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Przewoźny M, Senderska-Płonowska M, Rząsa A, Wierzbicki H, Borkowski J, Swagemakers JH, Żak-Bochenek A, Stefaniak T. Usefulness of Selected Acute-Phase Proteins in the Postsurgical Monitoring of Arthroscopy and Splint Bone Removal in Horses. Animals (Basel) 2021; 11:ani11102952. [PMID: 34679973 PMCID: PMC8532912 DOI: 10.3390/ani11102952] [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: 08/09/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary The study shows the changes in concentration of acute phase proteins (fibrinogen, haptoglobin, protease inhibitors) in the serum of patients from the equine clinic. Blood was collected from horses that underwent arthroscopy (41 horses) and splint bone removal (13 horses). The concentration of the above-mentioned proteins was recorded from the time before the surgery until the 28th day after the surgery and compared to a control group of healthy horses (60 horses). Acute phase proteins change their concentration before clinical symptoms appear; therefore, they could play a key role in early recognition and preventing complications. Abstract Background: Arthroscopy and splint bone removal are the common orthopedic procedures in horses. Estimation of the dynamics of acute phase proteins in postoperative monitoring seems to be interesting diagnostic approach. The aim of the study was to investigate changes in the concentrations of plasma inflammatory markers—fibrinogen, haptoglobin, and protease inhibitors—following orthopedic surgery in horses. The study involved 114 horses, divided into two study groups undergoing: arthroscopy (41 horses) and splint bone removal (13 horses). The control group consisted of 60 healthy horses. The blood was collected before the surgery and 24, 48, 72 h, 5, 7, 10, 14 and 28 days after the surgery. Plasma fibrinogen, serum haptoglobin and proteinase inhibitors were measured. Results: In non-complicated cases of arthroscopy and splint bone removal, fibrinogen and haptoglobin increased stepwise from 24 h, achieved the maximum level at 72 h and returned to preoperative levels after 10–14 days. In one complicated case after arthroscopy surgery the marked increase in fibrinogen and haptoglobin concentrations was observed 24 h earlier than standard parameters of inflammation Conclusion: The study shows the evolution of APPs after arthroscopy and splint bone removal in 28 days postsurgery period and in the case of one complicated case of arthroscopy.
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Affiliation(s)
- Maciej Przewoźny
- Klinika dla Koni Equi Vet Serwis Dr Maciej Przewoźny, 64-320 Buk, Poland;
| | - Magdalena Senderska-Płonowska
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, Wrocław University of Environmental and Life Sciences, 50-137 Wrocław, Poland; (A.R.); (A.Ż.-B.); (T.S.)
- Correspondence:
| | - Anna Rząsa
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, Wrocław University of Environmental and Life Sciences, 50-137 Wrocław, Poland; (A.R.); (A.Ż.-B.); (T.S.)
| | - Heliodor Wierzbicki
- Department of Genetics, University of Environmental and Life Sciences, 50-137 Wrocław, Poland;
| | - Jacek Borkowski
- Department of Biochemistry, Academy of Physical Education, 50-137 Wrocław, Poland;
| | | | - Agnieszka Żak-Bochenek
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, Wrocław University of Environmental and Life Sciences, 50-137 Wrocław, Poland; (A.R.); (A.Ż.-B.); (T.S.)
| | - Tadeusz Stefaniak
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, Wrocław University of Environmental and Life Sciences, 50-137 Wrocław, Poland; (A.R.); (A.Ż.-B.); (T.S.)
