Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases.

The objective of this study was to investigate the postoperative use of intrasynovial honey as an antimicrobial after treatment for synovial sepsis in horses. One colt and 2 mares were presented with acute lameness, with or without an associated wound. All 3 cases were initially managed with surgical endoscopic or tenoscopic debridement and lavage for treatment of different synovial structures. Collection of synovial fluid was consistent with synovial sepsis and this was diagnosed in each case. All horses subsequently underwent arthroscopic lavage under general anesthetic and intraarticular or intrathecal medical-grade honey (MGH) was then instilled. All 3 cases recovered well and were free from lameness at all gaits. Although there is extensive research about the antimicrobial properties of honey and growing interest in the biocompatibility of honey in joints with the use of honey hydrogels in human medicine, the research in veterinary medicine is lacking. There are studies describing the antimicrobial properties of honey in healing wounds in horses, but there are no published studies describing the use of honey within a synovial structure. Further research is necessary to assess the biocompatibility of honey in equine articular cartilage. In the cases described in this article, the use of honey demonstrated a safe adjunctive therapy after conventional surgical treatment for septic arthritis.

L'objectif de cette étude était d'étudier l'utilisation postopératoire du miel intrasynovial comme antimicrobien après le traitement d'une infection synoviale chez les chevaux. Un poulain et deux juments ont été présentés avec une boiterie aiguë, avec ou sans plaie associée. Les trois cas ont été initialement pris en charge par un débridement chirurgical endoscopique ou ténoscopique et un lavage pour le traitement de différentes structures synoviales. La collecte de liquide synovial était compatible avec une infection synoviale et celle-ci a été diagnostiquée dans chaque cas. Tous les chevaux ont ensuite subi un lavage arthroscopique sous anesthésie générale et du miel de qualité médicale (MGH) intra-articulaire ou intrathécal a ensuite été instillé. Les trois cas se sont bien rétablis et étaient exempts de boiterie à toutes les allures. Bien qu'il existe des recherches approfondies sur les propriétés antimicrobiennes du miel et un intérêt croissant pour la biocompatibilité du miel dans les articulations avec l'utilisation d'hydrogels de miel en médecine humaine, la recherche en médecine vétérinaire fait défaut. Il existe des études décrivant les propriétés antimicrobiennes du miel dans la cicatrisation des plaies chez les chevaux, mais aucune étude publiée ne décrit l'utilisation du miel dans une structure synoviale. Des recherches supplémentaires sont nécessaires pour évaluer la biocompatibilité du miel dans le cartilage articulaire équin. Dans les cas décrits dans cet article, l'utilisation du miel a démontré une thérapie d'appoint sûre après le traitement chirurgical conventionnel de l'arthrite septique.(Traduit par Docteur Serge Messier).

Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses.

BACKGROUND: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION: This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.

A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.

OBJECTIVE: To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. STUDY DESIGN: Retrospective controlled clinical case series. ANIMALS: Horses (n = 68) with ORDSP. METHODS: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) using Mayo scissors; supraspinous ligaments were left intact. All horses had the same controlled exercise plan and returned to work 3-6 weeks after treatment. RESULTS: Methylprednisolone was administered in 1-7 spaces in 38 cases, compared with ISLD in 3-8 spaces in 37 cases. Thirty-four horses (89%) treated medically initially resolved signs of back compared with 35 horses (95%) treated surgically. From these, back pain recurred in 19 medical cases and in none of the surgical cases. Horses having ISLD were 24 times more likely to experience long-term resolution of signs of back pain (OR 24; 95%CI: 5-115; P = < .0001). Repeat radiographs in 19 surgical cases indicated that interspinous spaces widened significantly postoperatively (P = < .0001). CONCLUSIONS: This surgical technique allowed horses with back pain and radiographic ORDSP to return to work without further clinical signs of back pain and to show radiographic evidence of improvement.

Modeling the airway epithelium in allergic asthma: interleukin-13- induced effects in differentiated murine tracheal epithelial cells.

