Characterization of placentome vascular perfusion in relation to pregnancy associated glycoproteins throughout gestation in pregnant beef heifers

During pregnancy, blood flow to the uterus changes to support fetal demand. Placentomes serve as vascular attachment sites on the placenta for exchange of gases, nutrients, and metabolic products. Non-invasive methods of ultrasonography and biomarkers have been described to assess placental health and fetal viability. Pregnancy associated glycoproteins (PAGs) are produced by the ruminant placenta and are detected in maternal circulation. In cattle, changes in circulating PAG concentrations are associated with embryonic and fetal outcomes. The objective of this study was to determine the association between placentome blood perfusion and circulating PAG concentrations as they relate to the health of the developing fetus. We hypothesized that placentome perfusion and PAG concentration will be positively correlated and associated with neonatal outcome. A prospective, observational study was designed using 26 pregnant, nulliparous, Angus heifers in which PAG concentration and placentome blood perfusion were assessed throughout gestation, with assessment of calving characteristics following parturition. Placentome blood perfusion was visualized at 30-day intervals via transrectal Doppler ultrasonography with power flow function. Ultrasound images were analyzed using ImageJ software to determine the percent area of perfusion and integrated pixel densities. Venous blood was collected and PAG concentrations were determined via serum PAG enzyme-linked immunoassay. Mean placentome blood perfusion increased as gestation advanced. PAG concentrations demonstrated the expected temporal trend, increasing with gestation length, and were positively linearly correlated with placentome perfusion (P < 0.0001). The relationship identified between circulating PAG concentration and placentome blood perfusion suggests the use of transrectal power flow Doppler ultrasonography as a noninvasive technique to determine placental blood flow morphometrics to assess conceptus wellbeing throughout pregnancy.

Sedation with dexmedetomidine decreases skin perfusion in cats

OBJECTIVE

To evaluate skin perfusion in cats receiving dexmedetomidine compared to a placebo.

ANIMALS

9 healthy adult research cats.

METHODS

A randomized, blinded, placebo-controlled study design was used. Two sites, the dorsal metatarsus (site: limb) and lateral flank (site: flank), were evaluated with laser speckle contrast imaging (LSCI) at baseline and following administration of dexmedetomidine (1, 3, or 5 mcg/kg, IV) or a placebo (0.9% saline, IV). Mean speckle contrast (MSC), a surrogate for perfusion, was obtained from LSCI and compared between treatments. Heart rate, sedation score, and body temperature were recorded. Skin perfusion to the flank and limb, reported as MSC, was assessed via LSCI at baseline and at 5, 10, and 15 minutes posttreatment.

RESULTS

There was a significant decrease in heart rate (P < .001) in cats receiving 1, 3, and 5 mcg/kg dexmedetomidine compared to placebo. There was a significant increase in median sedation score at all time points postsedation compared to baseline (P < .018). Changes in MSC for the metatarsus were not significantly different between treatments at any time point (P = .12). For the flank, MSC was significantly higher for cats treated with dexmedetomidine compared to baseline (P ≤ .01). Skin perfusion to the flank decreased as early as 5 minutes posttreatment with dexmedetomidine and persisted for at least 15 minutes, regardless of dexmedetomidine dose.

CLINICAL RELEVANCE

Dexmedetomidine decreased skin perfusion in cats, even at low doses. Veterinarians may elect for an alternative sedative medication when decreased skin perfusion is a concern.

Effects of a 10% dimethyl sulfoxide solution on radiocarpal joint amikacin pharmacokinetics during intravenous regional limb perfusion in standing sedated horses

OBJECTIVE

To determine the effect of a 10% dimethyl sulfoxide (DMSO) solution on the peak concentration (CMAX ) of amikacin in the radiocarpal joint (RCJ) during intravenous regional limb perfusion (IVRLP) compared with 0.9% NaCl.

STUDY DESIGN

Randomized crossover study.

ANIMALS

Seven healthy adult horses.

METHODS

The horses underwent IVRLP with 2 g of amikacin sulfate diluted to 60 mL using a 10% DMSO or 0.9% NaCl solution. Synovial fluid was collected from the RCJ at 5, 10, 15, 20, 25, and 30 minutes after IVRLP. The wide rubber tourniquet placed on the antebrachium was removed after the 30 min sample. Amikacin concentrations were quantified by a fluorescence polarization immunoassay. The mean CMAX and time to peak concentration (TMAX ) of amikacin within the RCJ were determined. A one-sided paired t-test was used to determine the differences between treatments. The significance level was p < .05.

RESULTS

The mean ± SD CMAX in the DMSO group was 1361.8 ± 593 μg/mL and in the 0.9% NaCl group it was 860 ± 481.6 μg/mL (p = .058). Mean TMAX using the 10% DMSO solution was 23 and 18 min using the 0.9% NaCl perfusate (p = .161). No adverse effects were associated with use of the 10% DMSO solution.

CONCLUSION

Although there were higher mean peak synovial concentrations using the 10% DMSO solution no difference in synovial amikacin CMAX between perfusate type was detected (p = .058).

CLINICAL SIGNIFICANCE

Use of a 10% DMSO solution in conjunction with amikacin during IVRLP is a feasible technique and does not negatively affect the synovial amikacin levels achieved. Further research is warranted to determine other effects of using DMSO during IVRLP.

Morphine concentrations in distal thoracic limb synovial fluid following intravenous regional limb perfusion in horses

Twelve adult horses were randomly assigned to 2 groups in a prospective experimental trial. A pneumatic tourniquet (425 mmHg) was placed, under sedation, proximal to the carpus on one randomly chosen thoracic limb. A cephalic vein catheter was placed distal to the tourniquet to establish an intravenous regional limb perfusion technique (IVRLP) with morphine (0.1 mg/kg) diluted with saline 0.9% to 0.1 mL/kg, and the tourniquet left in place for 30 minutes. Horses were euthanized at 1 h (Group I) or 6 h (Group II) following the IVRLP and synovial fluid from the radiocarpal, intercarpal, metacarpophalangeal, distal interphalangeal, and digital flexor tendon sheath was obtained from the injected and contralateral (control) limb immediately after. Morphine concentrations were determined using liquid chromatography-mass spectrometry. An unpaired t-test was used to compare morphine concentrations from both groups (P < 0.05). Synovial morphine concentrations were detected in the injected limb in all horses in Group I, except in one horse in the radiocarpal joint, and detected in 5 of 6 horses in Group II. Mean synovial concentrations ranged between 301.8 ± 192.3 and 608 ± 446.6 ng/mL in Group I and between 27.0 ± 17.7 and 136.8 ± 103.6 ng/mL in Group II and were significantly higher in Group I between paired anatomical sites of both groups for the radiocarpal and distal interphalangeal joints, and the digital flexor tendon sheath. In conclusion, concentrations of morphine after IVRLP can be detected in synovial fluid distal to the tourniquet at 1 and 6 hours in horses.

Abdominal perfusion in canine patients with pyometra and sepsis evaluated by Doppler and contrast-enhanced ultrasound

BACKGROUND

Sepsis is a condition characterized by organic dysfunction, leading to hemodynamic instability and high morbidity and mortality rates in humans and animals. Early identification of perfusion changes and appropriate management of sepsis are crucial for improving patient prognosis. Currently, the Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) scores are widely studied for sepsis identification and evaluation of organ dysfunction. However, these scores do not assess gastrointestinal involvement, which is common in this condition. Contrast-enhanced ultrasound (CEUS) and Doppler have been considered promising diagnostic techniques for detecting changes in vascularization and microcirculation in a non-invasive and safe manner, particularly in the gastrointestinal system. This study aimed to evaluate duodenal perfusion using CEUS, as well as abdominal aortic and cranial mesenteric artery blood flow using Doppler ultrasound, and systolic arterial pressure (SAP) in 17 bitches with pyometra and in 10 healthy animals.

RESULTS

The variables were compared between the pyometra and control groups, as well between patients with and without sepsis determined by the SOFA or SIRS scores. Pyometra was found to cause a reduction in abdominal aortic blood flow volume, aortic peak systolic velocity, and resistivity index as evaluated by Doppler ultrasound. Patients with sepsis according to the SOFA criteria only presented lower SAP. In contrast, sepsis animals identified by the SIRS score exhibited lower SAP, aortic peak systolic velocity, aortic blood flow volume, and aortic resistivity index and additionally, higher peak intensity of contrast in the duodenal wall.

CONCLUSIONS

Pyometra causes a reduction in abdominal aortic blood flow, which is more pronounced in animals with sepsis identified by the SIRS criteria. These animals also exhibited a decrease in systolic blood pressure and an increase in duodenal perfusion, as evident by CEUS. However, these changes were not observed in patients with sepsis identified by the SOFA criteria. The alterations in intestinal perfusion observed in animals with sepsis indicate the presence of inflammation or dysfunction. In this regard, CEUS proves to be a valuable technique for detecting subtle changes in tissue hemodynamics that may not be apparent in conventional exams.