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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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Wright L, Ekstrøm CT, Kristoffersen M, Lindegaard C. Haematogenous septic arthritis in foals: Short- and long-term outcome and analysis of factors affecting prognosis. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L. Wright
- Evidensia Equine Specialist Hospital; Helsingborg Sweden
| | - C. T. Ekstrøm
- Section of Biostatistics; Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | | | - C. Lindegaard
- Evidensia Equine Specialist Hospital; Helsingborg Sweden
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Loftin PG, Beard WL, Guyan ME, White BJ. Comparison of Arthroscopic Lavage and Needle Lavage Techniques, and Lavage Volume on the Recovery of Colored Microspheres From the Tarsocrural Joints of Cadaver Horses. Vet Surg 2016; 45:240-5. [PMID: 26773461 DOI: 10.1111/vsu.12442] [Citation(s) in RCA: 4] [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: 11/28/2022]
Abstract
OBJECTIVE To quantify recovery of colored microspheres from normal cadaver tarsocrural joints using arthroscopic or needle lavage with 1-5 L of fluid. STUDY DESIGN Ex vivo experimental study. ANIMALS Adult Quarter Horse cadavers (n = 8). METHODS After euthanasia, 1.5 × 10(6) colored microspheres were injected into each tarsocrural joint. Each joint was randomly assigned to receive lavage (5 L 0.9% NaCl) with an arthroscope (dorsomedial arthroscope and dorsolateral egress cannula) or three 14 g needles (dorsomedial ingress, dorsolateral, and plantarolateral egress). Egress fluid from each liter was collected separately over time and the number of microspheres present in each recovered liter determined by spectrophotometry. RESULTS A significant interaction was present between treatment group and liter of fluid (P < .01). The number of microspheres recovered in the first liter of lavage fluid was significantly higher in the needle lavage group than in the arthroscopic lavage group (P < .01). For both groups, the number of microspheres recovered in the first liter of lavage fluid represented a majority of the total microspheres collected and was significantly different from each subsequent liter collected (P < .01). The number of microspheres recovered did not differ between liters 2, 3, 4, and 5 within or between treatment groups. CONCLUSION In this model, tarsocrural lavage with three 14 g needles was more effective at removing colored microspheres from the joint than arthroscopic lavage, suggesting that the number or placement of portals present may be more important than portal size and flow rate. No difference in microsphere recovery was seen with lavage volumes >1 L.
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Affiliation(s)
- Patrick G Loftin
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
| | - Warren L Beard
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
| | - Megan E Guyan
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
| | - Brad J White
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
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Abstract
OBJECTIVE To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. STUDY DESIGN Retrospective case series. ANIMALS Foals (n = 8). METHODS Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic signs, surgical technique and perioperative treatment. Follow-up radiographs were evaluated and outcome was determined from veterinary examination, race records, and telephone questionnaire. RESULTS Six foals survived long term (15 months-4 years); all had intralesional and systemic antimicrobial therapy, along with synovial lavage and antimicrobial medication. All were sound and achieved either yearling sales (n=3), show hunter or racing (2). Two foals died in the short term from renal failure and suppurative peritonitis secondary to cecal perforation, 1 remaining lame with suppurative osteonecrosis confirmed at necropsy. This foal was not administered intralesional antimicrobial therapy. CONCLUSIONS Prompt medical and surgical therapy for osteomyelitis of the patella can result in a good prognosis for soundness and a potential athletic career. Concurrent septicemia or other systemic perinatal disease can result in prolonged therapy and delayed recovery.
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Clutterbuck AL, Harris P, Allaway D, Mobasheri A. Matrix metalloproteinases in inflammatory pathologies of the horse. Vet J 2008; 183:27-38. [PMID: 19022687 DOI: 10.1016/j.tvjl.2008.09.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Revised: 09/05/2008] [Accepted: 09/30/2008] [Indexed: 01/09/2023]
Abstract
The extracellular matrix (ECM) of connective tissue is constantly being remodelled to allow for growth and regeneration. Normal tissue maintenance requires the ECM components to be degraded and re-synthesised in relatively equal proportions. This degradation is facilitated by matrix metalloproteinases (MMPs) and their proteolytic action is controlled primarily by the tissue inhibitors of metalloproteinases (TIMPs). Both MMPs and TIMPs exist in a state of dynamic equilibrium, with a slight excess of one or the other depending on the need for either ECM breakdown or synthesis. Long-term disruption to this balance between MMPs and TIMPs will have pathological consequences. Matrix metalloproteinases are involved in a number of diseases in mammals, including the horse. Excess MMP activity can cause ECM destruction, as seen in the lamellar basement membrane in laminitis and the articular cartilage in osteoarthritis. Matrix metalloproteinase under-activity can potentially impede healing by preventing fibrinolysis in fibrotic conditions and the removal of scar tissue in wounds. Matrix metalloproteinases also degrade non-ECM proteins and regulate cell behaviour via the release of growth factors from the substrates they cleave, increasing the scope of their effects. This review looks at the involvement of MMPs in equine health and pathologies, whilst exploring the potential consequences of therapeutic intervention.
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Affiliation(s)
- Abigail L Clutterbuck
- Division of Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, College Road, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom
| | - Pat Harris
- WALTHAM Centre for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Melton Mowbray, Leicestershire, LE14 4RT, United Kingdom
| | - David Allaway
- WALTHAM Centre for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Melton Mowbray, Leicestershire, LE14 4RT, United Kingdom
| | - Ali Mobasheri
- Division of Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, College Road, Sutton Bonington, Leicestershire, LE12 5RD, United Kingdom.
