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Michotte M, Raes E, Oosterlinck M. Diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds. Equine Vet J 2024. [PMID: 38199977 DOI: 10.1111/evj.14050] [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: 04/16/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The diagnostic value of plain radiography for diagnosing synovial penetration in limb wounds near synovial structures has not been determined. OBJECTIVES To assess diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds. STUDY DESIGN Retrospective case study. METHODS Case records of horses presented to the Faculty of Veterinary Medicine of Ghent University (2011-2021) with limb wounds near synovial structures were categorised in groups with and without synovial penetration using results of synovial fluid analysis and surgical findings. Plain radiographic images were evaluated retrospectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the total study sample and for the cases with and without use of a metallic probe in the wound during radiographic evaluation. RESULTS Based on the total sample of 141 horses with synovial penetration and 75 cases without synovial involvement, plain radiography presented a sensitivity of 61% (95% CI: 52%-69%), a specificity of 81% (95% CI: 70%-89%), a PPV of 86% (95% CI: 79%-90%) and a NPV of 53% (95% CI: 46%-58%). With the use of a metallic probe, a sensitivity of 54% (95% Cl: 39%-69%), a specificity of 88% (95% Cl: 64%-99%), a PPV of 93% (95% Cl: 78%-98%) and a NPV of 41% (95% Cl: 32%-49%) were obtained. MAIN LIMITATIONS Sample size did not allow comparing different synovial structures. Results can be influenced by individual case characteristics. CONCLUSIONS If findings of a series of plain radiographs suggest synovial penetration in horses with a wound near a synovial cavity, then synovial penetration is likely, but the absence of plain radiographic findings does not rule out synovial penetration. The use of a metallic probe during radiography may be helpful. However, plain radiography should be interpreted cautiously, and clinical decision making should also include other techniques.
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Affiliation(s)
- Marie Michotte
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Els Raes
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Maarten Oosterlinck
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Neutrophil Gelatinase-Associated Lipocalin in Synovial Fluid from Horses with and without Septic Arthritis. Animals (Basel) 2022; 13:ani13010029. [PMID: 36611638 PMCID: PMC9817893 DOI: 10.3390/ani13010029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) has been suggested to be a highly sensitive and specific marker of joint infection in humans. The aim of the study was to investigate NGAL concentrations in synovial fluid (SF) from horses with septic synovitis, horses without septic synovitis, and horses with uncertain status. NGAL was measured in 177 admission samples obtained from 152 horses. From a subset of horses (n = 35), additional samples obtained sequentially over the course of treatment were available. Concentrations of NGAL were significantly higher in septic synovitis (n = 47 samples) than in samples classified as non-septic (n = 103) or samples with uncertain status (n = 27), with median NGAL concentrations in the three groups being 1236, 16.8, and 266.4 µg/L, respectively. NGAL discriminated nearly perfectly between septic and non-septic (area under the receiver operating characteristic curve 0.98, 95% confidence interval 0.95-1.00). The optimal cut-off value for maximal sensitivity (87.2%) and specificity (75.0%) to discriminate septic samples from those with uncertain status was 444.6 µg/L, with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval 0.74-0.93). Concentrations declined over time in horses undergoing treatment. NGAL is a novel biomarker that seems to have great potential for identifying septic synovitis and for monitoring the response to treatment of synovial infection in horses.
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Strootmann T, Spitzbarth I, della Tommasa S, Brehm W, Köller G, Troillet A. Synovial Fluid Analysis and Microscopic Assessment of Macrophage Quantities and Morphology in Equine Septic Arthritis. Tierarztl Prax Ausg G Grosstiere Nutztiere 2022; 50:377-385. [DOI: 10.1055/a-1956-5245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Objective Research and provision of data on macrophages by cytological synovial fluid analysis and light microscopy in horses with septic arthritis
Material and methods Records of 167 synovial fluid samples were evaluated and subdivided into different groups: (1) non-septic, (2) haematogenous septic arthritis in foals and (3) traumatic/iatrogenic septic arthritis. The effect of joint lavage on synovial fluid cytology and on the occurrence of macrophage phenotypes was investigated.
