Evaluation of regional limb perfusion with amikacin using the saphenous, cephalic, and palmar digital veins in standing horses.
Abstract: Previous studies have shown that regional limb perfusion (RLP) using the palmar digital (PD) vein delivers therapeutic concentration of amikacin to the distal limb. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of amikacin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous, or PD vein was used to perfuse the limb with amikacin. Two grams of amikacin was used for RLP using the saphenous and the cephalic veins, and one gram was used in the PD vein. Synovial samples were collected from the metacarpo-/metatarsophalangeal (MCP/MTP) joint, and blood samples were collected from the jugular vein. Maximum concentration (Cmax) of amikacin in the MCP/MTP joint using the cephalic and the saphenous vein was 277 and 363 mg/L, respectively. The amikacin concentrations achieved in the synovial fluid of the MCP/MTP joint in the current study were between 69 and 91 times the minimally inhibitory concentration of common susceptible bacterial pathogens causing orthopedic infections in horses. To conclude, this study shows that use of the proximal veins for RLP to treat distal limb infections is a viable alternative to using the palmar or plantar digital vein.
© 2012 Blackwell Publishing Ltd.
Publication Date: 2012-05-18 PubMed ID: 22607056DOI: 10.1111/j.1365-2885.2012.01414.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research article investigates the effectiveness of regional limb perfusion (RLP) with antibiotic amikacin using different veins in horses. The study concludes that the technique is viable in treating infections in horse’s lower limbs.
Research Methodology
- The study was performed on nineteen healthy horses as a testing sample.
- For RLP, two doses of Amikacin were used: two grams for saphenous and the cephalic veins, and one gram for the PD vein.
- The aim was to determine how well the antibiotic reached the lower parts of the limbs when introduced through the saphenous, cephalic, or PD vein.
- Synovial sample collection was done from the metacarpo-/metatarsophalangeal (MCP/MTP) joint. This is essentially the primary joint in a horse’s limb, equivalent to a human ankle.
- Blood samples were also collected from the jugular vein for testing purposes.
Research Findings
- The results revealed that the maximum concentration (Cmax) of Amikacin in the MCP/MTP joint, depending on the vein used, ranged between 277 mg/L and 363 mg/L.
- In comparison to the minimum inhibitory concentration (MIC) of common bacteria causing orthopedic infections in horses, the amount of Amikacin found at the limb site was between 69 and 91 times higher. The metric MIC is important as it represents the lowest concentration of a drug needed to inhibit growth of a bacterial strain.
- These findings suggest that the dosage and administration method of the Amikacin via RLP could be an effective way to combat such infections in horses.
Final Conclusion
- The study has made a significant contribution in demonstrating that using proximal veins (cephalic and saphenous) for Regional Limb Perfusion, with the right dosage of Amikacin, can effectively treat distal limb infections in horses.
- This offers a viable alternative to the previously used palmar or plantar digital vein for RLP, thus offering potentially more effective and versatile treatment options.
Cite This Article
APA
Kelmer G, Bell GC, Martin-Jimenez T, Saxton AM, Catasus C, Elliot SB, Meibohm B.
(2012).
Evaluation of regional limb perfusion with amikacin using the saphenous, cephalic, and palmar digital veins in standing horses.
J Vet Pharmacol Ther, 36(3), 236-240.
https://doi.org/10.1111/j.1365-2885.2012.01414.x Publication
Researcher Affiliations
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA. galkelmer@hotmail.com
MeSH Terms
- Amikacin / administration & dosage
- Animals
- Anti-Bacterial Agents / administration & dosage
- Drug Administration Routes
- Female
- Forelimb / blood supply
- Horses / physiology
- Male
Citations
This article has been cited 10 times.- Mizuguchi Y, Kato A, Aizu M. Regional antibiotic perfusion through the lateral saphenous vein in two horses with septic calcaneal osteitis.. J Vet Med Sci 2023 Jan 6;85(1):55-61.
- Redding LE, Elzer EJ, Ortved KF. Effects of regional limb perfusion technique on concentrations of antibiotic achieved at the target site: A meta-analysis.. PLoS One 2022;17(4):e0265971.
- Vajs T, Nekouei O, Biermann NM. A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement.. Animals (Basel) 2022 Feb 21;12(4).
- de Souza Garcia AF, Ribeiro G, de Assis Arantes J, Reginato GM, Xavier NV, Carregaro AB, Silva TJF, Grigoletto R, de Freitas SH, Dória RGS. Evaluation of totally implantable catheters in healthy horses.. BMC Vet Res 2021 Oct 26;17(1):339.
- Bonilla AG, Causeret L, Torrent-Crosa A. Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses.. Can Vet J 2021 Sep;62(9):975-981.
- Gustafsson K, Tatz AJ, Dahan R, Abu Ahmad W, Britzi M, Sutton GA, Kelmer G. Synovial Concentration of Trimethoprim-Sulphadiazine Following Regional Limb Perfusion in Standing Horses.. Animals (Basel) 2021 Jul 13;11(7).
- Dahan R, Oreff GL, Tatz AJ, Raz T, Britzi M, Kelmer G. Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses.. Can Vet J 2019 Mar;60(3):294-299.
- Nieto JE, Trela J, Stanley SD, Yamout S, Snyder JR. Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses.. Can J Vet Res 2016 Jul;80(3):230-5.
- Dória RG, Carvalho MB, Freitas SH, Laskoski LM, Colodel EM, Mendonça FS, Silva MA, Grigoletto R, Fantinato Neto P. Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb.. BMC Vet Res 2015 Jul 16;11:152.
- Hunter BG, Duesterdieck-Zellmer KF, Larson MK. Tiludronate concentrations and cytologic findings in synovial fluid after intravenous regional limb perfusion with tiludronate in horses.. PeerJ 2015;3:e889.
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