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Haralambus R, Juri M, Mokry A, Jenner F. The impact of opioid administration on the incidence of postanaesthetic colic in horses. Front Pain Res (Lausanne) 2024; 5:1347548. [PMID: 38440199 PMCID: PMC10910105 DOI: 10.3389/fpain.2024.1347548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
Effective management of postoperative pain is essential to ensure patient welfare, reduce morbidity and optimize recovery. Opioids are effective in managing moderate to severe pain in horses but concerns over their adverse effects on gastrointestinal (GI) motility and associated increased colic risk limit their widespread use. Studies investigating the impact of systemic opioids on both GI motility and colic incidence in horses have yielded inconclusive outcomes. Therefore, this retrospective study aims to assess the influence of systemic administration of butorphanol, morphine, and methadone on post-anaesthetic colic (PAC) incidence. Horses undergoing general anaesthesia for non-gastrointestinal procedures that were hospitalized for at least 72 h post-anaesthesia were included in this study. Anaesthetised horses were stratified by procedure type into horses undergoing diagnostic imaging without surgical intervention, emergency or elective surgery. In addition, patients were grouped by opioid treatment regime into horses receiving no opioids, intraanaesthetic, short- (<24 h) or long-term (>24 h) postoperative opioids. Administered opioids encompassed butorphanol, morphine and methadone. The number of horses showing signs of colic in the 72 h after anaesthesia was assessed for each group. A total of 782 horses were included, comprising 659 undergoing surgical procedures and 123 undergoing diagnostic imaging. The overall PAC incidence was 15.1%. Notably, horses undergoing diagnostic imaging without surgery had a significantly lower PAC rate of 6.5% compared to those undergoing surgery (16.7%, p = 0.0146). Emergency surgeries had a significantly lower PAC rate of 5.8% compared to elective procedures (18%, p = 0.0113). Of the 782 horses, 740 received intraoperative opioids and 204 postoperative opioids, 102 of which long-term (≥24 h). Neither intraoperative (p = 0.4243) nor short-term postoperative opioids (p = 0.5744) increased PAC rates. Notably, only the long-term (≥24 h) administration of morphine significantly increased PAC incidence to 34% (p = 0.0038). In contrast, long-term butorphanol (5.3% PAC, p = 0.8482) and methadone (18.4% PAC, p = 0.6161) did not affect PAC rates. In summary, extended morphine administration was the only opioid treatment associated with a significantly increased risk of PAC.
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Affiliation(s)
- Rhea Haralambus
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Florien Jenner
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Schoiswohl J, Eibl C, Haralambus R, Lipnik K, Schieder K, Franz S. T-cell-lymphoma presented as a solitary subcutaneous mass in the ventral cervical region of an adult llama- diagnostic and treatment. BMC Vet Res 2022; 18:62. [PMID: 35105366 PMCID: PMC8805260 DOI: 10.1186/s12917-022-03158-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neoplasm in South American camelids (SAC) are commonly described. The most frequently reported type of neoplasm are lymphomas and difference in the age suffering from lymphomas of and llamas is seen. This report describes a case of a solitary lymphoma in a 5 years and 9 month old llama mare displaying the approach of diagnostic imaging and successful surgical treatment. CASE PRESENTATION The llama was referred to the clinic for dyspnoea and inspiratory abnormal respiratory sounds. The clinical examination comprised blood cell count, ultrasonographic and radiographic examinations, endoscopy and fine needle aspiration cytology of a mass detected in the mid cervical region. The mass was surgically removed. Histopathological examination of the surgically removed mass diagnosed a malignant T-cell- lymphoma. According to the results of the clinical, ultrasonographic and radiographic examinations no tumor invasion was apparent in distant organs and the llama was discharged from the clinic seven days after surgery. CONCLUSION Lymphoma has been reported to be the most common neoplasia in camelids and are more often described in young alpacas and in adult llamas. To the author´s knowledge the case presented here is the first that described a broad panel of diagnostic tools including ultrasound, radiographs, endoscopy, fine needle aspiration cytology and histopathoogical examination as well as a successful surgical treatment of a solitary lymphoma in camelids.
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Affiliation(s)
- Julia Schoiswohl
- Department for Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Vienna, Austria.