Computed tomographic evaluation of pancreatic perfusion in 10 dogs with acute pancreatitis

Severe canine acute pancreatitis can be fatal; imaging features that can predict the clinical course of disease are useful for clinicians. On computed tomography (CT), both pancreatic heterogeneous contrast enhancement and portal vein thrombosis have been correlated with poorer outcome. Perfusion CT is used in human medicine to evaluate pancreatic microcirculation to predict the future development of severe sequela to pancreatitis; this technology has yet to be explored in dogs with acute pancreatitis. The objective of this prospective, case-control study is to evaluate pancreatic perfusion using contrast-enhanced CT in dogs with acute pancreatitis and compare it with previously established values obtained in healthy dogs. Ten client-owned dogs preliminarily diagnosed with acute pancreatitis received a full abdominal ultrasound, specific canine pancreatic lipase (Spec cPL), and perfusion CT. Computer software calculated pancreatic perfusion, peak enhancement index, time to peak enhancement, and blood volume for 3-mm and reformatted 6-mm slices. The data was analyzed using Shapiro-Wilk test, linear mixed model, and Spearman's rho. Values for 3-mm slices were similar to 6-mm slices (all P < 0.05). Dogs with acute pancreatitis had a faster time to peak enhancement than healthy dogs (P = 0.04-0.06). Dogs with acute pancreatitis and homogeneous pancreatic enhancement had higher perfusion, faster time to peak enhancement, and greater blood volume compared to healthy dogs and dogs with acute pancreatitis and heterogeneous pancreatic enhancement (all P = / < 0.05). Pancreatic perfusion decreased with increased pancreatitis severity. No correlation was identified between Spec cPL and pancreatic perfusion (all P > 0.05). These findings preliminarily support perfusion CT in dogs with acute pancreatitis.

Treatment of Septic Tenosynovitis and Osteoarthritis in an American White Pekin (Anas platyrhynchos domesticus) with Repeated Intravenous Regional Limb Perfusion and Antibiotic-Impregnated Calcium Sulfate Beads

A 2-year-old female American white pekin (Anas platyrhynchos domesticus) was assessed for a 2-month history of chronic lameness and swelling involving the left leg. Radiographic images of the left leg showed soft tissue swelling of the digits and tarsometatarsus with osteolysis of the tarsometatarsal-phalangeal joint. A complete blood count revealed marked leukocytosis and hyperproteinemia. A Streptococcus species was isolated from a bacterial culture of fluid obtained from the left tarsometatarsal-phalangeal joint. Biweekly intravenous regional limb perfusions of the left leg with ampicillin-sulbactam and amikacin were performed on the patient. Despite initial improvement in left leg lameness and swelling, follow-up radiographic images showed progressive osteolysis of the tarsometatarsal-phalangeal joint and associated digits. Surgical placement of antibiotic-impregnated calcium sulfate beads into the left tarsometatarsal-phalangeal joint was next performed with concurrent, repeated intravenous regional limb perfusion using the same antibiotic. Following the placement of antibiotic-impregnated beads and continued intravenous regional limb perfusion, the duck had decreased lameness and swelling of the left leg. Repeated antibiotic treatment through intravenous regional limb perfusion and concurrent placement of antibiotic-impregnated calcium sulfate beads is a practical treatment option for complicated distal limb infections in avian species. This therapeutic protocol has great potential in treating aggressive distal leg infections in many avian species because regional limb perfusion alone may not penetrate the joint adequately to achieve complete resolution of infection.

The effects of aging and gestational month on uteroplacental vascular perfusion, and umbilical artery hemodynamics in pregnant jennies

This study aimed to correlate the pulsed wave spectral indices of the middle uterine artery at both sides with placental development in jenny within mid-late pregnancies, and establish umbilical Doppler values for different ages and different gestational months. Twenty Equus Asinus pregnant jennies 260-450 kg (average, 320 ± 10 kg) were examined from 5 to 9 months of pregnancy with different ages (4-14 years). Monthly B-mode ultrasound examination was performed on both the combined thickness of the uterus and placenta (CTUP; mm) and umbilical artery cross-sectional diameter, and Doppler mode examination was performed on both the middle uterine (MUA at right [R] and left [L] sides) and umbilical arteries to measure both Doppler indices that expressed by resistance (RI) and pulsatility indices (PI), and blood flow rate. CTUP was elevated within pregnancy time at different ages (P < 0.05). L. PI was significantly declined throughout different ages (P < 0.05), but this declining trend was not observed in L. RI. The L. blood flow rate (R; bpm) was elevated among different ages and different months (P < 0.05). Both RI and PI were significantly decreased from 5 to 9 month of gestation period in jennies (P < 0.05).. The umbilical arteries cross-sectional diameter (Umb A; mm), was elevated among different ages and different months, while both Doppler indices were declined. A positive correlation was found (between both Doppler indices of both umbilical and uterine arteries P < 0.001). There was elevated vascular perfusion in uterine and umbilical arteries associated with reduced both Doppler indices along the course of pregnancy at different ages.

Perfusion with 10% neutral-buffered formalin is equivalent to 4% paraformaldehyde for histopathology and immunohistochemistry in a mouse model of experimental autoimmune encephalomyelitis

Intravascular (IV) perfusion of tissue fixative is commonly used in the field of neuroscience as the central nervous system tissues are exquisitely sensitive to handling and fixation artifacts which can affect downstream microscopic analysis. Both 10% neutral-buffered formalin (NBF) and 4% paraformaldehyde (PFA) are used, although IV perfusion with PFA is most commonly referenced. The study objective was to compare the severity of handling and fixation artifacts, semiquantitative scores of inflammatory and neurodegenerative changes, and quantitative immunohistochemistry following terminal IV perfusion of mice with either 10% NBF or 4% PFA in a model of experimental autoimmune encephalitis (EAE). The study included 24 mice; 12 were control animals not immunized and an additional 12 were immunized with PLP139-151 subcutaneously, harvested at day 20, and fixed in the same fashion. Equal numbers (4 per group) were perfused with 10% NBF or 4% PFA, and 4 were immersion-fixed in 10% NBF. NBF-perfused mice had less severe dark neuron artifact than PFA-perfused mice (P < .001). Immersion-fixed animals had significantly higher scores for oligodendrocyte halos, dark neuron artifact, and perivascular clefts than perfusion-fixed animals. Histopathology scores in EAE mice for inflammation, demyelination, and necrosis did not differ among fixation methods. Also, no significant differences in quantitative immunohistochemistry for CD3 and Iba-1 were observed in immunized animals regardless of the method of fixation. These findings indicate that IV perfusion of mice with 10% NBF and 4% PFA are similar and adequate fixation techniques in this model.

Acute Normovolemic Hemodilution-assisted Terminal Blood Procurement in Swine for Ex Vivo Organ Perfusion

Swine (Sus scrofa domesticus) are commonly used large animal subjects for the study of disease and preclinical therapies. Organ machine perfusion is a therapy that has gained momentum as a research platform for the study of ex vivo organ preservation and therapeutics. However, complex perfusion circuits and research protocols often require large volumes of blood as perfusate. Here, we report a technique for increasing terminal blood yield during swine organ and blood procurement; our method involves acute normovolemic hemodilution and exsanguination via the femoral artery. We collected a total of 47 ± 4 mL/kg of blood and 4.3 ± 0.6 g/kg of hemoglobin, representing 73% ± 6% of the estimated blood volume and 64% ± 8% of the total estimated intravascular hemoglobin (n = 4). Neither pH, lactate, nor pO2 levels changed significantly during blood procurement. Acute normovolemic hemodilution is an effective method for increasing RBC and hemoglobin yield during blood procurement in swine.

Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses

This study investigated the pharmacokinetics of ceftiofur after intravenous regional limb perfusion (IVRLP). Six horses were involved in 3 IVRLP sessions. For each session, operators with varying clinical experience placed the tourniquet. A wide-rubber tourniquet was applied in the antebrachium as 2 g of ceftiofur in a total volume of 100 mL was injected into the cephalic vein. Plasma and metacarpophalangeal synovial fluid samples were obtained to evaluate perfusate leakage and synovial fluid concentrations of ceftiofur over 24 h. Overall, mean plasma concentrations were not significantly different before and after tourniquet removal. Mean synovial fluid ceftiofur concentrations were significantly higher 5 min and 8 h after tourniquet removal versus 24 h, after which values above the minimum inhibitory concentration (MIC) (1 μg/mL) were not detected. Concentrations above the MIC were detected in 72% and 50% of the horses at 5 min and 8 h, respectively. Overall, higher synovial fluid concentrations were obtained for the operator with the most recent clinical experience performing IVRLP.

Orthopedic Infections-Clinical Applications of Intravenous Regional Limb Perfusion in the Field

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.

Investigation of the use of microwave ablation with and without cooling urethral perfusion for thermal ablation of the prostate gland in canine cadavers

OBJECTIVE

To investigate the use of microwave ablation (MWA) with cooling urethral perfusion and with no perfusion (MWA-UP and MWA-NP, respectively) for prostate gland ablation in canine cadavers.

