16262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 08/21/2021] [Accepted: 08/30/2021] [Indexed: 12/19/2022] Open
Abstract
Limited knowledge exists regarding the use of lidocaine as a prokinetic in ruminants and camelids to treat gastrointestinal ileus. In this retrospective study, ruminant and camelid cases diagnosed with ileus and treated with a lidocaine constant rate of infusion were assessed for adverse reactions and medical outcomes. A review of medical records was performed to identify cases in which lidocaine was administered as a prokinetic. Ten cases were identified consisting of 8 cattle, 1 goat, and 1 alpaca. Nine animals improved with a lidocaine treatment. No adverse effects were reported during lidocaine administration. Nine animals were discharged, and 1 was euthanized.
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Affiliation(s)
- Katie Yau
- Department of Population Health and Pathobiology, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Jennifer Halleran
- Department of Population Health and Pathobiology, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Melanie Boileau
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Derek Foster
- Department of Population Health and Pathobiology, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
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VanderBroek AR, Engiles JB, Kästner SBR, Kopp V, Verhaar N, Hopster K. Protective effects of dexmedetomidine on small intestinal ischaemia-reperfusion injury in horses. Equine Vet J 2020; 53:569-578. [PMID: 32862437 DOI: 10.1111/evj.13337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/06/2020] [Accepted: 08/13/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Strangulating small intestinal lesions in the horse have increased morbidity and mortality compared to nonstrangulating obstructions due to mucosal barrier disruption and subsequent endotoxaemia. OBJECTIVES To investigate protective effects of dexmedetomidine on small intestinal ischaemia-reperfusion injury in the horse. STUDY DESIGN Randomised, controlled, experimental study. METHODS Eighteen systemically healthy horses were randomly assigned to three groups: control, preconditioning, and post-conditioning. During isoflurane anaesthesia, complete ischaemia was induced in a 1-m segment of jejunum for 90 minutes. Horses in the preconditioning and post-conditioning groups received dexmedetomidine (3.5 µg/kg followed by 7 µg/kg/h) before (preconditioning) or after beginning ischaemia (post-conditioning), and during reperfusion. Jejunal biopsies were collected before ischaemia (baseline-1), at the end of the ischaemic period (ischaemia), and 30 minutes after reperfusion (reperfusion-1). Additional biopsies were taken 24 hours after reperfusion from ischaemia-reperfusion-injured jejunum (reperfusion-2). Epithelial injury was scored histologically, and morphometric analyses were used to calculate villus surface area (VSA) denuded of epithelium. Data were analysed using analysis of variance, Kruskal-Wallis and Wilcoxon two-sample tests. RESULTS In the control group, epithelial injury scores and percentage of VSA denudation for ischaemia-reperfusion-injured jejunum were higher compared to baseline-1 at all time points. The ischaemia and both reperfusion samples from the pre- and post-conditioning groups had lower epithelial injury scores and percentage of VSA epithelial denudation compared to the control group, with no difference from baseline-1 at any time point for the preconditioning group. MAIN LIMITATIONS Preconditioning has limited application in the clinical setting with naturally occurring strangulating small intestinal lesions. CONCLUSIONS Dexmedetomidine was protective for small intestinal ischaemia-reperfusion injury in the horse when administered before or during ischaemia.
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Affiliation(s)
- Ashley R VanderBroek
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Julie B Engiles
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Sabine B R Kästner
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Veronika Kopp
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Nicole Verhaar
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Klaus Hopster
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
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6
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Verhaar N, Pfarrer C, Neudeck S, König K, Rohn K, Twele L, Kästner S. Preconditioning with lidocaine and xylazine in experimental equine jejunal ischaemia. Equine Vet J 2020; 53:125-133. [PMID: 32119148 DOI: 10.1111/evj.13251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/17/2019] [Accepted: 02/20/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Pharmacological preconditioning of dexmedetomidine on small intestinal ischaemia/reperfusion injury has been reported in different animal models including horses. OBJECTIVES The objective was to assess if xylazine and lidocaine have a preconditioning effect in an experimental model of equine jejunal ischaemia. STUDY DESIGN Terminal in vivo experiment. METHODS Ten horses under general anaesthesia were either preconditioned with xylazine (group X; n = 5) or lidocaine (group L; n = 5). A historical untreated control group (group C; n = 5) was used for comparison. An established experimental model of equine jejunal ischaemia was applied, and intestinal samples were taken pre-ischaemia, after ischaemia and following reperfusion. Histomorphological examination was performed based on a modified Chiu score. Immunohistochemical staining for cleaved caspase-3, TUNEL and calprotectin was performed, and positive cell counts were expressed in cells/mm2 . RESULTS There was no progression of histomorphological mucosal injury from ischaemia to reperfusion, and there were no differences in histomorphology between the groups. After ischaemia, group X had significantly less caspase-positive cells compared to the control group with a median difference of 227% (P = .01). After reperfusion, group X exhibited significantly lower calprotectin-positive cell counts compared to the control group, with a median difference of 6.8 cells/mm2 in the mucosa and 44 cells in the serosa (P = .02 and .05 respectively). All groups showed an increase in caspase- and calprotectin-positive cells during reperfusion (P < .05). TUNEL-positive cells increased during ischaemia, followed by a decrease after reperfusion (P < .05). MAIN LIMITATIONS The small sample size and the use of a historical control group. Preconditioning effects of the tested drugs may be masked by the protective effects of isoflurane in the anaesthetic protocol. CONCLUSIONS Preconditioning with lidocaine did not have any effect on the tested variables. The lower cell counts of caspase- and calprotectin-positive cells in group X may indicate a beneficial effect of xylazine on ischaemia/reperfusion injury. Due to the absence of a concurrent reduction of histomorphological injury, the clinical significance remains uncertain.