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Abstract
AbstractDegenerative joint diseases, such as osteoarthritis, adversely impact the health of the equine athlete as well as the economics of the equine industry. Our understanding of the aetiology of osteoarthritis, although not nearly exhaustive, has increased substantially in recent years. Molecules, including cytokines, inflammatory mediators, and metalloproteinases, have been identified and associated with the progression of joint disease. Several factors, including trauma to the joint, immobilization, conformation, shoeing, and ageing, have been linked with osteoarthritis. Our continued efforts into elucidating critical biological mediators and risk factors, coupled with better chondroprotective therapies and diagnostic tools, should facilitate our ability to maintain the skeletal health of the equine athlete
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Ivester KM, Adams SB, Moore GE, Van Sickle DC, Lescun TB. Gentamicin concentrations in synovial fluid obtained from the tarsocrural joints of horses after implantation of gentamicin-impregnated collagen sponges. Am J Vet Res 2006; 67:1519-26. [PMID: 16948595 DOI: 10.2460/ajvr.67.9.1519] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine synovial fluid gentamicin concentrations and evaluate adverse effects on the synovial membrane and articular cartilage of tarsocrural joints after implantation of a gentamicin-impregnated collagen sponge. ANIMALS 6 healthy adult mares. PROCEDURES A purified bovine type I collagen sponge impregnated with 130 mg of gentamicin was implanted in the plantarolateral pouch of 1 tarsocrural joint of each horse, with the contralateral joint used as a sham-operated control joint. Gentamicin concentrations in synovial fluid and serum were determined for 120 hours after implantation by use of a fluorescence polarization immunoassay. Synovial membrane and cartilage specimens were collected 120 hours after implantation and evaluated histologically. RESULTS Median peak synovial fluid gentamicin concentration of 168.9 microg/mL (range, 115.6 to 332 microg/mL) was achieved 3 hours after implantation. Synovial fluid gentamicin concentrations were < 4 microg/mL by 48 hours. Major histologic differences were not observed in the synovial membrane between control joints and joints implanted with gentamicin-impregnated sponges. Safranin-O fast green stain was not reduced in cartilage specimens obtained from treated joints, compared with those from control joints. CONCLUSIONS AND CLINICAL RELEVANCE Implantation of a gentamicin-impregnated collagen sponge in the tarsocrural joint of horses resulted in rapid release of gentamicin, with peak concentrations > 20 times the minimum inhibitory concentration reported for common pathogens that infect horses. A rapid decrease in synovial fluid gentamicin concentrations was detected. The purified bovine type I collagen sponges did not elicit substantial inflammation in the synovial membrane or cause mechanical trauma to the articular cartilage.
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Affiliation(s)
- Kathleen M Ivester
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
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Lescun TB, Ward MP, Adams SB. Gentamicin concentrations in synovial fluid and joint tissues during intravenous administration or continuous intra-articular infusion of the tarsocrural joint of clinically normal horses. Am J Vet Res 2006; 67:409-16. [PMID: 16506901 DOI: 10.2460/ajvr.67.3.409] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare gentamicin concentrations achieved in synovial fluid and joint tissues during IV administration and continuous intra-articular (IA) infusion of the tarsocrural joint in horses. ANIMALS 18 horses with clinically normal tarsocrural joints. PROCEDURE Horses were assigned to 3 groups (6 horses/group) and administered gentamicin (6.6 mg/kg, IV, q 24 h for 4 days; group 1), a continuous IA infusion of gentamicin into the tarsocrural joint (50 mg/h for 73 hours; group 2), or both treatments (group 3). Serum, synovial fluid, and joint tissue samples were collected for measurement of gentamicin at various time points during and 73 hours after initiation of treatment. Gentamicin concentrations were compared by use of a Kruskal-Wallis ANOVA. RESULTS At 73 hours, mean +/- SE gentamicin concentrations in synovial fluid, synovial membrane, joint capsule, subchondral bone, and collateral ligament of group 1 horses were 11.5 +/- 1.5 microg/mL, 21.1 +/- 3.0 microg/g, 17.1 +/- 1.4 microg/g, 9.8 +/- 2.0 microg/g, and 5.9 +/- 0.7 microg/g, respectively. Corresponding concentrations in group 2 horses were 458.7 +/- 130.3 microg/mL, 496.8 +/- 126.5 microg/g, 128.5 +/- 74.2 microg/g, 99.4 +/- 47.3 microg/g, and 13.5 +/- 7.6 microg/g, respectively. Gentamicin concentrations in synovial fluid, synovial membrane, and joint capsule of group 1 horses were significantly lower than concentrations in those samples for horses in groups 2 and 3. CONCLUSIONS AND CLINICAL RELEVANCE Continuous IA infusion of gentamicin achieves higher drug concentrations in joint tissues of normal tarsocrural joints of horses, compared with concentrations after IV administration.