ANIMALS

Cadavers of 18 sexually intact male dogs.

PROCEDURES

After technique refinement in 2 cadavers, laparotomy with ultrasound-guided MWA-UP (n = 8) or MWA-NP (8) of the prostate gland was performed in 16 cadavers. Normograde cystourethroscopy was performed before and after treatment; recorded images were reviewed in a blinded manner for scoring of urethral mucosal discoloration and loss of integrity. Difficulty with cystoscope insertion was recorded if present. Excised prostate glands were fixed for serial sectioning, gross measurements, and calculation of percentage ablation. Percentages of prostate tissue necrosis from MWA, denuded urethral mucosa, and depth of epithelial surface loss in an adjacent section of the colon were estimated histologically. Variables of interest were statistically analyzed.

RESULTS

Difficulty with cystoscope insertion after treatment was significantly more common and scores for urethral mucosal discoloration and loss of integrity were significantly higher (indicating more severe lesions) for the MWA-NP group than for the MWA-UP group. The histologically assessed percentage of denuded urethral mucosa was also greater for the MWA-NP group. Overall median percentage prostate gland ablation was 73%; this result was not associated with prostate gland volume or chronological order of treatment.

CONCLUSIONS AND CLINICAL RELEVANCE

MWA-UP induced subtotal thermal necrosis of prostate glands in canine cadavers while limiting urethral mucosal injury. Further study is required to optimize the technique and evaluate its safety and efficacy in vivo as a future curative-intent treatment for prostatic tumors in dogs.

Time required to achieve maximum amikacin concentration in the synovial fluid of the tarsocrural joint following administration of the drug by intravenous regional limb perfusion in horses

OBJECTIVE

To determine the median time to maximum concentration (t_max) of amikacin in the synovial fluid of the tarsocrural joint following IV regional limb perfusion (IVRLP) of the drug in a saphenous vein of horses.

ANIMALS

7 healthy adult horses.

PROCEDURES

With each horse sedated and restrained in a standing position, a 10-cm-wide Esmarch tourniquet was applied to a randomly selected hind limb 10 cm proximal to the point of the tarsus. Amikacin sulfate (2 g diluted with saline [0.9% NaCl] solution to a volume of 60 mL) was instilled in the saphenous vein over 3 minutes with a peristaltic pump. Tarsocrural synovial fluid samples were collected at 5, 10, 15, 20, 25, and 30 minutes after completion of IVRLP. The tourniquet was removed after collection of the last sample. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median maximum amikacin concentration and t_max were determined.

RESULTS

1 horse was excluded from analysis because an insufficient volume of synovial fluid for evaluation was obtained at multiple times. The median maximum synovial fluid amikacin concentration was 450.5 μg/mL (range, 304.7 to 930.7 μg/mL), and median t_max was 25 minutes (range, 20 to 30 minutes). All horses had synovial fluid amikacin concentrations ≥ 160 μg/mL (therapeutic concentration for common equine pathogens) at 20 minutes after IVRLP.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that, in healthy horses, maintaining the tourniquet for 20 minutes after IVRLP of amikacin in a saphenous vein was sufficient to achieve therapeutic concentrations of amikacin in the tarsocrural joint.

Computed tomographic evaluation of pancreatic perfusion in healthy dogs

OBJECTIVE

To evaluate the feasibility of contrast-enhanced CT for assessment of pancreatic perfusion in healthy dogs.

ANIMALS

6 healthy purpose-bred female Treeing Walker Coonhounds.

PROCEDURES

Contrast-enhanced CT of the cranial part of the abdomen was performed with 3-mm slice thickness. Postprocessing computer software designed for evaluation of human patients was used to calculate perfusion data for the pancreas and liver by use of 3-mm and reformatted 6-mm slices. Differences in perfusion variables between the pancreas and liver and differences in liver-specific data of interest were evaluated with the Friedman test.

RESULTS

Multiple pancreatic perfusion variables were determined, including perfusion, peak enhancement index, time to peak enhancement, and blood volume. The same variables as well as arterial, portal, and total perfusion and hepatic perfusion index were determined for the liver. Values for 6-mm slices appeared similar to those for 3-mm slices. The liver had significantly greater median perfusion and peak enhancement index, compared with the pancreas.

CONCLUSIONS AND CLINICAL RELEVANCE

Measurement of pancreatic perfusion with contrast-enhanced CT was feasible in this group of dogs. Hepatic arterial and pancreatic perfusion values were similar to previously published findings for dogs, but hepatic portal and hepatic total perfusion measurements were not. These discrepancies might have been attributable to physiologic differences between dogs and people and related limitations of the CT software intended for evaluation of human patients. Further research is warranted to assess reliability of perfusion variables and applicability of the method for assessment of canine patients with pancreatic abnormalities.

Intravenous and intraosseous regional limb perfusion of ceftiofur sodium in an avian model

OBJECTIVE

To assess whether IV regional limb perfusion (IVRLP) and intraosseous regional limb perfusion (IORLP) of ceftiofur sodium resulted in clinically relevant drug concentrations in the synovial fluid of the tibiotarsal-tarsometatarsal joint of chickens (ie, an avian model) and to determine whether one of those techniques was superior to the other.

ANIMALS

12 healthy adult hens.

PROCEDURES

Birds were randomly assigned to receive ceftiofur sodium (2 mg/kg) by the IVRLP (n = 4), IORLP (4), or IM (control; 4) route once daily for 6 consecutive days. Blood and tibiotarsal-tarsometatarsal synovial fluid samples were collected 15 minutes after ceftiofur administration on predetermined days for quantification of ceftiofur concentration. Plasma and synovial fluid ceftiofur concentrations were compared among the 3 groups.

RESULTS

All 4 birds in the IVRLP group developed mild to moderate bruising around the injection site, but this bruising did not prohibit completion of the prescribed treatment regimen. No adverse effects were observed in any of the other birds. The mean plasma and synovial fluid ceftiofur concentrations exceeded the therapeutic threshold for most common bacterial pathogens (> 1.0 μg/mL) at all sample acquisition times for all 3 groups. The mean synovial fluid ceftiofur concentration for the IVRLP group was significantly greater than that for the IORLP and control groups at all sample acquisition times.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that IVRLP may be a safe and effective technique for antimicrobial administration to birds with joint infections, contaminated wounds, pododermatitis, and other musculoskeletal infections of the distal aspect of a limb.

Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses

The objectives of this study were to evaluate the compatibility and the pharmacokinetic properties of combined amikacin and penicillin administration by intravenous regional limb perfusion (IVRLP) in horses. A tourniquet was applied proximal to the carpus of 7 clinically healthy adult horses and 2 g of amikacin and 10 × 10⁶ IU of penicillin (100 mL total volume) were sequentially injected into the cephalic vein just distal to the tourniquet. Synovial samples were collected from the joint at several times after injection. All samples were analyzed for amikacin and penicillin concentration. The mean maximum concentration (C_max) of both amikacin and penicillin was over 10-fold the relevant minimal inhibitory concentration (MIC) for all horses and remained above those MICs for at least 24 hours. The results of this study indicate that combining amikacin with penicillin during IVRLP in normal horses delivers high therapeutic synovial concentrations of both drugs.

Endotoxin-induced changes of type VII collagen- cleaving matrix metalloproteinases in lamellar tissue of extracorporeally perfused equine limbs

OBJECTIVE To investigate the effect of lipopolysaccharide (LPS) on type VII collagen- cleaving matrix metalloproteinases (MMPs) in the lamellar tissue of extracorporeally perfused equine limbs. SAMPLE 10 right forelimbs and 3 left forelimbs collected from 10 adult horses after slaughter at a licensed abattoir. PROCEDURES Extracorporeal perfusion of the isolated equine limbs was performed for 10 hours under physiologic conditions (control-perfused limbs; n = 5) and with the addition of 80 ng of LPS/L of perfusate (LPS-perfused limbs; 5). Lamellar tissue specimens were then collected from the dorsal aspect of the hooves. Additionally, corresponding control specimens were collected from the 3 nonperfused left forelimbs. Immunohistochemical analysis was performed on paraffin-embedded tissue blocks with antibodies against total (latent and active) MMP-1, MMP-2, MMP-8, and MMP-9 as well as antibody against active MMP-9. Intensity of immunohistochemical staining was scored, and stain distribution in the lamellar tissue was noted. RESULTS Staining intensity of total and active MMP-9 was significantly increased in LPS-perfused versus control-perfused limbs. No such difference was identified for MMP-1, MMP-2, and MMP-8. CONCLUSIONS AND CLINICAL RELEVANCE Of the 4 MMPs that are capable of degrading type VII collagen, MMP-9 was the only one for which production increased in the lamellar tissue of isolated equine limbs perfused with versus without a clinically relevant concentration of LPS. These results suggested that MMP-9 may be involved in initiation of pathological changes in lamellar tissue in endotoxin-induced laminitis, whereas MMP-1, MMP-2, and MMP-8 may be less relevant.

Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock

BACKGROUND

This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock.

METHODS

Haemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg- 1 body weight. OCT-A imaging of retinal perfusion was performed using an OCT device. Incident dark-field illumination microscopy videos were obtained for the evaluation of conjunctival microcirculation. Haemodynamic variables and flow density data in the OCT angiogram were analysed before and during progressive haemorrhage resulting in haemorrhagic shock as well as after fluid resuscitation with 10 ml∙kg- 1 body weight of balanced hydroxyethyl starch solution (6% HES 130/0.4). Videos of the conjunctival microcirculation were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman's test and the degree of correlation between two variables was expressed as Spearman's rank correlation coefficient.

RESULTS

Mean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density in the superficial retinal OCT angiogram decreased significantly after shock induction (baseline 44.7% (40.3; 50.5) vs haemorrhagic shock 34.5% (32.8; 40.4); P = 0.027) and recovered after fluid resuscitation (46.9% (41.7; 50.7) vs haemorrhagic shock; P = 0.027). The proportion of perfused vessels of the conjunctival microcirculation showed similar changes. The flow density measured using OCT-A correlated with the conjunctival microcirculation (perfused vessel density: Spearman's rank correlation coefficient ρ = 0.750, P = 0.001) and haemodynamic parameters (CI: ρ = 0.693, P < 0.001).

CONCLUSIONS

Retinal flow density, measured using OCT-A, significantly decreased in shock and recovered after fluid therapy in an experimental model of haemorrhagic shock. OCT-A is feasible to assess changes in retinal perfusion in haemorrhagic shock and fluid resuscitation.

Effects of regional limb perfusion volume on concentrations of amikacin sulfate in synovial and interstitial fluid samples from anesthetized horses

OBJECTIVE To evaluate the effect of volume of IV regional limb perfusion (IVRLP) on amikacin concentrations in synovial and interstitial fluid of horses. ANIMALS 8 healthy adult horses. PROCEDURES Each forelimb was randomly assigned to receive IVRLP with 4 mL of amikacin sulfate solution (250 mg/mL) plus 56 mL (total volume, 60 mL) or 6 mL (total volume, 10 mL) of lactated Ringer solution. Horses were anesthetized, and baseline synovial and interstitial fluid samples were collected. A tourniquet was placed, and the assigned treatment was administered via the lateral palmar digital vein. Venous blood pressure in the distal portion of the limb was recorded. Additional synovial fluid samples were collected 30 minutes (just before tourniquet removal) and 24 hours after IVRLP began; additional interstitial fluid samples were collected 6 and 24 hours after IVRLP began. RESULTS 30 minutes after IVRLP began, mean amikacin concentration in synovial fluid was significantly greater for the large-volume (459 μg/mL) versus small-volume (70 μg/mL) treatment. Six hours after IVRLP, mean concentration in interstitial fluid was greater for the large-volume (723 μg/mL) versus small-volume (21 μg/mL) treatment. Peak venous blood pressure after large-volume IVRLP was significantly higher than after small-volume IVRLP, with no difference between treatments in time required for pressure to return to baseline. CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that large-volume IVRLP would deliver more amikacin to metacarpophalangeal joints of horses than would small-volume IVRLP, without a clinically relevant effect on local venous blood pressure, potentially increasing treatment efficacy.

Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses

The aim of this study was to determine the pharmacokinetics of amikacin and penicillin G sodium when administered in combination as an intravenous regional limb perfusion (IVRLP) to horses. Seven healthy adult horses underwent an IVRLP in the cephalic vein with 2 g of amikacin sulfate and 10 mill IU of penicillin G sodium diluted to 60 mL in 0.9% saline. A pneumatic tourniquet set at 450 mmHg was left in place for 30 min. Synovial fluid was collected from the metacarpophalangeal joint 35 min and 2, 6, 12, and 24 h after infusion of the antimicrobials. Concentrations of amikacin and penicillin in synovial fluid were quantitated by liquid chromatography tandem-mass spectrometry analysis. Therapeutic concentrations of amikacin and penicillin for equine-susceptible pathogens were achieved in the synovial fluid. Maximum synovial concentrations (Cmax) (mean ± SE) for amikacin and penicillin were 132 ± 33 μg/mL and 8474 ± 5710 ng/mL, respectively. Only 3 horses had detectable levels of penicillin at 6 h and 1 at the 12 h sample. The combination of amikacin with penicillin G sodium via IVDLP resulted in reported therapeutic concentrations of both antibiotics in the synovial fluid. The Cmax:MIC (minimum inhibitory concentration) ratio for amikacin was 8:1 and Time > MIC for penicillin was 6 h. At 24 h, the mean concentration of amikacin was still above 4 μg/mL. Terminal elimination rate constants (T1/2 lambdaz) were 13.6 h and 2.8 h for amikacin and penicillin, respectively. The use of IVDLP with penicillin may therefore not be practical as rapid clearance of penicillin from the synovial fluid requires frequent perfusions to maintain acceptable therapeutic concentrations.

The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse

This study investigated the influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion (IVRLP) and assessed the efficacy of low volume IVRLP. The front limbs of 9 horses were randomly assigned to 1 of 3 volume groups: 10 mL (Group 1), 30 mL (Group 2), or 60 mL (Group 3). A tourniquet was applied distal to the carpus and the limbs were perfused with 500 mg genta-micin diluted to the assigned volume via a catheter placed in the lateral palmar digital vein at the level of the proximal sesamoid bones. Synovial fluid samples were collected from the metacarpophalangeal joint at 30 minutes, followed by removal of the tourniquet. Gentamicin concentration in synovial fluid was detected using a fluorescence polarization immunoassay. There were no statistically significant differences among gentamicin concentrations in synovial fluid among perfusate volume groups. Mean gentamicin concentration in Group 1 (125.9 μg/mL) was higher than Group 2 (82.7 μg/mL) and Group 3 (56.1 μg/mL).

Optimization of an isolated perfused rainbow trout liver model: Clearance studies with 7-ethoxycoumarin

To date, research with isolated perfused fish livers has been limited by the relatively short time period during which stable performance can be achieved. In the present study, modifications to existing methods were employed with the goal of extending the usable life of an isolated perfused trout liver preparation. Liver performance was evaluated by measuring O(2) consumption (VO(2)), vascular resistance, K(+) leakage, glucose flux, lactate flux, and clearance of a model metabolic substrate, 7-ethoxycoumarin (CL(H,7-EC)). Livers perfused with solutions containing 15, 38, or 150microM bovine serum albumin (BSA) exhibited relatively stable physiological performance for up to 10h. CL(H,7-EC) decreased rapidly between 1 and 2h in all livers tested, possibly due in part to accumulation of 7-EC within the tissue. CL(H,7-EC) declined slowly thereafter, decreasing by 30-40% between 2 and 10h. A linear equation was subsequently developed to correct measured levels of clearance for this decrease in metabolic activity over time. To illustrate the value of this preparation, experiments were conducted to examine the effects of protein binding on 7-EC clearance. Clearance rates corrected for declining activity (CL(H,7-EC,CORR)) changed in nearly direct proportion to changes in the free concentration of 7-EC efferent to the liver, as predicted by theoretical models of liver function. Additional studies were performed to characterize the concentration-dependence of 7-EC clearance. The rate of substrate disappearance from the perfusate increased in proportion to the total concentration of 7-EC afferent to the liver resulting in constant levels of CL(H,7-EC,CORR). CL(H,7-EC,CORR) values for four livers averaged 12.1+/-2.5mL/h/g-liver (mean+/-SD, n=57 individual determinations) and were in good agreement with an estimate of hepatic clearance obtained by extrapolating published in vitro data from isolated trout hepatocytes. The extended viability of isolated trout livers achieved in this study creates new opportunities for research on hepatic function in fish.

Tissue concentration of intrauterine and intravenously administered amoxicillin in the isolated hemoperfused bovine uterus model and in healthy cows

The tissue distribution of amoxicillin in the bovine uterus in dependence of the administration route was examined using the in vitro model of the isolated hemoperfused bovine uterus. Four hours after intrauterine instillation or onset of perfusion with amoxicillin ("systemic" treatment), respectively, samples of the uterine tissue were taken from different locations of the organ. The tissue concentration of amoxicillin in the single layers of the uterine wall was determined via high performance liquid chromatography (HPLC) analysis. To compare the results with data achieved in vivo, healthy cows were treated post partum intrauterinely or systemically, respectively, and the concentration of amoxicillin was determined in endometrial biopsies. In vitro intrauterine instillation resulted in significantly higher levels of amoxicillin in the inner layers of the uterine wall compared to systemic treatment, whereas the drug is distributed more homogenously through all layers in the systemically treated organs. In the in vivo experiments the tissue concentration of amoxicillin is significantly lower after intrauterine instillation compared to the in vitro data. In contrast, the endometrial concentrations in the uteri perfused with amoxicillin in vitro are comparable to those measured in endometrium of systemically treated cows. The MIC for gram positive and negative bacteria was exceeded in the uterine wall of all organs in vitro and in vivo after intrauterine treatment. In systemic treated cows the MIC for gram negative bacteria was exceeded in two of three cases, but never in the hemoperfused uteri. The data indicate that combined systemic and intrauterine treatment results in the best distribution of sufficient antibiotic concentrations in the uterine tissue. The isolated hemoperfused bovine uterus is shown to be suitable as an in vitro model for pharmacokinetic examinations, especially with regard to detailed information on the tissue distribution of drugs.

