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- Author or Editor: Annette M. McCoy x
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Abstract
OBJECTIVE
To evaluate synoviocentesis of the equine forelimb digital flexor tendon sheath (DFTS) via a basilar sesamoidean approach (BSA) or distal approach (DA).
ANIMALS
21 healthy adult horses without DFTS-related lameness.
PROCEDURES
The forelimbs of each horse underwent the BSA or DA (21 limbs/approach) performed by 1 individual. The volume of synovial fluid (SF) aspirated, time from skin puncture to collection of SF, and number of attempts to place a needle in the DFTS were compared between approaches.
RESULTS
An SF sample was successfully aspirated from 16 of 21 (76%) limbs with the BSA and 20 of 21 (95%) limbs with the DA. For the BSA and DA, the number of attempts to obtain SF was 2 and 1, respectively; the median volume of SF obtained was 0.4 and 0.7 mL, respectively; and the median time to SF collection was 17.91 and 18.48 seconds, respectively. Between the approaches, the number of limbs with SF successfully aspirated and number of attempts to collect SF differed significantly, whereas the volume of SF aspirated and time to SF collection did not.
CONCLUSIONS AND CLINICAL RELEVANCE
Regarding SF collection from forelimb DFTSs in horses without DFTS-related disease, use of the DA had a greater success rate with fewer attempts, compared with findings for the BSA, which may reflect the relative ease of identifying anatomic landmarks for the DA. Results suggested that a DA for DFTS synoviocentesis in horses appears efficient and effective and may minimize limb trauma by requiring fewer attempts for SF sample collection, compared with a BSA.
Abstract
OBJECTIVE
To evaluate the effect of the cyclooxygenase-2–selective NSAID firocoxib, compared to the nonselective NSAID flunixin meglumine on viscoelastic coagulation parameters in healthy horses.
ANIMALS
12 healthy adult mixed-breed horses.
PROCEDURES
Following a crossover protocol, horses were administered flunixin meglumine (1.1 mg/kg, IV, q 12 h for 5 days), allowed a 6-month washout period, and then administered firocoxib (0.3 mg/kg, PO, once, then 0.1 mg/kg, PO, q 24 h for 4 days). Omeprazole (1 mg/kg, PO, q 24 h) was administered concurrently with each NSAID. Viscoelastic coagulation profiles and traditional coagulation parameters (prothrombin time, partial thromboplastin time, and fibrinogen) were measured before and after each treatment.
RESULTS
Viscoelastic coagulation parameters were within reference intervals before and after both treatments. There was a statistically significant difference between treatments for amplitude at 10 minutes after clot time (P = .02) and maximum clot formation (P = .02); however, the magnitude of change was not clinically significant.
CLINICAL RELEVANCE
Short-term administration of flunixin meglumine and firocoxib did not result in significant alteration of viscoelastic coagulation profiles in healthy horses. However, clinicians should be aware of possible coagulopathy secondary to NSAID administration with long-term use or critical illness, and further study is indicated.
Abstract
OBJECTIVE
To characterize the pharmacokinetics of a clinically relevant dose of misoprostol administered PO or per rectum (PR) to horses.
ANIMALS
8 healthy adult horses.
PROCEDURES
In a randomized 3-way crossover design, horses received a single dose of misoprostol (5 μg/kg) administered PO (with horses fed and unfed) and PR, with a minimum 3-week washout period separating the experimental conditions. Blood samples were obtained before and at various points after drug administration (total, 24 hours), and plasma concentrations of misoprostol free acid were measured.
RESULTS
Mean maximum plasma concentration of misoprostol was significantly higher in the PR condition (mean ± SD, 967 ± 492 pg/mL) and unfed PO condition (655 ± 259 pg/mL) than in the fed PO condition (352 ± 109 pg/mL). Mean area under the concentration-versus-time curve was significantly lower in the PR condition (219 ± 131 pg•h/mL) than in the unfed (1,072 ± 360 pg•h/mL) and fed (518 ± 301 pg•h/mL) PO conditions. Mean time to maximum concentration was ≤ 30 minutes for all conditions. Mean disappearance half-life was shortest in the PR condition (21 ± 29 minutes), compared with values for the unfed (170 ± 129 minutes) and fed (119 ± 51 minutes) PO conditions. No adverse effects were noted.
CONCLUSIONS AND CLINICAL RELEVANCE
Misoprostol was rapidly absorbed and eliminated regardless of whether administered PO or PR to horses. Rectal administration may be a viable alternative for horses that cannot receive misoprostol PO, but this route may require more frequent administration to maintain therapeutic drug concentrations.
Abstract
Case Description—5 Vietnamese potbellied pigs were evaluated for abdominal distress that had not responded to medical treatment (4 pigs) or a draining tract of the cranial abdomen of unknown duration (1 pig).
Clinical Findings—Clinical signs in the pigs included anorexia, vomiting, and constipation. Physical examination revealed a palpable abdominal mass in all pigs. Radiography revealed distended loops of small intestine in 2 pigs.
Treatment and Outcome—3 pigs were treated successfully with wide-margin excision of the abdominal masses, and 2 were euthanized. Primary tumors were diagnosed at necropsy or through histologic evaluation of biopsy specimens obtained during surgery. Types of tumor included cholangiocellular carcinoma, transmural gastric carcinoma, small intestinal adenocarcinoma, metastatic hepatocellular carcinoma, and carcinoma. The tumors involved the stomach, small intestine, spiral colon, liver, and gall bladder. All 3 surgically treated pigs survived at least 9 months after surgery.