Results Regardless of aetiology and age of the horse, macrophage concentrations in synovial sepsis are decreased to a median of 5–6 % (unaffected joints: 23.5 %) and further diminished by joint lavage. Microscopic assessment led to the identification of 4 phenotypes. Morphological characteristics of type 1 showed similarities to monocytes and predominated in unaffected and in septic joints after lavage.
Conclusion and clinical relevance Macrophages are highly versatile by altering their phenotype. A morphological assessment by light microscopy is easily applicable. Type 1 presumably contributes to joint homeostasis.
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Affiliation(s)
- Teresa Strootmann
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University
| | - Ingo Spitzbarth
- Institute for Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University
| | | | - Walter Brehm
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University
| | - Gabor Köller
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University
| | - Antonia Troillet
- Clinic for Horses, Faculty of Veterinary Medicine, Ludwig-Maximilians-University
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4
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Pezzanite LM, Chow L, Phillips J, Griffenhagen GM, Moore AR, Schaer TP, Engiles JB, Werpy N, Gilbertie J, Schnabel LV, Antczak D, Miller D, Dow S, Goodrich LR. TLR-activated mesenchymal stromal cell therapy and antibiotics to treat multi-drug resistant Staphylococcal septic arthritis in an equine model. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1157. [PMID: 36467344 PMCID: PMC9708491 DOI: 10.21037/atm-22-1746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/23/2022] [Indexed: 01/29/2024]
Abstract
BACKGROUND Rapid development of antibiotic resistance necessitates advancement of novel therapeutic strategies to treat infection. Mesenchymal stromal cells (MSC) possess antimicrobial and immunomodulatory properties, mediated through antimicrobial peptide secretion and recruitment of innate immune cells including neutrophils and monocytes. TLR-3 activation of human, canine and equine MSC has been shown to enhance bacterial killing and clearance in vitro, in rodent Staphylococcal biofilm infection models and dogs with spontaneous multi-drug-resistant infections. The objective of this study was to determine if intra-articular (IA) TLR-3-activated MSC with antibiotics improved clinical parameters and reduced bacterial counts and inflammatory cytokine concentrations in synovial fluid (SF) of horses with induced septic arthritis. METHODS Eight horses were inoculated in one tarsocrural joint with multidrug-resistant Staphylococcus aureus (S. aureus). Bone marrow-derived MSC from three unrelated donors were activated with TLR-3 agonist polyinosinic, polycytidylic acid (pIC). Recipient horses received MSC plus vancomycin (TLR-MSC-VAN), or vancomycin (VAN) alone, on days 1, 4, 7 post-inoculation and systemic gentamicin. Pain scores, quantitative bacterial counts (SF, synovium), SF analyses, complete blood counts, cytokine concentrations (SF, plasma), imaging changes (MRI, ultrasound, radiographs), macroscopic joint scores and histologic changes were assessed. Results were reported as mean ± SEM. RESULTS Pain scores (d7, P=0.01, 15.2±0.2 vs. 17.9±0.5), ultrasound (d7, P=0.03, 9.0±0.6 vs. 11.8±0.5), quantitative bacterial counts (SF d7, P=0.02, 0±0 vs. 3.4±0.4; synovium P=0.003, 0.4±0.4 vs. 162.7±18.4), systemic neutrophil (d4, P=0.03, 4.6±0.6 vs. 7.8±0.6) and serum amyloid A (SAA) (d4, P=0.01, 1,106.0±659.0 vs. 2,858.8±141.3; d7, P=0.02, 761.8±746.2 vs. 2,357.3±304.3), and SF lactate (d7, P<0.0001, 5.4±0.2 vs. 15.0±0.3), SAA (endterm, P=0.01, 0.0 vs. 2,094.0±601.6), IL-6 (P=0.03, 313.0±119.2 vs. 1,328.2±208.9), and IL-18 (P=0.02, 11.1±0.5 vs. 13.3±3.8) were improved in TLR-MSC-VAN vs. VAN horses. Study limitations include the small horse sample size, short study duration, and lack of additional control groups. CONCLUSIONS Combined TLR-activated MSC with antibiotic therapy may be a promising approach to manage joint infections with drug resistant bacteria.