Tissue distribution of marbofloxacin after ‘systemic’ administration into the isolated perfused bovine udder

Mammary glands taken at slaughter from healthy lactating cows were perfused in vitro with warmed and gassed Tyrode solution. Marbofloxacin was administered "systemically" via the perfusion fluid at concentrations similar to those measured in plasma following intravenous administration of 2mg/kg marbofloxacin. Samples from the perfusate were taken over a 24h period. Glandular tissue samples at different vertical distances from the teat up to the udder base were gathered from each of the four quarters after 3, 6, 12 and 24h. The marbofloxacin content of the tissue samples was analysed by high performance liquid chromatography with UV detection. The addition of marbofloxacin to the perfusion fluid produced median concentrations above the MIC90 (0.016microg/mL) against Escherichia coli at all glandular tissue sites measured after 3 and 6h with remarkable variations. Samples taken after 12 and 24h contained marbofloxacin in concentrations (median) of 0.22 (<0.05-0.32)microg/g and 0.13 (<0.05-0.16)microg/g. It is concluded that a systemic administration of marbofloxacin is well suited for the treatment of E. coli mastitis.

New antimicrobials, systemic distribution, and local methods of antimicrobial delivery in horses

The local delivery of antimicrobials is a valuable therapeutic tool with a low morbidity, is practical to use, and is well tolerated by horses. Clinically, its use has allowed equine practitioners to achieve better results when treating musculoskeletal infections, and it represents an extremely useful tool in the practitioner's armamentarium against these types of infections. The technique is indicated to combat orthopedic infections involving bones, joints, physes, tendon sheaths, and foot tissues. Optimal treatment must include other approaches, such as systemic antimicrobial therapy and surgical debridement and lavage, and monitoring of the clinical progression of the patient can help to determine the ideal protocol for each patient.

The Role of Oestradiol in the Uterine Peristalsis in the Perfused Swine Uterus

This study was designed to examine the effects of oestradiol (E2) on sperm transport in the swine uterus. The bicornuate swine uterus is optimal for the study of the uterine transport and peristalsis because the influence of various factors can be examined on each uterine horn independently. Forty swine uteri (with or without ovarectomy) were perfused for a period of up to 7 h. Two different E2 concentrations (3 or 30 pg/ml) in the perfusion medium were administered for 30 min unilaterally. Through an intracervical catheter 1 ml of a high concentrated dextran blue solution was administered directly in the upper part of the cervix. After bilateral perfusion of the swine uterus with a bolus of 0.3 IU oxytocin the distribution of coloured particles was assessed macroscopically before and after incision of the uterine horns. Coloration was evaluated by two observers blinded to the site-specific administration of E2. In the 10 ovarectomized uteri with the 3 pg/ml E2 concentration a unilateral distribution towards the side of oestradiol administration was observed in six uteri, in four it was a bilateral distribution. In the 10 non-ovarectomized uteri with the 3 pg/ml E2 concentration a uni- and ipsilateral coloration was observed in five uteri, in five it was a bilateral distribution. In the 20 uteri with 30 pg/ml E2, a unilateral coloration of the uterus horns was observed in all uteri. Oestradiol is one of the main factors, which influences the direction of the sperm transport in a dose-dependent manner, in the perfused swine uterus.

Effect of osmolality on net fluid absorption in non-infected and ETEC-infected piglet small intestinal segments

In the small intestinal segment perfusion model the effect of osmolality on net fluid absorption in enterotoxigenic Escherichia coli (ETEC)-infected and non-infected small intestinal segments of piglets was investigated. In ETEC-infected segments net fluid absorption was reduced. Lowering the osmolality from 375 to 150 mOsmol/l by reducing sodium chloride concentrations increased net fluid absorption. There was a linear relationship between osmolality and net fluid absorption for both non-infected and ETEC-infected segments. Below 150 mOsmol/l the inverse relationship between osmolality and net fluid absorption disappeared. Substitution of sodium chloride with mannitol decreased net fluid absorption since mannitol cannot be actively absorbed. In ETEC-infected segments perfused with oral rehydration solution net fluid absorption significantly increased compared to a sodium chloride solution of similar osmolality, probably because of the high glucose concentration. Supplying hypotonic sodium chloride fluids to piglets can be beneficial in replenishing water and electrolyte losses in case of infectious diarrhoea.

Septic Arthritis, Tenosynovitis, and Infections of Hoof Structures

Infectious diseases of synovial and hoof structures in horses can be devastating to soundness and can result in life-threatening complications. Timely diagnosis and early aggressive treatment can result in successful outcomes and resumption of athletic careers; however, delays in recognition and therapy can be the most costly reasons for failure. Sterilization of affected compartments and tissues requires removal of microorganisms and compromised tissue. Debridement, lavage, and appropriate antimicrobial drug use are the most reliable avenues of treatment. Antimicrobial drugs can be administered by local, regional, and systemic routes. Lavage techniques and debridement typically require surgical manipulations.

Osteomyelitis in Horses

Much has been learned in the past decade about osteomyelitis. The inhibitory mechanisms of the "biofilm slime" layer that is formed by bacterial extracapsular exopolysaccharides and binds to bone, joints, and implants are now better understood than in the past. The surface colonization of bacteria that occurs within these biofilms is a biologic phenomenon that is somewhat unique to orthopedic infections. This survival strategy of bacteria is effective, and it is important for veterinarians who treat osteomyelitis to be aware of current diagnostic and therapeutic treatment modalities. The practitioner should be aware of the most common bacteria associated with osteomyelitis and the traditional treatments that are still used. Current therapeutic treatment modalities, such as antibiotic- impregnated polymethylmethacrylate, antibiotic-impregnated plaster of Paris, and regional perfusion, have become routine, however, and have been responsible for improving the prevention and outcome of osteomyelitis in the horse. It is the intent of this article to make equine veterinarians aware of current information as well as the future treatments of osteomyelitis.

Tissue distribution of cefquinome after intramammary and “systemic” administration in the isolated perfused bovine udder

Mammary glands taken at slaughter from healthy lactating cows were perfused in vitro with warmed and gassed Tyrode solution. Cefquinome (88.8mg cefquinome sulphate per 8mL) was administered by the intramammary route to all quarters and/or "systemically" via the perfusion fluid at concentrations similar to those measured in plasma following intramuscular administration of 1mg cefquinome per kg body weight. Samples of the perfusate were taken over a 6-h period and from the regional lymph nodes after 6h. Using a scalpel, sections of glandular tissue - at different distances from and vertical to the teat right up to the udder base - were gathered from four quarters each per route of administration at 2, 4 and 6h. The cefquinome content of the tissue samples was analysed by high performance liquid chromatography with diode array detection and of the perfusate samples by bioassay. After intramammary administration, the concentration of cefquinome in the glandular tissue decreased exponentially with increasing distance from the teat. The addition of cefquinome to the perfusion fluid produced a mean concentration of 0.2-0.5microg/g at all glandular tissue sites. Combined intramammary and systemic treatment ensured that concentrations exceeded the MIC(90) values of the most common mastitis pathogens in all areas of the udder by 2h post-administration. There was considerable variability in the tissue concentrations of cefquinome, particularly after intramammary administration. These results suggest that for the treatment of acute mastitis a combination of both intramammary and systemic administration is likely to be advantageous in order to rapidly produce maximum cefquinome concentrations in all regions of the udder.

Assessment of platelet function in horses: ultrastructure, flow cytometry, and perfusion techniques

We studied equine platelet function and activation using ultrastructural examination, flow cytometry, and perfusion. The main aim of the study was to evaluate hemostatic mechanisms in horses using these techniques. Ultrastructural observations were done on resting and activated platelets. Flow cytometry was used to evaluate binding of antibodies to major platelet glycoproteins (GPIIb-IIIa, GPIV, and GPIb) and activation-dependent antigens (P-selectin and lysosomal integral membrane protein [LIMP]). Perfusion techniques were used to evaluate the interaction between platelets and damaged subendothelium. Aggregation experiments were done to identify the best agonists for flow cytometry. Ultrastructural observations confirmed that equine platelets lack a developed open canalicular system and that release of granule contents occurs by fusion of adjacent granule membranes that ultimately connect with external membranes. Flow cytometry identified a 2-fold increase in binding of antibodies against GPIIb-IIIa and GPIV after activation. Binding of antibodies against P-selectin and LIMP increased from 2.12 and 1.74% to 15.5 and 11.6%, respectively, in response to thrombin and to 21.86 and 10.50%, respectively, in response to collagen. Annexin V binding increased moderately after activation. Perfusion experiments with citrated blood indicated that equine platelets react more strongly to subendothelium than do human platelets. When blood was anticoagulated with low molecular weight heparin, a marked impairment of platelet interactions was observed. In conclusion, although some differences were observed between human and equine platelet function, some techniques currently used to assess human platelet function may be useful to assess equine platelets.