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Affiliation(s)
- Timothy B Lescun
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47909-1248, USA
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Mills ML, Rush BR, St Jean G, Gaughan EM, Mosier D, Gibson E, Freeman L. Determination of synovial fluid and serum concentrations, and morphologic effects of intraarticular ceftiofur sodium in horses. Vet Surg 2000; 29:398-406. [PMID: 10999453 DOI: 10.1053/jvet.2000.9141] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine the serum and synovial fluid concentrations of ceftiofur sodium after intraarticular (IA) and intravenous (IV) administration and to evaluate the morphologic changes after intraarticular ceftiofur sodium administration. STUDY DESIGN Strip plot design for the ceftiofur sodium serum and synovial fluid concentrations and a split plot design for the cytologic and histopathologic evaluation. ANIMALS Six healthy adult horses without lameness. METHODS Stage 1: Ceftiofur sodium (2.2 mg/kg) was administered IV. Stage 2: 150 mg (3 mL) of ceftiofur sodium (pHavg 6.57) was administered IA into 1 antebrachiocarpal joint. The ceftiofur sodium was reconstituted with sterile sodium chloride solution (pH 6.35). The contralateral joint was injected with 3 mL of 0.9% sterile sodium chloride solution (pH 6.35). Serum and synovial fluid samples were obtained from each horse during each stage. For a given stage, each type of sample (serum or synovial fluid) was collected once before injection and 12 times after injection over a 24-hour period. All horses were killed at 24 hours, and microscopic evaluation of the cartilage and synovium was performed. Serum and synovial fluid concentrations of ceftiofur sodium were measured by using a microbiologic assay, and pharmacokinetic variables were calculated. Synovial fluid was collected from the active joints treated during stage 2 at preinjection and postinjection hours (PIH) 0 (taken immediately after injection of either the ceftiofur sodium or sodium chloride), 12, and 24, and evaluated for differential cellular counts, pH, total protein concentration, and mucin precipitate quality. RESULTS Concentrations of ceftiofur in synovial fluid after IA administration were significantly higher (P = .0001) than synovial fluid concentrations obtained after IV administration. Mean peak synovial fluid concentrations of ceftiofur after IA and IV administration were 5825.08 microg/mL at PIH .25 and 7.31 microg/mL at PIH 4, respectively. Mean synovial fluid ceftiofur concentrations at PIH 24 after IA and IV administration were 4.94 microg/mL and .12 microg/mL, respectively. Cytologic characteristics of synovial fluid after IA administration did not differ from cytologic characteristics after IA saline solution administration. White blood cell counts after IA ceftiofur administration were < or =3,400 cells/ML. The mean synovial pH of ceftiofur treated and control joints was 7.32 (range, 7.08-7.5) and 7.37 (range, 7.31-7.42), respectively. Grossly, there were minimal changes in synovium or cartilage, and no microscopic differences were detected (P = .5147) between ceftiofur-treated joints and saline-treated joints. The synovial half-life of ceftiofur sodium after IA administration joint was 5.1 hours. CONCLUSIONS Synovial concentrations after intraarticular administration of 150 mg of ceftiofur sodium remained elevated above minimal inhibitory concentration (MIC90) over 24 hours. After 2.2 mg/kg IV, the synovial fluid ceftiofur concentration remained above MIC no longer than 8 hours. CLINICAL RELEVANCE Ceftiofur sodium may be an acceptable broad spectrum antimicrobial to administer IA in septic arthritic equine joints.