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Affiliation(s)
- Lynn M. Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Lyndah Chow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jennifer Phillips
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Gregg M. Griffenhagen
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - A. Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Thomas P. Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Julie B. Engiles
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
- Department of Pathobiology, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | | | - Jessica Gilbertie
- Department of Microbiology and Immunology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA
| | - Lauren V. Schnabel
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, North Carolina State University, Raleigh, NC, USA
| | - Doug Antczak
- Baker Institute, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Donald Miller
- Baker Institute, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Steven Dow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Laurie R. Goodrich
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Brock AK, Chamoun-Emanuelli AM, Howard EA, Huntzinger KD, Lawhon SD, Bryan LK, Cosgriff-Hernandez EM, Cohen ND, Whitfield-Cargile CM. Wound swabs versus biopsies to detect methicillin resistant Staphylococcus aureus in experimental equine wounds. Vet Surg 2022; 51:1196-1205. [PMID: 36102600 PMCID: PMC9588683 DOI: 10.1111/vsu.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 07/10/2022] [Accepted: 07/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare: (1) the load and diversity of cultivatable bacterial species isolated from tissue biopsies with cultures from surface swabs, and (2) the ability of each technique to detect methicillin-resistant Staphylococcus aureus (MRSA) in a model of MRSA-infected equine wounds. STUDY DESIGN Experimental in vivo study. ANIMALS Three light-breed adult horses. METHODS Four 2.5 × 2.5 cm full-thickness skin wounds were created on the dorsolateral aspect of each forelimb. Five days later, each wound was inoculated with a pure culture of MRSA (ATCC 43300). One hundred microlitres of 0, 5 × 108 , 5 × 109 or 5 × 1010 colony forming units (CFU)/ml was used to inoculate each wound. Surface swabs (Levine technique) and tissue biopsy samples (3 mm punch biopsy) were obtained at 2, 7, 14, and 21 days after inoculation. Quantitative aerobic culture was performed using routine clinical techniques. RESULTS A similar bacterial profile was identified from the culture of each wound-sampling technique and there was moderate correlation (R = 0.49, P < .001) between the bacterial bioburdens. Agreement was fair (κ = 0.31; 95% CI, 0.129-0.505) between the sampling techniques in identification of MRSA. Methicillin-resistant Staphylococcus aureus was isolated more frequently (P = .016) from cultures of tissue biopsies (79%; 76/96) than from surface swabs (62%; 60/96). CONCLUSION Bacterial load and diversity did not differ between sampling techniques but MRSA was detected more often from the cultures of tissue biopsies. CLINICAL SIGNIFICANCE Tissue biopsy should be preferred to culture swab in wounds where MRSA is suspected.
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Affiliation(s)
- Abbi K. Brock
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Ana M. Chamoun-Emanuelli
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Emily A. Howard
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Katie D. Huntzinger
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Sara D. Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Laura K. Bryan
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | | | - Noah D. Cohen
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Canaan M. Whitfield-Cargile
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843
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Sloan PB, Self KA, Kang Q, Lutter JD. Equine heel bulb lacerations: 62 cases (2004–2018). J Am Vet Med Assoc 2022; 260:1541-1546. [DOI: 10.2460/javma.22.03.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To characterize clinical findings and outcomes for horses with heel bulb lacerations.
ANIMALS
Medical records of a teaching hospital were reviewed to identify horses treated for heel bulb lacerations between February 2004 and October 2018. Long-term outcome was assessed by telephone communication with owners. Results were analyzed to determine association with clinical outcome.
RESULTS
31 mares and 31 geldings of various ages, breeds, and uses were evaluated. Thirty-six horses had a wound of 0 to 2 days’ duration, and 17 horses had a wound of > 2 days’ duration. Horses with a wound duration of < 2 days had a significantly greater likelihood of a higher outcome score (P = .025; OR = 7.08; 95% CI = 1.28% to 39.08%). Synovial communication with the wound was confirmed in 21 of 62 (33.9%) horses. One synovial structure was involved in 17 horses, and > 1 synovial structure was involved in 4 horses. Fifty-nine horses survived to discharge, and follow-up information was available for 18 (30.5%) horses. Of the horses available for follow-up, 78% returned to the previous level of work (14/18). Degree of lameness at presentation, degree of wound contamination, treatment prior to presentation, treatment with foot casting, and involvement of synovial structures were not found to be significantly associated with clinical outcome.