Antimicrobial regional limb perfusion in horses

Regional limb perfusion involves administration of an antimicrobial solution into the vasculature of a selected portion of the limb that has been isolated from the systemic circulation by controlled application of a tourniquet. The technique provides high antimicrobial concentrations in the region of interest and greatly contributes to the elimination of infection.

Comparison of the Role of the Subcutaneous Tissues in Cutaneous Wound Healing in the Dog and Cat

OBJECTIVE

To describe and compare the contribution of the subcutaneous tissues to 1st and 2nd intention cutaneous wound healing in the dog and cat.

STUDY DESIGN

Experimental study.

ANIMALS

Domestic shorthaired cats (n=6) and 6 beagle dogs.

METHODS

Paired wounds were created on either side of the dorsal midline; the subcutaneous tissue was removed on 1 side and left intact on the other. Square, open wounds of the dorsal aspect of the thorax were observed for 21 days to monitor granulation tissue formation, wound contraction, epithelialization, and total healing (contraction+epithelialization). Breaking strength of sutured linear wounds was measured 7 days after wounding. Laser-Doppler perfusion imaging (LDPI) was used to measure cutaneous perfusion.

RESULTS

First intention healing: subcutaneous tissue removal had no consistent effect on sutured wound strength at 7 days in dogs or cats. Second intention healing: removal of subcutaneous tissue reduced wound perfusion, granulation, contraction, epithelialization, and total healing. Granulation tissue formation and wound contraction were delayed to a significantly greater degree in cats than in dogs (P<.05). Two dogs (33%) had minor wound infections.

CONCLUSIONS

The subcutaneous tissues make an important contribution to 2nd intention cutaneous healing. Dog and cat wounds had delayed 2nd intention healing when subcutaneous tissues were removed; wounds in dogs, but not cats, had largely recovered from this delay by 21 days.

CLINICAL RELEVANCE

Extensive debridement of subcutaneous tissue may delay wound healing particularly in feline patients. A higher risk for wound infections may accompany extensive removal of subcutaneous tissues in dogs.

Treatment of a sole abscess in an Asian elephant (Elephas maximus) using regional digital intravenous perfusion

Regional digital i.v. perfusion was used to treat a severe sole abscess associated with a wire foreign body in a 19-yr-old female Asian elephant (Elephas maximus) housed at the Paris Zoo. The cow presented with acute right forelimb lameness and swelling that persisted despite 4 days of anti-inflammatory therapy. Under anesthesia, a 10- x 0.5- x 0.5-cm wire was extracted from the sole of the right foot. There was a 2-cm-deep, 7-cm-diameter abscess pocket that was subsequently debrided. Regional digital i.v. perfusion was performed and repeated 15 days later, using cefoxitin and gentamicin on both occasions. Between treatments, the cow received trimethoprim-sulfamethoxazole and phenylbutazone orally. Within 2 days of administering anesthesia and the first perfusion treatment, the lameness improved dramatically. When phenylbutazone was discontinued 1 wk after the first treatment, the lameness had completely resolved. At the second treatment, there was no evidence of further soft tissue infection, and the abscess pocket had resolved.

Effects of prolactin administered to a perfused area of the skin of Angora goats

It is suspected that prolactin may affect mohair growth; therefore, effects of infusing prolactin on mohair growth were investigated using a skin perfusion technique. Seven Angora wethers (average body weight, 30 +/- 3 kg) were implanted bilaterally with silicon catheters into the superficial branches of the deep circumflex iliac artery and vein. For the first 14 d of the experiment, animals were infused (2.4 mL/h) with prolactin (one side) or control (other side) into the deep circumflex iliac arteries. The infusion rate of prolactin was 2.21 mg/d and was calculated to triple prolactin blood concentration in the perfused region. The area of skin supplied by the deep circumflex iliac artery was approximately 240 cm2. Two weeks after the cessation of infusions, 100-cm2 areas within the perfused regions were shorn to determine mohair growth. Greasy and clean mohair production was decreased (P < 0.05) by prolactin compared with control (3.79 vs 4.62 and 3.02 vs 3.67 g/[100 cm2 x 28 d], respectively). Oxygen satura tion in blood hemoglobin from the deep circumflex iliac veins was greater (P < 0.02) on the side infused with prolactin than on the control side (75.1 vs 68.2%). Higher concentrations of methionine, lysine, valine, isoleucine, and leucine were observed in blood of the deep circumflex iliac vein on the side infused with prolactin vs that infused with control (P < 0.05). In conclusion, direct skin infusion with prolactin decreased mohair fiber synthesis by the skin and may have concomitantly lessened oxygen consumption. Thus, effects of increasing prolactin concentration approximately two-fold in the skin on mohair fiber growth may not be limited to simple competition for nutrients between skin and other tissues such as the mammary gland.

Development and evaluation of a new apparatus for continuous perfusion of isolated perfused pig heart

To develop a better model of isolated perfused heart, a new apparatus of coronary artery cannula- fixed-in-aortic tube was developed for continuous normothermic perfusion and compared to the Casalis apparatus with cold ischemia. Eight mongrel pigs with the body weight of 18 to 24 kg were divided half into two groups. All the continuous perfusion experimental hearts resumed a spontaneous heart beat and stabilized earlier than the control hearts without the need of defibrillator or pacemaker, indicating no reperfusion injury on the heart. All the experimental hearts did not show fibrillation nor stopped beating during the entire experiment, whereas the control hearts fibrillated. Two control hearts stopped beating, and only one of the two survived with the help of pacemaker.The coronary systolic, diastolic, and mean pressures were more stable with low variation in the experimental hearts than the cold ischemic control hearts. The experimental hearts consumed more oxygen than the control hearts, indicating more cardiac output. According to these results, the continuous normothermic perfusion method by the new cannula, even though with a short-period of hypothermic perfusion, provided better myocardial protection than the cold ischemia.

Acute effects of escalating doses of amiodarone in isolated guinea pig hearts

Cardiac effects of escalating concentrations of amiodarone were determined on isolated perfused guinea pig hearts (Langendorff preparations). Spontaneously beating hearts were instrumented for the measurement of RR, PQ, QRS, QT and QTc durations (from a bipolar electrogram), and dP/dtmax and dP/dtmin from an isovolumetric left ventricular pressure curve. Ten hearts were exposed to escalating concentrations of amiodarone (10-7, 10-6, 10-5 and 10-4 M) in dimethyl sulfoxide (DMSO)/Krebs-Henseleit or to DMSO/Krebs-Henseleit (vehicle). Measurements were collected during the last minute of a 15-min concentration. Means of all parameters were compared by ANOVA with repeated measures design. When compared with vehicle, amiodarone prolonged QT and QTc durations at concentrations >10-6 M. The apparent lengthening of RR, PQ and QRS at concentrations >10-6 M did not achieve statistical significance. Similarly, the apparent decreases in dP/dtmax and dP/dtmin at concentrations >10-6 M did not achieve statistical significance. The putative therapeutic concentration of amiodarone is between 2 and 4 x 10-6 M. In this study, at a concentration of 10-6 M, only RR and dP/dtmin tended to change, but they were not different from vehicle. Thus, amiodarone in this preparation has little potential for cardiac toxicity at therapeutic concentrations.

Effects of small peptides or amino acids infused to a perfused area of the skin of Angora goats on mohair growth

The effect of infusing dipeptides or their amino acids on mohair growth of Angora goats was investigated using a skin perfusion technique. Seven Angora wethers (average BW 24 +/- 2.5 kg) were implanted bilaterally with silicon catheters into the superficial branches of the deep circumflex iliac artery and vein and carotid artery. The experiment consisted of three 28-d phases. In the first 14 d of Phases 1 and 3, saline was infused into deep circumflex iliac arteries supplying skin and in Phase 2 a mixture of dipeptides (methionine-leucine [Met-Leu], lysine-leucine [Lys-Leu]) was infused into the artery on one side, and free amino acids were administered on the other side. Infusion rates of peptides were 0.85 mg/h Met-Leu and 0.85 mg/h Lys-Leu in 2.4 mL saline. Infusion rates of amino acids were 0.474 mg/h Lys, 0.483 mg/h Met, and 0.743 mg/h Leu in 2.4 mL saline. A 100-cm2 area within the perfused region was used to determine mohair growth. Two weeks after the cessation of infusions, perfused areas were shorn. Clean mohair production from the dipeptide- and amino acids-perfused regions were similar (4.21 vs 4.35 g/[100 cm2 +/- 28 d], respectively; P > 0.05). However, clean mohair production during dipeptides and amino acids infusions was greater (P < 0.01) than that observed during saline infusions (3.63 g/[100 cm2 +/- 28 d]). There were no significant differences between dipeptides and free amino acids in concentrations of various hormones and metabolites in blood from deep circumflex iliac veins (P > 0.05). In conclusion, the studied small dipeptides and amino acids similarly increased mohair fiber growth, presumably through supplying limiting amino acids directly to the fiber follicle.