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Affiliation(s)
- Nicole Verhaar
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Christiane Pfarrer
- Institute for Anatomy, University of Veterinary Medicine, Hannover, Germany
| | - Stephan Neudeck
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Kathrin König
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Karl Rohn
- Department of Biometry, University of Veterinary Medicine, Hannover, Germany
| | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Sabine Kästner
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
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7
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Freeman DE. Letter to the Editor: Response to Dr Blikslager's letter on post‐operative reflux. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
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8
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Blikslager AT. Letter to the Editor: Post‐operative reflux – a surgeon's perspective. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. T. Blikslager
- Department of Clinical Sciences North Carolina State University Raleigh North Carolina USA
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9
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Grauw J, Loon T. Successful treatment of prolonged postoperative ileus following resection of a small intestinal spindle cell sarcoma in a horse. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Janny Grauw
- Department of Equine SciencesUtrecht University Faculty of Veterinary MedicineUtrechtthe Netherlands
| | - Thijs Loon
- Department of Equine SciencesUtrecht University Faculty of Veterinary MedicineUtrechtthe Netherlands
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10
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Freeman DE. Is There Still a Place for Lidocaine in the (Postoperative) Management of Colics? Vet Clin North Am Equine Pract 2019; 35:275-288. [PMID: 31076222 DOI: 10.1016/j.cveq.2019.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intravenous lidocaine is widely used to prevent or treat postoperative ileus in horses. Clinical studies that support this approach are flawed and contradicted by others. Also, physical obstruction could be more important in causing postoperative reflux than postoperative ileus in the horse. The antiinflammatory properties of lidocaine and the role of inflammation from intestinal handling in the genesis of postoperative reflux are questionable. Because of cost and questionable efficacy of lidocaine, a well-designed clinical trial is required to support its continued use. However, lidocaine could be given to provide or enhance analgesia in selected cases with postoperative colic.
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Affiliation(s)
- David E Freeman
- Equine Surgery, University of Florida, College of Veterinary Medicine, Large Animal Clinical Sciences, PO Box 100136, Gainesville, FL 32610, USA.
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11
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Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems. Vet Clin North Am Equine Pract 2018. [PMID: 29534809 PMCID: PMC7126773 DOI: 10.1016/j.cveq.2017.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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Freeman DE. Fifty years of colic surgery. Equine Vet J 2018; 50:423-435. [DOI: 10.1111/evj.12817] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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13
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Burke M, Blikslager A. Advances in Diagnostics and Treatments in Horses with Acute Colic and Postoperative Ileus. Vet Clin North Am Equine Pract 2018; 34:81-96. [PMID: 29402479 DOI: 10.1016/j.cveq.2017.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Differentiating between medical and surgical causes of colic is one of the primary goals of the colic workup, because early surgical intervention improves prognosis in horses requiring surgery. Despite the increasing availability of advanced diagnostics (hematologic analyses, abdominal ultrasound imaging, etc), the most accurate indicators of the need for surgery remain the presence of moderate to severe signs of abdominal pain, recurrence of pain after appropriate analgesic therapy, and the absence of intestinal borborygmi. Investigation of novel biomarkers, which may help to differentiate surgical lesions from those that can be managed medically, continues to be an active area of research.
