Regional limb perfusion with antimicrobials in horses

Authors

  • Jackson Schade Universidade do Estado de Santa Catarina
  • Juliana Massitel Curti Universidade Estadual de Londrina
  • Gustavo Romero Gonçalves Universidade Estadual de Londrina
  • Taise Pissinato da Silva Universidade Estadual de Londrina
  • Emanuel Vitor Pereira Appolonio Universidade Estadual Paulista "Júlio de Mesquita Filho", Campus de Botucatu

DOI:

https://doi.org/10.5965/223811711812019281

Keywords:

equine, orthopedic infections, tourniquet

Abstract

Orthopedic infections are conditions commonly observed in horses, often affecting important structures such as bone and synovial tissue. Septic source conditions are extremely important in horses as they may result in permanent lameness caused by irreversible joint lesions. Therefore, treatments that result in higher concentrations of antimicrobials in infected areas act more effectively eliminating the bacterial population in these tissues. Therefore, the regional limb perfusion has proven to be an excellent alternative. This review addresses the main issues of regional limb perfusion with antimicrobials in horses. It will describe intravenous and intraosseous techniques, which involve the administration of an antimicrobial solution, in a part of the limb, previously isolated from the systemic circulation by applying a tourniquet. Regional perfusion has been described as a successful treatment for septic conditions at the distal region of the equine limb, since high concentrations of antimicrobial are achieved at the sites affected. In addition, it is easy to perform and presents a low risk of adverse systemic effects as well as reduced cost.

Downloads

Download data is not yet available.

References

ABRAHAMSEN E et al. 1989. Tourniquet-induced hypertension in a horse. Journal of the American Veterinary Medical Association 194: 386-388.

ALKABES SB et al. 2011. Comparison of two tourniquets and determination of amikacin sulfate concentrations after metacarpophalangeal joint lavage performed simultaneously with intravenous regional limb perfusion in horses. American Journal of Veterinary Research 72: 613-619.

BUTT TD et al. 2001. Comparison of 2 techniques for regional antibiotic delivery to the equine forelimb: intraosseous perfusion vs. intravenous perfusion. Canadian Veterinary Journal 42: 617-622.

CIMETTI LJ et al. 2004. How to perform intravenous regional limb perfusion using amikacin and DMSO. In: 50 Annual Convention of the American Association of Equine Practitioners. Proceedings… Denver: International Veterinary Information Service. p. 219-223.

COPLAND VS et al. 1989. Blood pressure response to tourniquet use in anesthetized horses. Journal of the American Veterinary Medical Association 195: 1097-1103.

CRUZ AM et al. 2006. New antimicrobials, systemic distribution, and local methods of antimicrobials delivery in horses. Veterinary Clinics Equine Practice 22: 297-322.

ERRICO JA et al. 2008. Comparison of two indirect techniques for local delivery of a high dose of an antimicrobial in the distal portion of forelimbs of horses. American Journal of Veterinary Research 69: 334-342.

FINSTERBUSCH A & WEINBERG H. 1972. Venous perfusion of the limb with antibiotics for osteomyelitis and other chronic infections. The Journal of Bone & Joint Surgery 54: 1227-1234.

HARTMANN FA et al. 1997. Isolation of methicillin-resistant Staphylococcus aureus from a postoperative wound infection in a horse. Journal of the American Veterinary Medical Association 211: 590-592.

HYDE RM et al. 2013. The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse. The Canadian Veterinary Journal 54: 363-367.

KELMER G et al. 2009. Evaluation of indwelling intravenous catheters for the regional perfusion of the limbs of horses. The Veterinary Record 165: 496-501.

KELMER G et al. 2012a. Evaluation of regional limb perfusion with amikacin using the saphenous, cephalic, and palmar digital veins. Journal of Veterinary Pharmacology and Therapeutics 36: 236-240.

KELMER G et al. 2012b. Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb. Veterinary Surgery 41: 938-943.

KELMER G et al. 2014. Evaluation of regional limb perfusion with chloramphenicol using the saphenous of cephalic vein in standing horses. Journal of Veterinary Pharmacology and Therapeutics 38: 35-40.

KELMER G et al. 2017. Evaluation of the pharmacokinetics of imipenem following regional limb perfusion using the saphenous and the cephalic veins in standing horses. Research in Veterinary Science 114: 64-68.

LEVINE DG et al. 2010. Efficacy of three tourniquet types for intravenous antimicrobial regional limb perfusion in standing horses. Veterinary Surgery 39: 1021-1024.

LUGO J. 2009. Regional Limb Perfusion with Antimicrobials. In: ROBINSON NE & SPRAYBERRY KA. Robinson´s Current Therapy in Equine Medicine. 6.ed. Saint Louis: Elsevier. p. 529-530.

LUGO J. 2015. Managing Orthopedic Infections. In: SPRAYBERRY KA & ROBINSON NE. Robinson´s Current Therapy in Equine Medicine. 7.ed. Saint Louis: Elsevier. p. 793-797.

MATTSON S et al. 2004. Intraosseous gentamicin perfusion of the distal metacarpus in standing horses. Veterinary Surgery 33: 180-186.