Butyrate impairs energy metabolism in isolated perfused liver of fed rats

This study was designed to test the effects of short-chain fatty acids (SCFA) with an even number of carbon atoms on hepatic energy metabolism. The effect of the SCFA was evaluated by measuring liver ATP content and oxygen consumption. The ATP content was evaluated using (31)P nuclear magnetic resonance in isolated liver from fed rats. In addition, respiratory activity (VO(2)) was assessed using Clark electrodes. The livers were perfused with acetate, butyrate or a medium chain length fatty acid, octanoate, at a concentration of 0.05--5.0 mmol/L. The addition of each substrate enhanced the rate of the net ATP consumption (V(i)), establishing a new ATP steady state that required a perfusion time of > or = 20 min, dependent on the chain length and concentration of the fatty acid (FA). The initial V(i) was unchanged for acetate and the ATP level stabilized at 58% of the initial level. Both butyrate and octanoate induced a dose-dependent increase in V(i). This may reflect an ATP-consuming process for the intracellular pH regulation observed during the acidosis associated with the beta-oxidation pathway. At the new steady state, the ATP concentration was approximately 45% of the initial level for both FA. VO(2) was both rapidly and reversibly increased, and the change was a function of butyrate or octanoate concentration and of the chain length. K(m) values were similar for butyrate and octanoate. Because all of the effects were similar for butyrate and octanoate, in contrast to acetate, we suggest that the impairment of the energy metabolism by butyrate resulted from an increase in the FADH(2)/NADH ratio due to beta-oxidation. In conclusion, the difference in the hepatic oxidation pathways of two products of intestinal fermentation (acetate and butyrate) explains their different actions on energy metabolism.

Fumonisin B1 carry-over into milk in the isolated perfused bovine udder

The mycotoxin fumonisin B1 (FB1) causes a variety of health problems in animals, while epidemiological evidence suggests it is linked to human esophageal cancer. We investigated the carry-over of FB1 into bovine milk using the isolated perfused bovine udder. Two mg of FB1 was injected into the perfusion blood of 3 udders, and milk and perfused serum levels were determined for 150 min. FB1 passed through the mammary barrier into the milk, but in such low concentrations as to present a negligible risk for consumers.

Tissue distribution of benzylpenicillin after intramammary administration in the isolated perfused bovine udder

Udders from previously healthy lactating cows were perfused with warmed and gassed Tyrode solution in vitro. Benzylpenicillin was administered in three formulations: an oily suspension with micronized particles of <10 microm diameter, an oily suspension with average particle size of 40 microm and an aqueous solution (3 million IU benzylpenicillin-potassium, volume 15 mL). The antibiotics were administered intracisternally to six front and six rear quarters each. Moreover, a dry-off-ointment (100 000 IU benzylpenicillin-potassium and 100 000 IU benzylpenicillin-benzathine, volume 7.5 mL) was tested in four udder halves. Perfusate samples were collected over 3 h. Furthermore, glandular tissue at different vertical distances from the teat base and the regional lymph node were sampled after 3 h. The determination of benzylpenicillin was performed by high pressure liquid chromatography with UV detection. With increasing distance from the teat base, the concentration of benzylpenicillin in tissue exponentially decreased. Using the aqueous solution or oily suspension that contained micronized active principle, higher concentrations were reached compared to the formulation with particle sizes of 40 microm. In udder lymph nodes, the concentration was highest after treatment with the coarse suspension. The transfer from the dry-off-ointment with benzathine-salt into perfusate was very low. These results suggest that it is possible to study tissue distribution of antibiotics in the isolated perfused bovine udder.

Development of an improved technique for the perfusion of the isolated caudal lobe of sheep liver

The study was designed to develop an improved technique for perfusing the isolated caudal lobe of sheep liver. Twenty caudal lobes were perfused for 3-4 h, in a non-recirculating mode, with Krebs-Henseleit bicarbonate buffer. The perfusion system was designed to give a constant flow. The hepatic viability and functional normality of the perfused lobe were assessed by measuring the perfusion flow rate, pH, K+ efflux, O2 uptake, substrate uptake, gluconeogenesis from propionate and amino acids, and ureagenesis from ammonia and amino acids. Liver tissue was sampled for histological examination, as well as for the determination of liver glycogen and wet : dry weight ratio. The perfusion flow rate and pH were both stable throughout the perfusion. The potassium concentration in the effluent perfusate did not increase during the perfusion, suggesting that there was no loss of viability or hypoxia. The perfused lobe extracted more than 50% of the O2 supply. The rate of oxygen consumption was comparable to the rate reported in vivo. The initial glycogen content was reduced by about 40% after 4 h perfusion. The wet : dry weight ratio was 3.6, consistent with the absence of tissue oedema. Urea production was stimulated when NH4Cl (0.3 mM) was added to the medium but there was no significant increase in urea release when alanine (0.15 mM), glutamine (0.2 mM) or lysine (0.2 mM) was added. Urea production, however, increased by about 171% when a physiological mixture of amino acids was added. Propionate (0.5 mM), alanine and glutamine stimulated glucose production but not lysine or the complete amino acid mixture. Glutamine release was lower than that reported in the rat liver. Changing the direction of flow also revealed an apparent difference between livers from sheep and rats in their metabolism of ammonia. The improved technique offers a simple practical and inexpensive approach to many problems in ruminant physiology and nutritional biochemistry.

Dynamic CT measurement of contrast medium washin kinetics in canine nasal tumors

Tumor oxygenation affects the biologic behavior of a tumor and also its radiation response. Decreased tumor oxygenation has been associated with an aggressive phenotype and with decreased local tumor control following irradiation. Thus, measurement of oxygenation may be useful for pretreatment evaluation of a tumor. Many methods for assessing tumor oxygenation are available but most are invasive. There is a need for a non-invasive measure of oxygenation, or a surrogate for oxygenation. Measurement of perfusion has been suggested as a substitute for measurement of oxygenation. The use of washin kinetics of iodinated contrast medium to estimate perfusion has been shown to be related to radiation response of human carcinomas. We quantified the washin kinetics of iodinated contrast medium using dynamic CT in 9 dogs. All dogs had a malignant nasal tumor and perfusion was quantified at two sites in each tumor to evaluate intratumoral variation in perfusion. Dogs were given an intravenous bolus injection of contrast medium and arterial and tumor washin kinetics quantified using a helical CT scanner. Perfusion was estimated from these data using previously validated methods. Eight of the 9 dogs received definitive radiation therapy and perfusion was quantified a second time in these 8 dogs midway through irradiation. Pretreatment perfusion varied between dogs by a factor of 16.9. Between dog variation in perfusion was subjectively greater than within tumor variation based on comparison of two intratumoral regions. Changes in perfusion in individual dogs during irradiation were observed, but no identifiable pattern of perfusion alteration was detected. Measurement of perfusion in canine nasal tumors using dynamic CT is possible and further study of this parameter as it relates to radiation response is reasonable.

Whole-body systemic transcapillary filtration rates, coefficients, and isogravimetric capillary pressures in Bufo marinus and Rana catesbeiana

Whole-body and organ-level transcapillary filtration rates and coefficients are virtually unexamined in ectothermal vertebrates. These filtration rates appear to be greater than in mammals when plasma volume shifts and lymphatic function are analyzed. Gravimetric techniques monitoring whole-body mass changes were used to estimate net systemic filtration in Bufo marinus and Rana catesbeiana while perfusing with low-protein Ringer's and manipulating venous pressure. Capillary pressures were estimated from arterial and venous pressures after measuring the venous to arterial resistance ratio of 0.23. The capillary filtration coefficient (CFC) for the two species was 25.2+/-1.47 mL min-1 kg-1 kPa-1. Isogravimetric capillary pressure (Pci), the pressure at which net fluid is neither filtered nor reabsorbed, was 1.12+/-0.054 kPa and was confirmed by an independent method. None of these variables showed a significant interspecific difference. The anuran CFC and Pci are significantly higher than those found using the same method on rats (7.6+/-2.04 mL min-1 kg-1 kPa-1 and 0.3+/-0.37 kPa, respectively) and those commonly reported in mammals. Despite the high CFC, the high Pci predicts that little net filtration will occur at resting in vivo capillary pressures.

Arterially perfused eye model of uveitis

OBJECTIVE

To develop an in vitro model of uveitis based on an ex situ perfused eye to evaluate the anti-inflammatory activity of new pharmacological products.