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Affiliation(s)
- Megan Burke
- NC State Veterinary Hospital, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA.
| | - Anthony Blikslager
- NC State Veterinary Hospital, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA
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14
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Lisowski ZM, Pirie RS, Blikslager AT, Lefebvre D, Hume DA, Hudson NPH. An update on equine post-operative ileus: Definitions, pathophysiology and management. Equine Vet J 2018; 50:292-303. [DOI: 10.1111/evj.12801] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 11/24/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Z. M. Lisowski
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - R. S. Pirie
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - A. T. Blikslager
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
| | - D. Lefebvre
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - D. A. Hume
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
- Mater Research; The University of Queensland; Woolloongabba Queensland Australia
| | - N. P. H. Hudson
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
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15
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Anderson SL, Singh B. Equine neutrophils and their role in ischemia reperfusion injury and lung inflammation. Cell Tissue Res 2018; 371:639-648. [PMID: 29335779 DOI: 10.1007/s00441-017-2770-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/07/2017] [Indexed: 01/06/2023]
Abstract
Horses are susceptible to a multitude of inflammatory conditions that are characterized by a strong neutrophilic response. Here, we review basic equine neutrophil biology and explore the role of neutrophils in inflammatory conditions with emphasis on intestinal ischemia and reperfusion injury and lung inflammation. In addition, unique aspects of equine neutrophil biology have been highlighted. Neutrophils comprise the highest proportion of circulating white blood cells in equine blood. The concentration of circulating equine neutrophils is a primary indicator of systemic inflammation. Additionally, equine neutrophils exposed to various stimulants develop "toxic" changes characterized as cytoplasmic basophilia, presence of Döhle bodies, cytoplasmic vacuolation and toxic granulation. In contrast to human neutrophils, equine neutrophils fail to undergo chemotaxis in response to the peptide N-formyl-methionyl-leucyl-phenylalanine and are dependent on the addition of arachidonic acid due to reduced activity of phospholipase A2 to synthesize leukotrienes as part of the arachidonic acid pathway. Understanding the biologic function of neutrophils in horses is integral to developing methods to modulate inflammation associated with ischemia reperfusion injury and lung disease.
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Affiliation(s)
- Stacy L Anderson
- College of Veterinary Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN, 37752, USA.
| | - Baljit Singh
- College of Veterinary Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
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Abstract
The equine intestinal mucosa is intimately involved in maintaining homeostasis both on a systemic level by controlling extracellular fluid movement and at the local level to maintain barrier function. Horses are particularly susceptible to the clinical syndrome of colic, with the most severe cases involving strangulating obstruction that induces ischemia. Because of the mucosal vascular architecture, the mucosal epithelium is particularly susceptible to ischemic injury. The potential for reperfusion injury has been investigated and found to play a minimal role. However, inflammation does affect mucosal repair. Mechanisms of repair, including villus contraction, epithelial restitution, and tight junction closure, are critical to reforming the mucosal barrier. Nonsteroidal anti-inflammatory drugs have an impact on this repair, particularly at the level of the tight junctions. Completion of mucosal regeneration requires proliferation, which is now being actively studied in equine enteroids. All of these aspects of equine mucosal pathobiology are reviewed in depth.
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Affiliation(s)
- Anthony Blikslager
- Center for Gastrointestinal Biology and Disease, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27607, USA;
| | - Liara Gonzalez
- Center for Gastrointestinal Biology and Disease, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27607, USA;
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17
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Dholakia U, Clark-Price SC, Keating SCJ, Stern AW. Anesthetic effects and body weight changes associated with ketamine-xylazine-lidocaine administered to CD-1 mice. PLoS One 2017; 12:e0184911. [PMID: 28910423 PMCID: PMC5599034 DOI: 10.1371/journal.pone.0184911] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/01/2017] [Indexed: 02/06/2023] Open
Abstract
Anesthesia for mice is commonly performed through the injection of parenteral agents via the intraperitoneal (IP) route. Variability in anesthetic sensitivities has been noted in mice resulting in inconsistencies in anesthetic depth and/or mortality. Anesthetic protocols that improve consistency and safety are needed. The objectives of this study were to assess the effects of intraperitoneal (IP) ketamine (95 mg/kg) and xylazine (7 mg/kg) alone or combined with lidocaine at 4, 8, or 16 mg/kg on time to loss (LRR) and return (RRR) of righting reflex, duration of immobilization and loss of pedal withdrawal response (PWR), body weight and histopathology in CD-1 mice. In a prospective, randomized trial, 36 male CD-1 mice, 4–6 weeks of age were randomly assigned to 5 groups: saline (SA, n = 4); ketamine-xylazine (KX, n = 8); ketamine-xylazine-lidocaine 4 mg/kg (KXL4, n = 8); ketamine-xylazine-lidocaine 8 mg/kg (KXL8, n = 8); ketamine-xylazine-lidocaine 16 mg/kg (KXL16, n = 8). Two mice in each group were euthanized at day 2 post-injection and the remaining mice were euthanized at day 11 post-injection. After IP injection, LRR and RRR, duration of immobilization and loss of PWR, body weight and histopathology were evaluated. LRR occurred sooner in mice receiving KXL16 compared with KX, with median (range) times of 78 (62–104) and 107 (91–298) seconds, respectively. Loss of PWR occurred in 1, 5, 4, 6 mice for groups KX, KXL4, KXL8, and KXL16 respectively. Median (range) duration of absent PWR was longer in mice receiving KXL16 at 13 (0–30) minutes, compared to KX at 0 (0–9) minutes. Duration of immobilization and RRR were not different between groups. Weight loss occurred 2 days following anesthesia but was not different between groups. Weight gain was significantly greater in all lidocaine groups 11 days post-injection compared to KX. No mortality or histopathologic abnormalities were observed in any group. Lidocaine administered with ketamine and xylazine shortens the onset of anesthesia in mice and improves anesthetic depth without prolonging recovery time.