CLINICAL RELEVANCE
Results suggest that horses with heel bulb lacerations have a good prognosis for survival and a favorable prognosis for return to work. Clinical application of additional findings needs further investigation before clinical relevance can be ascertained.
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Affiliation(s)
- Pearce B. Sloan
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | | | - Qing Kang
- Department of Statistics, College of Arts and Sciences, Kansas State University, Manhattan, KS
| | - J. Dylan Lutter
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
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Gillingham J, Mair TS. Surgical treatment of synovial sepsis: Is endoscopy the best approach? EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fürst AE, Lischer CJ. Other Clinical Problems of the Equine Foot. Vet Clin North Am Equine Pract 2021; 37:695-721. [PMID: 34782100 DOI: 10.1016/j.cveq.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Many disorders affect the equine foot, and many hoof problems have multiple predisposing causes. Surgery may be necessary after conservative management has failed. Diseases of the hoof capsule may seem simple, but their effect on performance can be long-lasting and healing is often prolonged. Diagnosis of problems within the hoof capsule is enhanced with the use of computed tomography and MRI. The prognosis of fractures has improved with strategic placement of lag screws across fracture planes using aiming devices and advanced intraoperative imaging techniques. Collaboration between the clinician and a skilled farrier is important for successful management of hoof disorders.
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Affiliation(s)
- Anton E Fürst
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland.
| | - Christoph J Lischer
- Faculty of Veterinary Medicine, Equine Clinic, Freie Universität Berlin, Oertzenweg 19b, Berlin 14163, Germany
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Kilcoyne I, Nieto JE. Orthopedic Infections-Clinical Applications of Intravenous Regional Limb Perfusion in the Field. Vet Clin North Am Equine Pract 2021; 37:275-291. [PMID: 34243876 DOI: 10.1016/j.cveq.2021.04.003] [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] [Indexed: 11/18/2022] Open
Abstract
For the equine veterinarian, orthopedic emergencies are a common occurrence in clinical practice, with traumatic wounds of the distal limb and penetrating injuries of the hoof being some of the most common medical conditions to affect horses. Intravenous regional limb perfusion is a technique widely used for the treatment of orthopedic infections in horses. The objectives of this review are to discuss some of the clinical applications for this treatment modality in the field and to review the technique for the practitioner.
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Affiliation(s)
- Isabelle Kilcoyne
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, One Shields Avenue, Davis, CA 95616, USA.
| | - Jorge E Nieto
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, One Shields Avenue, Davis, CA 95616, USA
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Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ. Meropenem Administered via Intravenous Regional Limb Perfusion for Orthopedic Sepsis in Horses: A Clinical Retrospective Study. Front Vet Sci 2021; 8:629627. [PMID: 33842571 PMCID: PMC8033006 DOI: 10.3389/fvets.2021.629627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/16/2021] [Indexed: 11/19/2022] Open
Abstract
Septic synovitis is a critical orthopedic condition in horses. Early intervention is key, with antibiotic therapy typically initiated prior to culture and susceptibility reports becoming available. The pharmacokinetics of several antibiotics have been studied in horses for use in intravenous regional limb perfusion (IVRLP) for septic synovitis, including the carbapenem antibiotic, meropenem. For a variety of factors, some veterinary clinicians may select IVRLP meropenem as therapy for these cases. Meropenem is a vital antibiotic in human medicine, making veterinary use divisive. However, verifying the efficacy of meropenem contrasted to other IVRLP antibiotics is essential for appropriate antimicrobial stewardship. To investigate this, equine patient medical records at a single veterinary teaching hospital were examined. Cases treated with meropenem or gentamicin via IVRLP for septic synovitis were retrospectively analyzed for demographics, diagnostics, treatments, outcomes, and adverse effects. Twenty-three meropenem and 37 gentamicin treated horses were analyzed; demographic information was similar between groups. In the meropenem group, nine horses received meropenem only; the remainder received another antibiotic initially then changed to meropenem. Structures infected included joints (meropenem = 13, gentamicin = 17), tendon sheaths (meropenem = 5, gentamicin = 8) and navicular bursae (meropenem = 2, gentamicin = 6). Overall survival to discharge was 86% (52/60), with meropenem 91% (21/23) and gentamicin 84% (31/37), with no statistically significant differences noted between meropenem or gentamicin groups for overall survival to discharge or outcome after discharge. Twenty-four of 26 bacterial isolates obtained from culture were reported as sensitive to imipenem, a carbapenem antibiotic similar to meropenem. Reported susceptibility to other antibiotics such as ceftiofur (n = 22/26), ampicillin (n = 18/26), amikacin (n = 15/26), or gentamicin (n = 12/26) was also frequently present. In the population of this study, antimicrobial activity augmented with IVRLP using either meropenem or gentamicin both appear to be an effective treatment for septic synovial structures, therefore, less critical antimicrobials may be a viable and more judicious treatment option.