MOORE RM et al. 1992. Antimicrobial susceptibility of bacterial isolates from 233 horses with musculoskeletal infection during 1979-1989. Equine Veterinary Journal 24: 450-456.

MURPHEY ED et al. 1999. Regional intravenous perfusion of the distal limb of horses with amikacin sulfate. Journal Veterinary Pharmacology and Therapeutics 22: 68-71.

NAVARRE CB et al. 1999. Ceftiofur distribution in plasma and joint fluid following regional limb injection in cattle. Journal Veterinary Pharmacology and Therapeutics 22: 13-19.

PALMER SE & HOGAN PM. 1999. How to perform Regional limb perfusion in the standing horse. In: 45 Annual Meeting of the American Association of Equine Practitioners. Proceedings… Kentucky. p. 124-127.

PARKER RA et al. 2010. Osteomyelitis and osteonecrosis after intraosseous perfusion with gentamicin. Veterinary Surgery 39: 644-648.

PARRA-SANCHEZ A et al. 2006. Pharmacokinetics and pharmacodynamics of enrofloxacin and low dose of amikacin administered via regional intravenous limb perfusion in standing horses. American Journal of Veterinary Research 67: 1687-1695.

PILLE F et al. 2005. Synovial fluid and plasma concentrations of ceftiofur after regional intravenous perfusion in the horse. Veterinary Surgery 34: 610-617.

RAFAEL LA et al. 2014. Avaliação do efeito trombogênico da perfusão regional intravenosa com gentamicina em equinos. Arquivo Brasileiro de Medicina Veterinária e Zootecnia 66: 1449-1456.

RICHARDSON DW & AHERN BJ. 2012. Sinovial and Osseous Infections. In: AUER JA & STICK JA. Equine Surgery. 4.ed. Saint Louis: Elsevier. p. 1189-1200.

RUBIO-MARTÍNEZ LM & CRUZ AM. 2006. Antimicrobial regional limb perfusion in horses. Journal of the American Veterinary Medical Association 228: 706-712.

RUBIO-MARTÍNEZ LM et al. 2005. Medullary plasma pharmacokinetics of vancomycin after intravenous and intraosseous perfusion of the proximal phalanx in horses. Veterinary Surgery 34: 618-624.

RUBIO-MARTÍNEZ LM et al. 2006. Evaluation of safety and pharmacokinetics of vancomycin after intraosseous regional limb perfusion and comparison of results with those obtained after intravenous regional limb perfusion in horses. American Journal of Veterinary Research 67: 1701-1707.

RUBIO-MARTÍNEZ LM et al. 2012. Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999-2009). Journal of the American Veterinary Medical Association 241: 1650-1658.

SANTSCHI EM et al. 1998. How to perform equine intravenous digital perfusion. In: 44 Annual Convention of the American Association of Equine Practitioners. Proceedings… Baltimore. p. 124-127.

SCHNEIDER RK et al. 1992. A retrospective study of 192 horses affected with septic arthritis/tenosynovitis. Equine Veterinary Journal 24: 436-442.

SCHNEIDER RK. 2006. Synovial and Osseous Infections. In: AUER, JA & STICK JA. Equine Surgery. 3.ed. Saint Louis: Elsevier. p. 1121-1129.

SISSON S & GROSSMAN JD. 1986. Anatomia dos animais domésticos. 5.ed. Rio de Janeiro: Guanabara Koogan. 1134p.

SVENSSON E et al. 1997. Pharmacodynamic effects of antibiotics and antibiotic combinations on growing and nongrowing Staphylococcus epidermidis cells. Antimicrobial Agents and Chemotherapy 41: 107-111.

SWINEBROAD EL et al. 2003. Osteomyelitis secondary to trauma involving the proximal end of the radius in horse: five cases (1987-2001). Journal of the American Veterinary Medical Association 223: 486-491.

TACK KJ & SABATH LD. 1985. Increased minimum inhibitory concentrations with anaerobiasis for tobramycin, gentamicin, and amikacin, compared to latamoxef, piperacillin, chloramphenicol, and clindamycin. Chemotherapy 31: 204-210.

TAINTOR J et al. 2006. Comparison of amikacin concentrations in normal and inflamed joints of horses following intra-articular administration. Equine Veterinary Journal 38: 189-191.

WERNER LA et al. 2003. Bone gentamicin concentrations after intra-articular injections or regional intravenous perfusion in the horse. Veterinary Surgery 32: 559-565.

WHITEHAIR KJ et al. 1992. Regional limb perfusion for antibiotic treatment of experimentally induced septic arthritis. Veterinary Surgery 21: 367-373.

Published

2019-06-19

How to Cite

SCHADE, Jackson; CURTI, Juliana Massitel; GONÇALVES, Gustavo Romero; SILVA, Taise Pissinato da; APPOLONIO, Emanuel Vitor Pereira. Regional limb perfusion with antimicrobials in horses. Revista de Ciências Agroveterinárias, Lages, v. 18, n. 2, p. 281–291, 2019. DOI: 10.5965/223811711812019281. Disponível em: https://revistas.udesc.br/index.php/agroveterinaria/article/view/9341. Acesso em: 1 dec. 2024.

Issue

Section

Review Article - Science of Animals and Derived Products