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Affiliation(s)
- Urshulaa Dholakia
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Stuart C. Clark-Price
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- * E-mail:
| | - Stephanie C. J. Keating
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Adam W. Stern
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
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18
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Bauck AG, Grosche A, Morton AJ, Graham AS, Vickroy TW, Freeman DE. Effect of lidocaine on inflammation in equine jejunum subjected to manipulation only and remote to intestinal segments subjected to ischemia. Am J Vet Res 2017; 78:977-989. [DOI: 10.2460/ajvr.78.8.977] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Bianco AW, Moore GE, Cooper BR, Taylor SD. In vitro anti-LPS dose determination of ketorolac tromethamine and in vivo safety of repeated dosing in healthy horses. J Vet Pharmacol Ther 2017; 41:98-104. [PMID: 28600856 DOI: 10.1111/jvp.12425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 05/06/2017] [Indexed: 12/27/2022]
Affiliation(s)
- A. W. Bianco
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
| | - G. E. Moore
- Department of Veterinary Administration; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
| | - B. R. Cooper
- Bindley Bioscience Center; Purdue University; West Lafayette IN USA
| | - S. D. Taylor
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
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20
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Abstract
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient.
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21
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Abstract
Rabbits have the ability to hide their signs and often present in a state of decompensatory shock. Handling can increase susceptibility to stress-induced cardiomyopathy and specific hemodynamic changes. Careful monitoring with a specific reference range is important to detect early decompensation, change the therapeutic plan in a timely manner, and assess prognostic indicators. Fluid requirements are higher in rabbits than in other small domestic mammals and can be corrected both enterally and parenterally. Critical care in rabbits can be extrapolated to many hindgut fermenters, but a specific reference range and dosage regimen need to be determined.
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Affiliation(s)
- Minh Huynh
- Exotic Department, Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France.
| | - Anaïs Boyeaux
- Department of Emergency and Critical Care, Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France
| | - Charly Pignon
- Exotics Medicine Service, Alfort National Veterinary School, 7 avenue du Général de Gaulle, Maisons-Alfort 94700, France
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Vinther AML, Heegaard PMH, Skovgaard K, Buhl R, Andreassen SM, Andersen PH. Characterization and differentiation of equine experimental local and early systemic inflammation by expression responses of inflammation-related genes in peripheral blood leukocytes. BMC Vet Res 2016; 12:83. [PMID: 27250718 PMCID: PMC4888743 DOI: 10.1186/s12917-016-0706-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 05/22/2016] [Indexed: 01/17/2023] Open
Abstract
Background Local inflammation may progress into systemic inflammation. To increase our understanding of the basic immunological processes during transition of equine local inflammation into a systemic state, investigation into the equine systemic immune response to local inflammation is warranted. Therefore, the aim of this study was to investigate the innate peripheral blood leukocyte (PBL) immune response to local inflammation in horses, and to compare this response with the PBL immune response during the early phase of acute systemic inflammation. Expression of 22 selected inflammation-related genes was measured in whole blood leukocytes from 6 horses in an experimental cross-over model of lipopolysaccharide- (LPS-) induced acute synovitis (3 μg LPS intraarticularly; locally inflamed [LI] horses) and endotoxemia (1 μg LPS/kg intravenously; systemically inflamed [SI] horses). Multiple clinical and hematological/biochemical examinations were performed, and serial blood samples were analyzed by reverse transcription quantitative real-time PCR. Post-induction expression profiles of all genes were compared between study groups using principal component analysis (PCA) and hierarchical clustering. Results Moderate synovitis and mild systemic inflammation of approximately 24 h duration was confirmed by clinical and paraclinical observations in LI and SI horses, respectively. In the LI group, samples obtained 3–16 h post-injection showed distinct clustering in the PCA compared with baseline levels, indicating a transcriptional response to local inflammation in PBLs in this time interval. There was no clinical or hematological indication of actual systemic inflammation. There was a clear separation of all LI samples from all SI samples in two distinct clusters, indicating that expression profiles in the two study groups were different, independent of time since LPS injection. Co-regulated genes formed four clusters across study groups which were distinctly differently regulated. Only few of individual genes displayed different expression between the study groups at all times after LPS injection. Conclusions Local inflammation in horses initiated an innate transcriptional response in PBLs, which differed from the transcriptional response during the early phase of systemic inflammation. This study may provide new insights into the immunobiology of PBLs during the transition of local inflammation into a systemic state. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0706-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne Mette L Vinther
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark.
