Pharmacokinetics of metronidazole and its concentration in body fluids and endometrial tissues of mares.

Serum concentrations of metronidazole were determined in 6 healthy adult mares after a single IV injection of metronidazole (15 mg/kg of body weight). The mean elimination rate (K) was 0.23 h-1, and the mean elimination half-life (t1/2) was 3.1 hours. The apparent volume of distribution at steady state was 0.69 L/kg, and the clearance was 168 ml/h/kg. Each mare was then given a loading dose (15 mg/kg) of metronidazole at time 0, followed by 4 maintenance doses (7.5 mg/kg, q 6 h) by nasogastric tube. Metronidazole concentrations were measured in serial samples of serum, synovia, peritoneal fluid, and urine. Metronidazole concentrations in CSF and endometrial tissues were measured after the fourth maintenance dose. The highest mean concentration in serum was 13.9 +/- 2.18 micrograms/ml at 40 minutes after the loading dose (time 0). The highest mean synovial and peritoneal fluid concentrations were 8.9 +/- 1.31 micrograms/ml and 12.8 +/- 3.21 micrograms/ml, respectively, 2 hours after the loading dose. The lowest mean trough concentration in urine was 32 micrograms/ml. Mean concentration of metronidazole in CSF was 4.3 +/- 2.51 micrograms/ml and the mean concentration in endometrial tissues was 0.9 +/- 0.48 micrograms/g at 3 hours after the fourth maintenance dose. Two mares hospitalized for treatment of bacterial pleuropneumonia were given metronidazole (15.0 mg/kg, PO, initially then 7.5 mg/kg, PO, q 6 h), while concurrently receiving gentamicin, potassium penicillin, and flunixin meglumine IV. Metronidazole pharmacokinetics and serum concentrations in the sick mares were similar to those obtained in the healthy mares.

Skin pustules and nodules caused by Actinomyces viscosus in a horse.

A 12-year-old Arabian stallion was evaluated for a refractory skin problem of 2 years' duration. Skin nodules and pustules, which would rupture, had developed over the right lumbar muscles. Anaerobic culturing from the pustules yielded Actinomyces viscosus, and histologic examination of biopsy specimens revealed globular eosinophilic structures. Concomitant treatment with isoniazid (8 mg/kg of body weight, q 24 h for 8 weeks), trimethoprim-sulfadiazine (30 mg/kg, q 24 h for 8 weeks), and sodium iodide solution (66 mg/kg, every 1, 2, or 4 weeks, for 32 weeks) resolved the condition.

Ethmoidal hematoma in nine horses.

Ethmoidal hematoma was diagnosed in 9 horses by results of physical examination, endoscopy, radiography, and histologic examination of tissues. The horses had stertorous breathing (n = 4) or intermittently sanguineous nasal discharge (n = 7). All horses underwent sinusotomy and extirpation of the lesion. At reexamination 15 to 104 months after surgery (mean, 61 months), 3 horses had recurrence of ethmoidal hematoma, and 1 horse had ethmoidal hematoma involving the contralateral ethmoturbinates. One of the horses with recurrence of ethmoidal hematoma also developed a contralateral lesion; both lesions recurred and additional surgeries were performed.

Vacuum phenomenon in the metatarsophalangeal joint of a horse.

Vacuum phenomenon was induced inadvertently during radiographic examination of a metatarsophalangeal joint of a lame horse. The phenomenon was recreated in a sound horse when a metacarpophalangeal joint was radiographed in a stress-flexed position. Distraction of apposing articular surfaces may induce the vacuum phenomenon, which could result in misdiagnosis of an osteochondral defect or fracture.

Effects of clustered drill holes on the breaking strength of the equine third metacarpal bone.

The breaking strength (stress at failure) of equine third metacarpal bones, with and without clustered drill holes, was determined in vitro. Paired ossa metacarpalia II-IV of 39 horses (n = 39) between 2 and 7 years old were tested in palmarodorsal 3-point bending. Four treatments were compared. Clustered 2.7- or 3.5-mm drill holes, in a 4- or 7-hole pattern, were made in the dorsal cortex of the distal diaphysis of the left third metacarpal bone. Undrilled right third metacarpi were used as controls. Bones with clustered drill holes failed by an oblique fracture through 1 or more drill holes, whereas undrilled bones failed with a middiaphyseal transverse fracture. Clustered drill holes acted as a stress concentrator and significantly (P less than 0.05) decreased the stress required for failure. However, differences in breaking strength between treatment groups were not significant (P greater than 0.05).

Osteostixis for incomplete cortical fracture of the third metacarpal bone. Results in 11 horses.

Eleven horses with acute or chronic incomplete cortical fractures of the left or right third metacarpal bone (McIII) were treated with surgical puncture (osteostixis). The fractures were diagnosed by physical examination and radiography. Four to eight holes, 2.7 or 3.5 mm in diameter, were drilled in the fractured bone. Radiographically, the fractures were healed by month 3, and the drill holes were inapparent by month 7. Nine horses (82%) returned to race competition, and two horses were retired, one the result of a surgical complication. The mean time between surgery and the first race was 9.4 months. None of the bones refractured within 24 months of surgery. Osteostixis was not technically difficult and a second operation for implant removal was not necessary.

Surgical treatment of sand colic in equids: 48 cases (1978-1985).

Medical records of 48 equids (47 horses, 1 pony) with surgical sand colic were reviewed. The diagnosis of sand colic was made if a sand impaction(s) was palpated during exploratory abdominal surgery or if a large quantity of sand was found during colotomy. Most equids did not experience a previous episode of sand diarrhea or sand colic. Clinical findings and results of clinicopathologic determinations were not diagnostic. Rectal palpation findings in 40 of 46 horses were compatible with large-colon and/or cecal distention. Impactions were palpable per rectum in only 7 horses, but emergency abdominal surgery revealed one or more impactions in 46 of 48 equids. Single impaction most commonly was observed at the pelvic flexure. Twenty-six horses had concurrent large-colon torsion or displacement. Pelvic flexure colotomy was performed in 44 horses. Of 48 equids, 44 survived and were discharged.

Hemoperitoneum caused by rupture of a juvenile granulosa cell tumor in an equine neonate.

A neonatal foal was examined because of apparent abdominal pain and distention, anemia, and hemoperitoneum. Exploratory laparotomy was performed, and a large spherical mass, which had ruptured, was found in the area of the left ovary. Left salpingo-oophorectomy was performed. The mass was determined to be a juvenile granulosa cell tumor.

Subchondral cyst-like lesions in the distal portion of the radius of four horses.

Four horses with subchondral cyst-like lesions in the medial radial facet of the distal portion of the radius were examined. Joint effusion and signs of pain from flexion of the antebrachiocarpal joint were not observed, but lameness was observed in 3 of the 4 horses. Regional nerve blocks and intra-articular anesthesia were used to localize the lesions, and conservative treatment resulted in soundness for performance.