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Affiliation(s)
- M L Mills
- Department of Veterinary Clinical Sciences, Kansas State University, Manhattan, USA
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Yarbrough TB, Lee MR, Hornof WJ, Koblik PD, Brodack J, Troup C, O'Brien TR, Pool R. Samarium 153-labeled hydroxyapatite microspheres for radiation synovectomy in the horse: a study of the biokinetics, dosimetry, clinical, and morphologic response in normal metacarpophalangeal and metatarsophalangeal joints. Vet Surg 2000; 29:191-9. [PMID: 10730712 DOI: 10.1111/j.1532-950x.2000.00191.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the effects of Samarium-153 bound to hydroxyapatite microspheres (153SmM) when injected into the metacarpophalangeal and metatarsophalangeal joints of horses. STUDY DESIGN - Horses were injected with 153SmM in metacarpophalangeal and metatarsophalangeal joints with the diagonal contralateral joints used as untreated controls. ANIMALS OR SAMPLE POPULATION Twelve adult horses without pre-existing disease involving the metacarpo/metatarsophalangeal joints. METHODS Horses were divided into three groups: high-dose Samarium-153 (12.5 to 17.0 millicurie [mCi]), intermediate dose (6.5 to 12.0 mCi), and low dose (3.5 to 6.0 mCi). Horses were examined daily for 7 days postinjection for clinical abnormalities, lameness, and surface and systemic radiation levels. One horse from each group was euthanatized at 14, 30, and 60 days postinjection and the effects of the 153SmM examined microscopically in the cartilage and synovial membrane. RESULTS Intraarticular(153)SmM caused inflammation characterized by lameness, effusion, and regional edema for 48 to 72 hours. Minimal levels of active 153SmM were identified in the blood or urine and were well below the maximal tolerance of 1 mCi. Microscopically the radiation caused no effects on the articular cartilage. The synovectomy created was good but not ideal in that some areas did have necrosis into the subintimal regions and a few islands of intact intimal cells persisted. CONCLUSIONS The use of 153SmM is an effective means of targeting the synovial intimal cells with minimal extrasynovial leakage of radiation. CLINICAL RELEVANCE The metacarpophalangeal and metatarsophalangeal joints of the horse can be safely treated with 153SmM without damage to the cartilage or significant extracapsular leakage.
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Affiliation(s)
- T B Yarbrough
- Department of Surgical and Radiologic Sciences, University of California, Davis 95616, USA
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Abstract
Matrix metalloproteinases (MMPs) may be important in the destruction of cartilage seen in equine osteoarthritis and may be detectable in synovial fluid. Synovial fluids were obtained from normal equine joints and from joints of horses with aseptic and septic joint diseases. The total MMP gelatinase enzyme activities were measured by gelatin zymography and image analysis of the gels. The bioactivity of gelatinase in synovial fluid was determined by a gelatin degradation ELISA. Potential MMP-2 & MMP-9 monomer enzyme activities were significantly elevated in both septic and aseptic joint disease synovial fluids in comparison to fluids from normal joints. The dimer form of MMP-9 enzyme activity was significantly elevated in fluids from septic joint disease cases in comparison to fluids form normal joints, but not fluids from horses with aseptic joint diseases. MMP-9 monomer and dimer levels in synovial fluids correlated with the synovial fluid white blood cell count. Using the gelatin degradation ELISA to measure net active gelatinases, significant increases in gelatinase bioactivities were seen in synovial fluids from both aseptic and septic joint disease cases. The enzymes in equine joint diseases were present in a bioactive form, in that they were present in the activated form and present in excess of inhibitors, and could therefore be important in the degradation of articular cartilage in joint disease.
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Affiliation(s)
- P D Clegg
- Department of Veterinary Clinical Science and Animal Husbandry, University Veterinary Teaching Hospital, University of Liverpool, Leahurst, UK
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Hanson JA, Seeherman HJ, Kirker-Head CA, O'Callaghan MW. The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis. Equine Vet J 1996; 28:480-8. [PMID: 9049498 DOI: 10.1111/j.2042-3306.1996.tb01621.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space.
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Affiliation(s)
- J A Hanson
- Section of Radiology, Tufts University School of Veterinary Medicine, North Grafton, Massachusetts 01536, USA
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19
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Abstract
Orthopedic infections-those involving bones, joints, tendon sheaths, or bursae-are some of the most difficult problems for equine surgeons to treat successfully. Sources of the infection are usually hematogenous, traumatic, or iatrogenic and knowledge of the most likely causative bacteria is very useful in selecting the most appropriate antimicrobial(s) to either prevent or treat these infections in horses. This article discusses the clinical findings, diagnosis, treatment, and prevention of orthopedic infections in horses. More recent treatment methods such as synovial drainage techniques (arthroscopy and arthrotomy), intrasynovial antimicrobials, regional perfusion of antimicrobials, and antimicrobial-impregnated polymethylmethacrylate (PMMA) beads or cylinders are also addressed.
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Affiliation(s)
- G M Baxter
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, USA
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20
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Abstract
Diagnosis and treatment of congenital and acquired tendon disorders in cattle are discussed. A brief discussion of tendon structure, anatomy, biomechanics, and healing is included. Congenital abnormalities presented include hyperextension deformities, flexural deformities, arthrogryposis, and spastic paresis. Acquired abnormalities discussed include tendon displacement, tendinitis, tendon disruption, and tenosynovitis. Antibiotic selection for musculoskeletal infections is briefly discussed.
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Affiliation(s)
- D E Anderson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, USA
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