| | - Cassandra Eibl
- Department for Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Vienna, Austria
| | - Rhea Haralambus
- Department/Hospital for Companion Animals and Horses, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Wien, Austria
| | - Karoline Lipnik
- Institute of Pathology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Vienna, Austria
| | - Katrin Schieder
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Vienna, Austria
| | - Sonja Franz
- Department for Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärpl. 1, 1210, Vienna, Austria
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Haralambus R, Florczyk A, Sigl E, Gültekin S, Vogl C, Brandt S, Schnierer M, Gamerith C, Jenner F. Detection of synovial sepsis in horses using enzymes as biomarker. Equine Vet J 2021; 54:513-522. [PMID: 33977535 PMCID: PMC9290786 DOI: 10.1111/evj.13459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/10/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Background Synovial sepsis is a commonly occurring, potentially career‐ending or even life‐threatening orthopaedic emergency. Diagnosis of synovial sepsis is currently primarily based on synovial fluid analysis, which often leaves diagnostic ambiguity due to overlap of clinicopathological parameters between septic and aseptic inflammatory synovitis. Objectives To evaluate the reliability of lysozyme (LYS), myeloperoxidase (MPO) and elastase (ELT) as biomarkers for synovial sepsis in horses using a photometric assay to measure increased enzyme activity. Study design Prospective, single‐blinded, analytical, clinical study. Methods Equine synovial samples were assigned to one of three groups: (1) healthy controls (n = 10), (2) aseptic (n = 27) and (3) septic synovitis (n = 30). The enzyme activity assays (LYS, MPO and ELT) were compared with standard synovial fluid parameters and broad‐range bacterial 16S rDNA PCR. Results LYS and MPO activities were significantly different between septic synovial samples, and both aseptic and control samples (P < .001, LYS: confidence interval [CI]: 2.25‐3.41, resp., 2.21‐3.8, MPO: CI 0.752‐1.6, resp., 0.639‐1.81). LYS achieved a 100% sensitivity and 100% specificity in differentiating between septic and aseptic (cut‐off value 751.4) or control (cut‐off: 484.6) samples (P < .001). MPO reached 93.33% sensitivity, 100% specificity for distinguishing septic from control (cut‐off value: 0.1254) synovial samples and 93.33% sensitivity, 81.48% specificity for discriminating between septic and aseptic (cut‐off value: 0.1305) synovial samples (P < .001). ELT activity could not be measured in any synovial sample. Both the LYS and the MPO measurements showed a highly significant correlation with PCR (LYS r = .79, MPO r = .69), synovial leukocyte count (LYS r = .752, MPO r = .571), % neutrophils (LYS r = .751, MPO r = 0.663) and each other (r = .744, all P < .001). Main limitations Variation in horses’ signalment, affected synovial structures and synovial fluid freezing times may have affected the discriminative power of this study. Conclusions Increased MPO and LYS activities allow reliable, rapid diagnosis of synovial sepsis with high sensitivity and specificity.
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Affiliation(s)
- Rhea Haralambus
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Agnieszka Florczyk
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Eva Sigl
- Qualizyme Diagnostics GmbH & Co KG, Neue Stiftingtalstraße 2, Graz, Austria
| | - Sinan Gültekin
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Claus Vogl
- Department of Biomedical Sciences, Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Sabine Brandt
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Marlies Schnierer
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Clemens Gamerith
- Qualizyme Diagnostics GmbH & Co KG, Neue Stiftingtalstraße 2, Graz, Austria.,Department of Environmental Biotechnology, University of Natural Resources and Life Sciences Vienna, Tulln an der Donau, Austria
| | - Florien Jenner
- Department of Companion Animals and Horses, Equine Surgery Unit, University of Veterinary Medicine Vienna, Vienna, Austria
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von Ritgen S, Böhler A, Rosser J, Haralambus R, Florczyk A. Polytrauma Patient With Upper Airway Obstruction—Case Report. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2016.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Witte TH, Wilke M, Stahl C, Jandová V, Haralambus R, Straub R. Use of a hand-assisted laparoscopic surgical technique for closure of an extensive mesojejunal rent in a horse. J Am Vet Med Assoc 2013; 243:1166-9. [PMID: 24094265 DOI: 10.2460/javma.243.8.1166] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 7-year-old 573-kg (1,261 -lb) Swiss Warmblood gelding was evaluated because of signs of acute abdominal pain. CLINICAL FINDINGS Physical examination revealed a markedly distended abdomen with subjectively reduced borborygmi in all abdominal quadrants. A large, gas-distended viscus was present at the pelvic brim preventing complete palpation of the abdomen per rectum. Ultrasonographic evaluation could not be safely performed in the initial evaluation because of severe signs of abdominal pain. TREATMENT AND OUTCOME Ventral midline celiotomy was performed, and right dorsal displacement of the ascending colon was corrected. Progressive signs of abdominal pain after surgery prompted repeat ventral midline celiotomy, and small intestinal incarceration in a large, radial mesojejunal rent was detected. The incarceration was reduced, but the defect was not fully accessible for repair via the celiotomy. Repair of the mesenteric defect was not attempted, and conservative management was planned after surgery; however, signs of colic returned. A standard laparoscopic approach was attempted from both flanks in the standing patient, but the small intestine could not be adequately mobilized for full evaluation of the rent. Hand-assisted laparoscopic surgery (HALS) allowed identification and reduction of jejunal incarceration and repair of the mesenteric rent. Although minor ventral midline incisional complications were encountered, the horse recovered fully. CLINICAL RELEVANCE HALS techniques should be considered for repair of mesenteric rents in horses. In the horse of this report, HALS facilitated identification, evaluation, and repair of a large radial mesenteric rent that was not accessible from a ventral median celiotomy.
