Clinical effect of torsemide in a horse with congestive heart failure and atrial fibrillation.
Abstract: In this case report, a high dose of torsemide (6mg/kg, every 12 hours for 3 days followed by 12mg/kg, every 12 hours for 4 days) was administered orally to a horse with congestive heart failure (CHF) and atrial fibrillation. Blood samples for measurement of plasma torsemide concentrations were obtained one hour after each drug administration. Pharmacodynamic effects of oral torsemide were evaluated by daily physical examination, electrocardiography, and serum biochemistry. The horse tolerated administration of torsemide. A decrease in ventral oedema and venous congestion was subjectively noted at day 7. Torsemide plasma concentration markedly increased at day 5 (peak concentration of 15.41 µg/mL). Evidence of an increase in renal markers was observed throughout the study period. Electrolyte measurements revealed mild hyponatremia and hypochloremia, and moderate hypokalaemia. No electrocardiographic changes related to torsemide administration were observed. After seven days of treatment, the horse was euthanised due to his disease stage and poor prognosis. Results indicate that torsemide was absorbed after oral administration and was well tolerated in this horse. Furthermore, clinical improvement in this single case indicates that torsemide might be utilized as an oral alternative to furosemide in the management of equine patients in CHF. The high doses of torsemide used in this case report should be reserved for cases without clinical response to lower doses and with close monitoring of electrolytes and renal function parameters. Further investigation of torsemide clinical efficacy and safety in horses with CHF with a larger cohort and prolonged administration is warranted.
Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.
Publication Date: 2024-01-06 PubMed ID: 38190865DOI: 10.1016/j.jevs.2024.105001Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Case Reports
Summary
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The study describes the impact of the drug torsemide on a horse suffering from congestive heart failure and atrial fibrillation. It comments on the drug’s effectiveness, the horse’s response to the treatment, and its potential as an alternate drug to be used in similar scenarios.
Methodology
- The researchers administered a high dose of torsemide orally to a horse already diagnosed with CHF (Congestive Heart Failure) and atrial fibrillation.
- The medication was given at a dosage of 6mg/kg every 12 hours for the first three days, followed by 12mg/kg every 12 hours for the subsequent four days
- Blood samples were taken hourly after each dosage to measure plasma torsemide concentrations and observe its presence and effect in the horse’s system
- Daily evaluations, including physical examinations, electrocardiography, and serum biochemistry, were conducted to determine the after-effects of torsemide.
Findings
- The horse responded well to torsemide administration, indicating that the drug was well-tolerated.
- A significant reduction in ventral oedema (a type of swelling) and venous congestion was observed on the seventh day of the treatment.
- Plasma torsemide concentrations saw a steep increase on day five, recording a peak concentration of 15.41 µg/mL.
- The study also observed an increase in renal markers, denoting more active or efficient kidney function.
- Electrolyte measurements showed mild decreases in sodium (hyponatremia) and chlorine (hypochloremia) levels, and a moderate reduction in potassium (hypokalaemia).
- There were no observable changes in the horse’s electrocardiogram, suggesting that the drug had no adverse effects on the heart’s electrical activity.
- Despite the initial improvements, the horse was euthanised after the seventh day, given the poor prognosis and advancement stage of the disease.
Conclusion and Future Implications
- This case study shows that torsemide was absorbed and well-tolerated when orally administered to a horse, hinting at its potential as a possible alternative to furosemide in managing patients suffering from equine CHF.
- However, the researchers caution that the high dosage of torsemide used in this case should only be considered in cases where there is no clinical response to smaller doses and should be monitored closely for any changes in electrolyte levels and renal function parameters.
- The study concludes that further investigation of the clinical efficacy and safety of torsemide in treating horses with CHF, incorporating a larger cohort and extended administration period, is recommended.
Cite This Article
APA
Agne GF, Kapusniak AE, Wooldridge AA, Jung SW.
(2024).
Clinical effect of torsemide in a horse with congestive heart failure and atrial fibrillation.
J Equine Vet Sci, 105001.
https://doi.org/10.1016/j.jevs.2024.105001 Publication
Researcher Affiliations
- School of Animal and Veterinary Sciences, The University of Adelaide, 1454 Mudla Wirra Road, Roseworthy, 5371, South Australia, AUS. Electronic address: gustavo.ferliniagne@adelaide.edu.au.
- School of Animal and Veterinary Sciences, The University of Adelaide, 1454 Mudla Wirra Road, Roseworthy, 5371, South Australia, AUS.
- Department of Clinical Sciences, Auburn University, 1130 Wire Rd, Auburn, 36849, Alabama, USA.
- Department of Clinical Sciences, Auburn University, 1130 Wire Rd, Auburn, 36849, Alabama, USA.
Conflict of Interest Statement
Declaration of competing interest The authors declare no conflict of interest.