Clinical Relevance—Although rare, neoplasia of the alimentary system should be considered among the differential diagnoses for potbellied pigs with signs of abdominal distress. Wide-margin excision of the neoplastic tissue may result in a good outcome in affected pigs.
Abstract
OBJECTIVE
To describe misoprostol pharmacokinetics and anti-inflammatory efficacy when administered orally or per rectum in endotoxin-challenged horses.
ANIMALS
6 healthy geldings.
PROCEDURES
A randomized 3-treatment crossover design was performed with a minimum washout period of 28 days between treatment arms. Prior to endotoxin challenge (lipopolysaccharide, 30 ng/kg IV over 30 minutes), horses received misoprostol (5 µg/kg once) per os (M-PO) or per rectum (M-PR) or water as control (CON). Clinical parameters were evaluated and blood samples obtained to measure plasma misoprostol free acid concentration, leukocyte counts, and tumor necrosis factor-α (TNFα) and interleukin 6 (IL-6) leukocyte gene expression and serum concentrations.
RESULTS
In the M-PO treatment arm, maximum plasma concentration and area under the concentration-versus-time curve (mean ± SD) were higher (5,209 ± 3,487 pg/mL and 17,998,254 ± 13,194,420 h·pg/mL, respectively) and median (interquartile range) time to maximum concentration (25 min [18 to 34 min]) was longer than in the M-PR treatment arm (854 ± 855 pg/mL; 644,960 ± 558,866 h·pg/mL; 3 min [3 to 3.5 min]). Significant differences in clinical parameters, leukocyte counts, and TNFα or IL-6 gene expression or serum protein concentration were not detected. Downregulation of relative gene expression was appreciated for individual horses in the M-PO and M-PR treatment arms at select time points.
CLINICAL RELEVANCE
Considerable variability in measured parameters was detected among horses within and between treatment arms. Misoprostol absorption and systemic exposure after PO administration differed from previous reports in horses not administered LPS. Investigation of multidose administration of misoprostol is warranted to better evaluate efficacy as an anti-inflammatory therapeutic.
Abstract
OBJECTIVE
To compare the pharmacokinetics between repeated doses and to characterize changes in the fecal microbiome after oral and rectal multidose misoprostol administration.
ANIMALS
6 healthy university-owned geldings.
PROCEDURES
In a randomized, crossover study, misoprostol (5 μg/kg) was administered orally or rectally every 8 hours for 10 doses, or not administered (control), with a 21-day washout between treatments. Concentration-versus-time data for dose 1 and dose 10 were subject to noncompartmental analysis. For microbiota analysis using 16S rRNA amplicon sequencing, manure was collected 7 days before study onset, immediately before dose 1, and 6 hours, 7 days, and 14 days after dose 10, with time-matched points in controls.
RESULTS
Repeated dosing-related differences in pharmacokinetic parameters were not detected for either administration route. The area under the concentration-versus-time curve was greater (P < .04) after oral versus rectal administration. The relative bioavailability of rectal administration was 4 to 86% of that of oral administration. Microbial composition, richness, and β-diversity differed among subjects (P < .001 all) while only composition differed between treatments (P ≤ .01). Richness was decreased 6 hours after dose 10 and at the control-matched time point (P = .0109) in all subjects. No other differences for time points, treatments, or their interactions were observed.
CLINICAL RELEVANCE
Differences in systemic exposure were associated with the route of administration but were not detected after repeated administration of misoprostol. Differences in microbiota parameters were primarily associated with interindividual variation and management rather than misoprostol administration.
Abstract
OBJECTIVES
To evaluate suturing skills of veterinary students using 3 common performance assessments (PAs) and to compare findings to data obtained by an electromyographic armband.
SAMPLE
16 second-year veterinary students.
PROCEDURES
Students performed 4 suturing tasks on synthetic tissue models 1, 3, and 5 weeks after a surgical skills course. Digital videos were scored by 4 expert surgeons using 3 PAs (an Objective Structured Clinical Examination [OSCE]- style surgical binary checklist, an Objective Structured Assessment of Technical Skill [OSATS] checklist, and a surgical Global Rating Scale [GRS]). Surface electromyography (sEMG) data collected from the dominant forearm were input to machine learning algorithms. Performance assessment scores were compared between experts and correlated to task completion times and sEMG data. Inter-rater reliability was calculated using the intraclass correlation coefficient (ICC). Inter-rater agreement was calculated using percent agreement with varying levels of tolerance.
RESULTS
Reliability was moderate for the OSCE and OSATS checklists and poor for the GRS. Agreement was achieved for the checklists when moderate tolerance was applied but remained poor for the GRS. sEMG signals did not correlate well with checklist scores or task times, but features extracted from signals permitted task differentiation by routine statistical comparison and correct task classification using machine learning algorithms.
CLINICAL RELEVANCE
Reliability and agreement of an OSCE-style checklist, OSATS checklist, and surgical GRS assessment were insufficient to characterize suturing skills of veterinary students. To avoid subjectivity associated with PA by raters, further study of kinematics and EMG data is warranted in the surgical skills evaluation of veterinary students.