| | - Peter M H Heegaard
- Innate Immunology Group, Section for Immunology and Vaccinology, National Veterinary Institute, Technical University of Denmark, Frederiksberg, Denmark
| | - Kerstin Skovgaard
- Innate Immunology Group, Section for Immunology and Vaccinology, National Veterinary Institute, Technical University of Denmark, Frederiksberg, Denmark
| | - Rikke Buhl
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Stine M Andreassen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Pia H Andersen
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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23
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Rodrigo‐Mocholi D, Steblaj B, Vlaminck L, Gasthuys F, Schauvliege S. Continuous caudal epidural analgesia for perioperative pain control after bilateral mastectomy in a mare. VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2015-000275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Diego Rodrigo‐Mocholi
- Surgery and Anaesthesiology of Domestic AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Surgery and Anaesthesiology of Large AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Department of SurgeryUniversity of GentMerelbekeBelgium
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
| | - Barbara Steblaj
- Small Animal Intensive Care UnitCHUVAEcole Nationale Vétérinaire d'AlfortMaisons‐AlfortFrance
- Surgery and Anaesthesiology of Large AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Department of SurgeryUniversity of GentMerelbekeBelgium
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
| | - Lieven Vlaminck
- Surgery and Anaesthesiology of Domestic AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Surgery and Anaesthesiology of Large AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Department of SurgeryUniversity of GentMerelbekeBelgium
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
| | - Frank Gasthuys
- Surgery and Anaesthesiology of Domestic AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Surgery and Anaesthesiology of Large AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Department of SurgeryUniversity of GentMerelbekeBelgium
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
| | - Stijn Schauvliege
- Surgery and Anaesthesiology of Domestic AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Surgery and Anaesthesiology of Large AnimalsFaculty of VeterinaryGhent UniversityMerelbekeBelgium
- Department of SurgeryUniversity of GentMerelbekeBelgium
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
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24
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van der Wal SEI, van den Heuvel SAS, Radema SA, van Berkum BFM, Vaneker M, Steegers MAH, Scheffer GJ, Vissers KCP. The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain. Eur J Pain 2015; 20:655-74. [PMID: 26684648 DOI: 10.1002/ejp.794] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The neuroinflammatory response plays a key role in several pain syndromes. Intravenous (iv) lidocaine is beneficial in acute and chronic pain. This review delineates the current literature concerning in vitro mechanisms and in vivo efficacy of iv lidocaine on the neuroinflammatory response in acute and chronic pain. DATABASES AND DATA TREATMENT We searched PUBMED and the Cochrane Library for in vitro and in vivo studies from July 1975 to August 2014. In vitro articles providing an explanation for the mechanisms of action of lidocaine on the neuroinflammatory response in pain were included. Animal or clinical studies were included concerning iv lidocaine for acute or chronic pain or during inflammation. RESULTS Eighty-eight articles regarding iv lidocaine were included: 36 in vitro studies evaluating the effect on ion channels and receptors; 31 animal studies concerning acute and chronic pain and inflammatory models; 21 clinical studies concerning acute and chronic pain. Low-dose lidocaine inhibits in vitro voltage-gated sodium channels, the glycinergic system, some potassium channels and Gαq-coupled protein receptors. Higher lidocaine concentrations block potassium and calcium channels, and NMDA receptors. Animal studies demonstrate lidocaine to have analgesic effects in acute and neuropathic pain syndromes and anti-inflammatory effects early in the inflammatory response. Clinical studies demonstrate lidocaine to have advantage in abdominal surgery and in some neuropathic pain syndromes. CONCLUSIONS Intravenous lidocaine has analgesic, anti-inflammatory and antihyperalgesic properties mediated by an inhibitory effect on ion channels and receptors. It attenuates the neuroinflammatory response in perioperative pain and chronic neuropathic pain.