Mucous cells of the airway epithelium play a crucial role in the pathogenesis of human inflammatory airway diseases. Therefore, it is of importance to complement in vivo studies that use murine models of allergic asthma with in vitro mechanistic studies that use murine airway epithelial cells, including mucus-containing cells. In this study, we report the development and characterization of an in vitro culture system for primary murine tracheal epithelial (MTE) cells comprising ciliated cells and a substantial number of mucous cells. The increase in mucous cell number over that observed in the native murine airway, or in previously described murine cultures, creates a culture intermediate between the in vivo murine airway epithelium and in vitro cultures of human airway epithelial cells. To establish the usefulness of this culture system for the study of epithelial effects during inflammatory airway diseases, the cells were exposed to interleukin (IL)-13, a central inflammatory mediator in allergic asthma. The IL-13 induced two characteristic epithelial effects, proliferation and modulation of MUC5AC gene expression. There was a concentration dependence of these events, wherein high concentrations of IL-13 (10 ng/ml) induced proliferation, whereas lower concentrations (1 ng/ml) increased MUC5AC mRNA (where mRNA is messenger RNA). Interestingly, these effects occurred in an inverse manner, with the high concentration of IL-13 also provoking a significant decrease in MUC5AC gene expression. Thus, MTE cells cultured in this manner may provide an important link between experimental findings from animal models of allergic asthma and their application to human disease.

PI3K signaling is required for prostaglandin-induced mucosal recovery in ischemia-injured porcine ileum.

We have previously shown that PGE(2) and PGI(2) induce recovery of transepithelial resistance (TER) in ischemia-injured porcine ileal mucosa, associated with initial increases in Cl(-) secretion. We believe that the latter generates an osmotic gradient that stimulates resealing of tight junctions. Because of evidence implicating phosphatidylinositol 3-kinase (PI3K) in regulating tight junction assembly, we postulated that this signaling pathway is involved in PG-induced mucosal recovery. Porcine ileum was subjected to 45 min of ischemia, after which TER was monitored for a 180-min recovery period. Endogenous PG production was inhibited with indomethacin (5 microM). PGE(2) (1 microM) and PGI(2) (1 microM) stimulated recovery of TER, which was inhibited by serosal application of the osmotic agent urea (300 mosmol/kgH(2)O). The PI3K inhibitor wortmannin (10 nM) blocked recovery of TER in response to PGs or mucosal urea. Immunofluorescence imaging of recovering epithelium revealed that PGs restored occludin and zonula occludens-1 distribution to interepithelial junctions, and this pattern was disrupted by pretreatment with wortmannin. These experiments suggest that PGs stimulate recovery of paracellular resistance via a mechanism involving transepithelial osmotic gradients and PI3K-dependent restoration of tight junction protein distribution.

Effects of hydrocortisone on substrates of energy metabolism in alpacas.

OBJECTIVE: To evaluate effects of hydrocortisone administration, with and without concurrent administration of insulin, on intermediary metabolism in alpacas. ANIMALS: 8 adult castrated male alpacas. PROCEDURE: On each of 2 consecutive days, food was withheld from alpacas for 8 hours. Alpacas then were administered 1 mg of hydrocortisone sodium succinate/kg, IV (time 0). On 1 of the days, randomly assigned alpacas were also administered regular insulin (0.2 U/kg, IV) 120 minutes after hydrocortisone administration. Blood samples were collected at 0, 120, 135, 150, 165, 180, 210, 240, 300, and 360 minutes. Plasma concentrations of glucose and lactate and serum concentrations of triglycerides, cholesterol, nonesterified fatty acids, and beta-hydroxybutyrate were determined. Data were compared between days. Additionally, serum insulin concentrations before and after hydrocortisone administration were determined for selected samples. RESULTS: Hydrocortisone administration induced hyperglycemia, hyperinsulinemia, a reduction in concentrations of triglycerides and cholesterol, and a reduction in triglyceride-to-cholesterol ratio. Subsequent insulin administration temporarily negated the hyperglycemic effects of hydrocortisone, induced temporary hyperlactemia, and augmented the reduction in blood triglycerides. CONCLUSIONS AND CLINICAL RELEVANCE: A single dose of a short-acting corticosteroid does not increase blood lipid fractions in healthy alpacas, probably because of a competent endogenous insulin response. Corticosteroids may induce differing responses in camelids with depleted glycogen stores or an ineffective insulin response. Administration of insulin can effectively negate the hyperglycemic effects of hydrocortisone and augment lipoprotein clearance. Hence, insulin administration may be therapeutic for alpacas with hyperglycemia, hyperlipemia, or hyperketonemia.