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Affiliation(s)
- Thomas H Witte
- Swiss Institute of Equine Medicine, Vetsuisse Faculty, University of Bern CH-3012, Bern, Switzerland., Research Station ALP-Haras, Schwarzenburgstrasse 161, 3003 Bern, Switzerland
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Stadler S, Kainzbauer C, Haralambus R, Brehm W, Hainisch E, Brandt S. Successful treatment of equine sarcoids by topical aciclovir application. Vet Rec 2011; 168:187. [DOI: 10.1136/vr.c5430] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S. Stadler
- Pferdeklinik Tillysburg; Bruck bei Hausleiten 11 4490 St Florian Austria
| | - C. Kainzbauer
- Equine Biotechnology Unit; Large Animal Surgery and Orthopaedics, Equine Clinic; University of Veterinary Medicine; Veterinaerplatz 1 1210 Vienna Austria
| | - R. Haralambus
- Large Animal Surgery and Orthopaedics, Equine Clinic; University of Veterinary Medicine; Veterinaerplatz 1 1210 Vienna Austria
| | - W. Brehm
- Faculty of Veterinary Medicine; University of Leipzig; An den Tierkliniken 21 04103 Leipzig Germany
| | - E. Hainisch
- Large Animal Surgery and Orthopaedics, Equine Clinic; University of Veterinary Medicine; Veterinaerplatz 1 1210 Vienna Austria
| | - S. Brandt
- Equine Biotechnology Unit; Large Animal Surgery and Orthopaedics, Equine Clinic; University of Veterinary Medicine; Veterinaerplatz 1 1210 Vienna Austria
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Brandt S, Haralambus R, Schoster A, Kirnbauer R, Stanek C. Peripheral blood mononuclear cells represent a reservoir of bovine papillomavirus DNA in sarcoid-affected equines. J Gen Virol 2008; 89:1390-1395. [PMID: 18474554 DOI: 10.1099/vir.0.83568-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Bovine papillomaviruses of types 1 and 2 (BPV-1 and -2) chiefly contribute to equine sarcoid pathogenesis. However, the mode of virus transmission and the presence of latent infections are largely unknown. This study established a PCR protocol allowing detection of <or=10 copies of the BPV-1/-2 genes E5 and L1. Subsequent screening of peripheral blood mononuclear cell (PBMC) DNA derived from horses with and without BPV-1/2-induced skin lesions demonstrated the exclusive presence of E5, but not L1, in PBMCs of BPV-1/2-infected equines. To validate this result, a blind PCR was performed from enciphered PBMC DNA derived from 66 horses, revealing E5 in the PBMCs of three individuals with confirmed sarcoids, whereas the remaining 63 sarcoid-free animals were negative for this gene. L1 could not be detected in any PBMC DNA, suggesting either deletion or interruption of this gene in PBMCs of BPV-1/-2-infected equines. These results support the hypothesis that PBMCs may serve as host cells for BPV-1/-2 DNA and contribute to virus latency.
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Affiliation(s)
- Sabine Brandt
- Equine Centre, Veterinary University Vienna, Vienna, Austria
| | - Rhea Haralambus
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Berne, Berne, Switzerland.,Equine Centre, Veterinary University Vienna, Vienna, Austria
| | | | - Reinhard Kirnbauer
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University Vienna, Vienna, Austria
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Brandt S, Haralambus R, Shafti-Keramat S, Steinborn R, Stanek C, Kirnbauer R. A subset of equine sarcoids harbours BPV-1 DNA in a complex with L1 major capsid protein. Virology 2008; 375:433-41. [PMID: 18395238 DOI: 10.1016/j.virol.2008.02.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 11/30/2007] [Accepted: 02/14/2008] [Indexed: 10/22/2022]
Abstract
Bovine papillomavirus type 1 or 2 (BPV-1, BPV-2) are accepted causal factors in equine sarcoid pathogenesis. Whereas viral genomes are consistently found and expressed within lesions, intact virions have never been detected, thus permissiveness of sarcoids for BPV-1 replication remains unclear. To reassess this issue, an immunocapture PCR (IC/PCR) was established using L1-specific antibodies to capture L1-DNA complexes followed by amplification of the viral genome. Following validation of the assay, 13 sarcoid-bearing horses were evaluated by IC/PCR. Samples were derived from 21 tumours, 4 perilesional/intact skin biopsies, and 1 serum. Tissue extracts from sarcoid-free equines served as controls. IC/PCR scored positive in 14/24 (58.3%) specimens obtained from sarcoid-patients, but negative for controls. Quantitative IC/PCR demonstrated <125 immunoprecipitable viral genomes/50 microl extract for the majority of specimens. Moreover, full-length BPV-1 genomes were detected in a complex with L1 proteins. These complexes may correspond to virion precursors or intact virions.
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Affiliation(s)
- S Brandt
- Equine Biotechnology Unit (EBU), Equine Centre, Veterinary University Vienna, Vienna, Austria.
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