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Affiliation(s)
- S E I van der Wal
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - S A S van den Heuvel
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - S A Radema
- Department of Medical Oncology, RUMC, Nijmegen, The Netherlands
| | - B F M van Berkum
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - M Vaneker
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - M A H Steegers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - G J Scheffer
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
| | - K C P Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands
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25
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Davis JL. Nonsteroidal anti-inflammatory drug associated right dorsal colitis in the horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J. L. Davis
- North Carolina State University College of Veterinary Medicine; Raleigh USA
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26
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Cook VL, Blikslager AT. The use of nonsteroidal anti-inflammatory drugs in critically ill horses. J Vet Emerg Crit Care (San Antonio) 2014; 25:76-88. [PMID: 25521286 DOI: 10.1111/vec.12271] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 09/15/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To review the physiology of the cyclooxygenase (COX) enzymes with reference to the beneficial effects of nonsteroidal anti-inflammatory drugs (NSAIDs) related to their analgesic and antiendotoxic properties as well as the mechanisms responsible for adverse gastrointestinal, renal, and coagulation effects. DATA SOURCES Human and veterinary peer reviewed literature VETERINARY DATA SYNTHESIS NSAIDs are frequently administered to critically ill horses for their analgesic and anti-inflammatory effects. However, NSAIDs have significant side effects principally on the gastrointestinal mucosa and kidneys. These side effects may be exacerbated in critically ill horses if they have gastrointestinal damage or are volume depleted CONCLUSIONS This review provides important information for equine veterinarians and criticalists on the advantages and disadvantages of using traditional NSAIDs and newer equine COX-2 selective NSAIDs for the management of different conditions in critically ill horses.
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Affiliation(s)
- Vanessa L Cook
- From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI (Cook); and
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Hopster-Iversen CCS, Hopster K, Staszyk C, Rohn K, Freeman DE, Rötting AK. Effects of experimental mechanical manipulations on local inflammation in the jejunum of horses. Am J Vet Res 2014; 75:385-91. [PMID: 24669925 DOI: 10.2460/ajvr.75.4.385] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine characteristics of the inflammatory reaction in the jejunum of horses in response to various mechanical manipulations. ANIMALS 12 adult warm blood horses without gastrointestinal tract disorders. PROCEDURES The proximal aspect of the jejunum in each horse was divided into 5 segments, and the following manipulations were performed: manual emptying, placement of Doyen forceps, enterotomy alone, enterotomy with mucosal abrasion, and serosal abrasion. Jejunum samples were collected before (control), immediately after, and 30 minutes after the end of manipulations and histologically evaluated to determine distribution of neutrophils and eosinophils. RESULTS Macroscopically, all manipulations resulted in jejunal hemorrhage and edema. Compared with control samples, neutrophil numbers were significantly higher after manipulations in the serosa (after all manipulation types), circular muscle layer (after manual emptying), submucosa (after placement of Doyen forceps), and mucosa (after all manipulations except enterotomy alone). Eosinophil numbers were significantly higher in the submucosa after mechanical abrasion of the serosa and manual emptying versus control samples. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated mechanical manipulation of the jejunum resulted in local inflammatory reactions characterized predominantly by infiltration of neutrophils. This could contribute to the development of postoperative ileus or adhesions in horses without macroscopically detectable injury of the jejunum during surgery.
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28
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Hudson NPH, Pirie RS. Equine post operative ileus: A review of current thinking on pathophysiology and management. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- N. P. H. Hudson
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; Easter Bush Campus Roslin Midlothian UK
| | - R. S. Pirie
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; Easter Bush Campus Roslin Midlothian UK
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29
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Anderson SL, Duke-Novakovski T, Singh B. The immune response to anesthesia: part 2 sedatives, opioids, and injectable anesthetic agents. Vet Anaesth Analg 2014; 41:553-66. [PMID: 24962601 DOI: 10.1111/vaa.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/24/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To review the immune response to injectable anesthetics and sedatives and to compare the immunomodulatory properties between inhalation and injectable anesthetic protocols. STUDY DESIGN Review. METHODS AND DATABASES Multiple literature searches were performed using PubMed and Google Scholar from March 2012 through November 2013. Relevant anesthetic and immune terms were used to search databases without year published or species constraints. The online database for Veterinary Anaesthesia and Analgesia and the Journal of Veterinary Emergency and Critical Care were searched by issue starting in 2000 for relevant articles. CONCLUSION Sedatives, injectable anesthetics, opioids, and local anesthetics have immunomodulatory effects that may have positive or negative consequences on disease processes such as endotoxemia, generalized sepsis, tumor growth and metastasis, and ischemia-reperfusion injury. Therefore, anesthetists should consider the immunomodulatory effects of anesthetic drugs when designing anesthetic protocols for their patients.