PROCEDURE

Eyes were removed from more than 60 dogs and 9 horses immediately after euthanasia and perfused with nutrient medium through the lateral long ciliary artery. Perfused eyes produced aqueous humour, and perfusion pressure was adjusted to obtain an intraocular pressure in the physiological range. When the eyes were treated with histamine, a complement C5a analogue peptide and hydrogen peroxide, typical signs of uveitis were produced. These included miosis, vascular leakage, reduced intraocular pressure, reduced flow of perfusate and, in some eyes, conjunctival oedema.

RESULTS

Canine eyes showed a decrease in intraocular pressure and a decrease in perfusate flow rate when challenged with 100 mumol/L hydrogen peroxide. Flunixin meglumine (5 mumol/L), ketoprofen (5 mumol/L), indomethacin (5 mumol/L) as well as a new drug pirfenidone (10 mumol/L) prevented changes in intraocular pressure induced by hydrogen peroxide, but did not significantly moderate the mediator-induced changes in perfusate flow.

CONCLUSIONS

This model is suitable for evaluating potential anti-inflammatory activity of drugs without having to induce uveitis in an experimental animal. The technique is suitable for species that range in size from cats to horses.

Hypothermic storage of feline kidneys for transplantation: successful ex vivo storage up to 7 hours

OBJECTIVE

To describe the effect of hypothermic storage on transplanted feline kidneys.

STUDY DESIGN

Kidneys were stored in University of Wisconsin (UW) sodium gluconate (n = 3) or phosphate-buffered sucrose (n = 5) solutions before transplantation.

ANIMAL POPULATION

Eight cats with renal failure and seven normal cats as kidney donors.

METHODS

Kidneys were perfused through the renal artery with cold (10 degree C) storage solution and immersed in the solution on ice until transplantation.

RESULTS

Mean ex vivo storage time was 4.8 +/- 0.36 hours (range, 3.5 to 7 hours). Seven recipient cats survived surgery. Five of the cats had decreased serum creatinine concentrations from a mean of 8.2 mg/dL (range, 4.0 to 15.8 mg/dL) preoperatively to 1.7 mg/dL (range 1.3 to 2.2 mg/dL) within 4 days of surgery. In one cat, serum creatinine concentration dropped from 15.1 to 3.7 mg/dL in 3 days, but the cat developed a ureteral stricture that required revision. One graft did not function, and the cat died on day 19. The mean postoperative survival time of cats that were discharged from the hospital (n = 6) was 254 days (range, 49 to 717 days) at the time of this report. Long-term renal function (> 60 days postoperatively; n = 5) was excellent with mean serum creatinine concentrations of 1.6 +/- 0.15 mg/dL.

CONCLUSIONS

Hypothermic storage is feasible for short-term preservation of feline kidneys. The maximal length of feasible storage remains unknown.

CLINICAL RELEVANCE

Hypothermia protects against ischemia-induced nephron loss during ex vivo manipulation of the allograft and allows longer safe vascular anastomosis times. Short-term hypothermic storage also provides time to accommodate modifications in scheduling or anesthetic management of the recipient operation.

In vitro flow characteristics of the Ahmed and self-constructed anterior chamber shunts

OBJECTIVE

To compare in vitro opening pressures (OP) and closing pressures (CP) of the Ahmed VS-1 and VS-2 glaucoma valves with those of several self-constructed valve 'prototypes,' and to assess their ability to maintain perfusion pressures between 6 and 21 mm of Hg.

SAMPLE POPULATION

Ahmed VS-1 (n = 6), 2 groups of Ahmed VS-2 (group 1: n = 12; group 2: n = 14), and self-constructed valves with linear incisions in the long axis of the tube wall (n = 6) or X-shaped incisions in the tube walls (n = 2).

PROCEDURE

Valves were perfused with deionized water, lactated Ringer's solution (LRS), Dulbecco's modified Eagle's medium (DMEM), DMEM plus 50% equine serum (ES), and 100% ES. Flow rates of 2.85, 4.2, 6.0, 9.0, and 12.0 microliter/min were used for each perfusate. Valves were tested 3 times for reproducibility, and OP/CP were compared for each system.

RESULTS

OP/CP of the VS-1, VS-2 (group 1), VS-2 (group 2), and linear 1.0-cm incisional valves with thick tubing consistently increased with increasing perfusion rate. Linear 0.5-cm (thick tubing) and 1.0-cm (thin tubing) incisional valves had increasing OP/CP with increasing perfusion rate in all but a few instances. Mean OP/CP decreased with increasing perfusate osmolarity for all perfusates except LRS, using the VS-1 and V-2 (group 2) valves. Mean OP/CP were consistently lower for VS-1 than VS-2 (group 1) valves at any given flow rate and for any given perfusate. Mean OP/CP were consistently lower for VS-2 (group 1) than VS-2 (group 2) valves at any given flow rate and for any given perfusate. The linear 0.5-cm incisional valves with thick and thin tubing induced the highest mean OP/CP, maximizing at > 30 mm of Hg.

CONCLUSIONS

Only the VS-2 (group 2) valves consistently had mean OP/CP between 6 and 21 mm of Hg for all perfusates and at all flow rates.

CLINICAL RELEVANCE

Anterior chamber shunts, although imperfect, appear to offer a physiologically sound alternative for glaucoma management.

Effects of dipeptides administered to a perfused area of the skin in Angora goats

The effect of dipeptide infusion on mohair growth of Angora goats was investigated using a skin perfusion technique. Six Angora wethers (average BW 32 +/- 2 kg) were implanted bilaterally with silicon catheters into the superficial branches of the deep circumflex iliac artery and to the deep circumflex iliac vein. For the first 14 d of the experiment, animals received infusions into the deep circumflex iliac arteries of either a mixture of Met-Leu and Lys-Leu (one side) or saline (other side). Infusion rates of amino acids were .72 mg/h Met-Leu and .72 mg/h Lys-Leu. The area of skin supplied by the deep circumflex iliac artery was approximately 300 cm2. An area of 150 cm2 within the perfused region was used to determine mohair growth. Two weeks after the cessation of infusions, perfused areas were shorn, and greasy and clean mohair production, staple length, and diameter were determined. Greasy and clean mohair production from the perfused region were increased by dipeptide infusion compared to the side infused with saline (1.91 vs 1.66 g, P < .05 and 1.56 vs 1.31 g, P < .04, respectively). No significant changes were observed in mohair diameter; however, staple length tended to increase as a result of dipeptide infusion (18.0 vs 16.1, P < .1). Decreased concentrations of Met, Cys, Lys, Phe, Val, Ileu, Leu, and Arg were observed in the venous blood taken from the deep circumflex iliac vein on the side infused with the amino acid mixture compared with blood taken from the saline side (P < .05). There were no treatment differences in triiodothyronine, thyroxine, or insulin concentrations in venous blood taken from the deep circumflex iliac vein. Direct skin infusion with dipeptide may have resulted in mobilization of amino acids for increased protein synthesis, or the infused dipeptides may have acted as growth promoters stimulating skin amino acid uptake and protein synthesis.

Recovery of Schistosoma japonicum from experimentally infected pigs by perfusion of liver and mesenteric veins

An optimized procedure for perfusion of pigs infected with Schistosoma japonicum was developed. The technique involves insertion of a perfusion influx tube into the thoracic descending aorta, clamping vessels to parts of the body which did not need to be perfused (the kidneys, hind legs, etc.) and placing a collection tube directly into the portal vein. In addition, the clamping technique allows for separate perfusion of the liver and intestinal veins. The perfusion medium was a sodium citrate buffer (40 degrees C) to which the vasodilator sodium nitroprusside was added. Furthermore, an experiment was conducted to investigate if the perfusion efficiency, measured by total worm recovery, could be increased if praziquantel was administered prior to perfusion. Twelve pigs were each infected with 1000 S. japonicum cercariae and their schistosomes were collected 11 weeks later by separate perfusion of the liver and intestinal veins. Six of these pigs were treated orally with praziquantel one hour before perfusion. In general, the vessels of the livers and intestines of all pigs were well perfused, judging by the resulting pale colour of the tissues. Worms from praziquantel treated pigs were collected within 5 min of perfusion as opposed to approximately 20 min in the non-treated pigs. More worms were collected from the livers of the praziquantel treated pigs, indicating a hepatic shift of schistosomes from the intestinal mesenteries. However, comparable numbers of worms were retained in the mesenteric veins following perfusion in the 2 groups, indicating that manual recovery of schistosomes from the intestinal mesenteries is necessary in addition to perfusion for obtaining the total worm counts. Another experiment was conducted to determine if the intensity and/or duration of infection had an effect on the number of worms collected by the perfusion technique. Seventy-two pigs were allocated into 3 groups of 24 pigs each, which were infected with either 100, 500 or 2000 cercariae per pig. The 3 groups were further divided into 4 subgroups of 6 pigs each which were perfused with our selective technique at 4, 11, 17 or 24 weeks post infection, respectively. All of the pigs received an oral praziquantel treatment prior to perfusion. The results indicated that increasing intensities and/or duration of infection resulted in trapping of schistosomes in intravascular inflammatory reactions which made it more difficult to collect the adult schistosomes by perfusion.