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Affiliation(s)
- Allison P. Mosichuk
- College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Joseph S. Smith
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
- Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Dane M. Tatarniuk
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Jarrod R. Troy
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Amanda J. Kreuder
- Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
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Frydendal C, Nielsen KB, Berg LC, van Galen G, Adler DMT, Andreassen SM, Jacobsen S. Influence of clinical and experimental intra-articular inflammation on neutrophil gelatinase-associated lipocalin concentrations in horses. Vet Surg 2021; 50:641-649. [PMID: 33522003 PMCID: PMC8048826 DOI: 10.1111/vsu.13582] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/09/2020] [Accepted: 12/17/2020] [Indexed: 01/26/2023]
Abstract
Objective To investigate neutrophil gelatinase‐associated lipocalin (NGAL) concentrations in serum and synovial fluid (SF) from horses with joint inflammation. Study design Experimental studies and retrospective clinical study. Sample population Serum and SF samples were available from healthy horses (n = 19), clinical cases, and horses with experimental joint inflammation. Clinical cases included horses with (n = 10) or without (n = 10) septic arthritis. Experimental intra‐articular inflammation was induced by lipopolysaccharide (LPS; n = 7, severe inflammation), lidocaine (n = 6, moderate inflammation), or mepivacaine (n = 6, mild inflammation). Methods Availability of samples was based on approval from the local ethical committee and from the Danish Animal Experiments Inspectorate. Neutrophil gelatinase‐associated lipocalin was measured with a previously validated enzyme‐linked immunosorbent assay. Repeated‐measurements one‐ and two‐way analysis of variance and correlation analysis were used to analyze NGAL concentrations and white blood cell counts (WBC). Results After injection of LPS or lidocaine, SF NGAL concentrations increased 343‐ (P = .0035) and 60‐fold (P = .0038) relative to baseline, respectively. Serum NGAL also increased in both groups (P < .05) but to lower concentrations than in SF. Concentrations were higher after injection of lidocaine SF NGAL than after injection of mepivacaine (P < .05) at 6 and 12 hours. Synovial fluid concentrations of NGAL were higher in horses with septic arthritis than in the nonseptic group (P = .0070) and in healthy controls (P = .0071). Concentrations of NGAL correlated with WBC in SF (P < .0001, R2 = 0.49) and in blood (P = .0051, R2 = 0.27). Conclusion Neutrophil gelatinase‐associated lipocalin concentrations increased in SF in response to experimentally induced and naturally occurring joint inflammation. Synovial fluid NGAL concentration correlated with WBC and, thus, seems to reflect intensity of joint inflammation. Clinical significance Neutrophil gelatinase‐associated lipocalin may prove to be a useful biomarker of joint inflammation and infection in horses.
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Affiliation(s)
- Catina Frydendal
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katrine B Nielsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lise C Berg
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gaby van Galen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ditte M T Adler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stine M Andreassen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stine Jacobsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
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