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Affiliation(s)
- Stacy L Anderson
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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30
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Gozalo-Marcilla M, Gasthuys F, Schauvliege S. Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 1: lidocaine and ketamine. Vet Anaesth Analg 2014; 41:335-45. [PMID: 24815750 DOI: 10.1111/vaa.12179] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. These drugs include lidocaine, ketamine, opioids and α2 -agonists. The Part 1 of this review will focus in the use of lidocaine and ketamine. DATABASES USED Pubmed & Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, lidocaine, ketamine. CONCLUSIONS Different drugs and their combinations can be administered systemically in anaesthetized horses, with the aim of reducing the amount of the volatile agent whilst improving the recovery qualities and providing a multimodal analgesic approach. However, full studies as to whether these techniques improve cardiopulmonary status are not always available and potential disadvantages should also be considered.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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31
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Slone EA, Fleming SD. Membrane lipid interactions in intestinal ischemia/reperfusion-induced Injury. Clin Immunol 2014; 153:228-40. [PMID: 24814240 DOI: 10.1016/j.clim.2014.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 04/10/2014] [Accepted: 04/29/2014] [Indexed: 01/02/2023]
Abstract
Ischemia, lack of blood flow, and reperfusion, return of blood flow, are a common phenomenon affecting millions of Americans each year. Roughly 30,000 Americans per year experience intestinal ischemia-reperfusion (IR), which is associated with a high mortality rate. Previous studies of the intestine established a role for neutrophils, eicosanoids, the complement system and naturally occurring antibodies in IR-induced pathology. Furthermore, data indicate involvement of a lipid or lipid-like moiety in mediating IR-induced damage. It has been proposed that antibodies recognize exposure of neo-antigens, triggering action of the complement cascade. While it is evident that the pathophysiology of IR-induced injury is complex and multi-factorial, we focus this review on the involvement of eicosanoids, phospholipids and neo-antigens in the early pathogenesis. Lipid changes occurring in response to IR, neo-antigens exposed and the role of a phospholipid transporter, phospholipid scramblase 1 will be discussed.
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Affiliation(s)
- Emily Archer Slone
- College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
| | - Sherry D Fleming
- Division of Biology, Kansas State University, Manhattan, KS 66506, USA.
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33
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Guedes AGP, Matthews NS, Hood DM. Effect of ketamine hydrochloride on the analgesic effects of tramadol hydrochloride in horses with signs of chronic laminitis-associated pain. Am J Vet Res 2012; 73:610-9. [PMID: 22533391 DOI: 10.2460/ajvr.73.5.610] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of ketamine hydrochloride on the analgesic effects of tramadol hydrochloride in horses with signs of pain associated with naturally occurring chronic laminitis. ANIMALS 15 client-owned adult horses with chronic laminitis. PROCEDURES Each horse received tramadol alone or tramadol and ketamine in a randomized, crossover study (≥ 2 months between treatments). Tramadol (5 mg/kg) was administered orally every 12 hours for 1 week. When appropriate, ketamine (0.6 mg/kg/h) was administered IV for 6 hours on each of the first 3 days of tramadol administration. Noninvasive systemic blood pressure values, heart and respiratory rates, intestinal sounds, forelimb load and off-loading frequency (determined via force plate system), and plasma tumor necrosis factor-α and thromboxane B(2) concentrations were assessed before (baseline) during (7 days) and after (3 days) each treatment. RESULTS Compared with baseline data, arterial blood pressure decreased significantly both during and after tramadol-ketamine treatment but not with tramadol alone. Forelimb off-loading frequency significantly decreased during the first 3 days of treatment with tramadol only, returning to baseline frequency thereafter. The addition of ketamine to tramadol treatment reduced off-loading frequency both during and after treatment. Forelimb load did not change with tramadol alone but increased with tramadol-ketamine treatment. Plasma concentrations of tumor necrosis factor-α and thromboxane B(2) were significantly reduced with tramadol-ketamine treatment but not with tramadol alone. CONCLUSIONS AND CLINICAL RELEVANCE In horses with chronic laminitis, tramadol administration induced limited analgesia, but this effect was significantly enhanced by administration of subanesthetic doses of ketamine.
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Affiliation(s)
- Alonso G P Guedes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
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Reed SK, Middleton JR, Ringen D, Nagy D. Use of cecal bypass via side-to-side ileocolic anastomosis without ileal transection for treatment of ileocecal intussusception in a Vietnamese pot-bellied pig (Sus scrofa). J Am Vet Med Assoc 2012; 241:237-40. [PMID: 22765371 DOI: 10.2460/javma.241.2.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 5-year-old castrated male Vietnamese pot-bellied pig (Sus scrofa) was evaluated because of anorexia, vomiting, diarrhea, and weight loss. CLINICAL FINDINGS Hypermotile gastrointestinal sounds were noted on abdominal auscultation. An inflammatory leukogram, dehydration, prerenal azotemia, hyponatremia, hypochloremia, hyperproteinemia, hyperglobulinemia, hypomagnesemia, and high γ-glutamyl transpeptidase activity were identified. Transabdominal ultrasonography revealed distended loops of small intestine. TREATMENT IV fluid therapy and analgesic treatment were unsuccessful in the resolution of clinical signs. Exploratory laparotomy revealed an ileocecal intussusception involving the distal portion of the ileum. Distal ileal and cecal bypass were achieved via side-to-side anastomosis of the proximal portion of the ileum and spiral colon with a gastrointestinal anastomosis stapler. Ileal transection or occlusion was not performed. Postoperative complications were minimal, and the pig was clinically normal 15 months after surgery and required no special care or diet. CLINICAL RELEVANCE Distal ileal and cecal bypass without ileal transection have not been described previously in Vietnamese pot-bellied pigs. Anastomosis of the proximal portion of the ileum to the spiral colon without major complications represents a novel, technically simple approach to bypass of the distal portion of the ileum and cecum.
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Affiliation(s)
- Shannon K Reed
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
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35
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Apophyseal avulsion fracture of the greater trochanter of the femur in a Thoroughbred filly. Vet Comp Orthop Traumatol 2012; 25:342-7. [PMID: 22695748 DOI: 10.3415/vcot-11-11-0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 03/21/2012] [Indexed: 11/17/2022]
Abstract
The case report of a 14-month-old Thoroughbred filly with acute onset of severe right hindlimb lameness is presented. The horse had a severe and sudden abduction of the hindlimbs due to a side effect of an overdose of lidocaine, which had been administered in a constant rate infusion after a colic surgery. Transcutaneous ultrasonography and standing radiography of the pelvis revealed proximal and cranial displacement of the greater trochanter and free bone fragments consistent with an apophyseal avulsion fracture of the greater trochanter. The complete diagnosis was obtained with the horse in a standing position. The filly was euthanatized because of deterioration resulting from the colic condition and of the poor prognosis of the fracture of the greater trochanter. Postmortem evaluation confirmed an apophyseal avulsion fracture of the right greater trochanter. To the authors' knowledge, ultrasonographic and radiographic findings of this fracture have not been described in the standing horse. The diagnosis was reached quite easily with the horse in a normal standing position when the characteristic ultrasonographic and radiographic findings were detected.
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Marshall JF, Blikslager AT. The effect of nonsteroidal anti-inflammatory drugs on the equine intestine. Equine Vet J 2012:140-4. [PMID: 21790769 DOI: 10.1111/j.2042-3306.2011.00398.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in the management of pain and endotoxaemia associated with colic in the horse. While NSAIDs effectively treat the symptoms of colic, there is evidence to suggest that their administration is associated with adverse gastrointestinal effects including right dorsal colitis and inhibition of mucosal barrier healing. Several studies have examined the pathophysiology of NSAID associated effects on the large and small intestine in an effort to avoid these complications and identify effective alternative medications. Differences in the response of the large and small intestines to injury and NSAID treatment have been identified. Flunixin meglumine has been shown in the small intestine to inhibit barrier function recovery and increase permeability to lipopolysaccharide (LPS). A range of NSAIDs has been examined in the small intestine and experimental evidence suggests that those NSAIDs with cyclooxygenase independent anti-inflammatory effects or a COX-2 selective mode of action may offer significant advantages over traditional NSAIDs.
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Affiliation(s)
- J F Marshall
- Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK.
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Alcott C, Sponseller B, Wong D, Davis J, Soliman A, Wang C, Hsu W. Clinical and Immunomodulating Effects of Ketamine in Horses with Experimental Endotoxemia. J Vet Intern Med 2011; 25:934-43. [DOI: 10.1111/j.1939-1676.2011.0749.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cuervo-Arango J, Domingo-Ortiz R. Systemic treatment with high dose of flunixin-meglumine is able to block ovulation in mares by inducing hemorrhage and luteinisation of follicles. Theriogenology 2011; 75:707-14. [DOI: 10.1016/j.theriogenology.2010.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 10/12/2010] [Accepted: 10/12/2010] [Indexed: 10/18/2022]
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Wong DM, Davis JL, White NA. Motility of the equine gastrointestinal tract: Physiology and pharmacotherapy. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2010.00173.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Managing pain in horses afflicted by chronic laminitis is one of the greatest challenges in equine clinical practice because it is the dreadful suffering of the animals that most often forces the veterinarian to end the battle with this disease. The purpose of this review is to summarize our current understanding of the complex mechanisms involved in generating and amplifying pain in animals with laminitis and, based on this information, to propose a modified approach to pain therapy. Furthermore, a recently developed pain scoring technique is presented that may help better quantify pain and the monitoring of responses to analgesic treatment in horses with laminitis.
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Effect of intravenous lidocaine administration on laminar inflammation in the black walnut extract model of laminitis. Equine Vet J 2010; 42:261-9. [DOI: 10.2746/042516409x475760] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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