Browsing by Author "Wilson, Katherine E."

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    Comparison of Airway Response in Recurrent Airway Obstruction-Affected Horses Fed Steamed Versus Non-steamed Hay
    Blumerich, Celeste Ann (Virginia Tech, 2012-06-21)
    Recurrent Airway Obstruction (RAO)-affected horses experience bronchoconstriction and airway inflammation in response to inhalation of irritants including hay molds. Steaming hay reduces fungal content, but the effect on the antigenic potential has not been investigated. We tested the hypothesis that RAO-affected horses develop less severe clinical disease when fed steamed versus non-steamed hay and this reduction coincides with decreased hay fungal content. Six RAO-affected horses in clinical remission were divided in two groups and fed steamed or non-steamed hay for 10 days using a two-way cross-over design. Hay was steamed using a commercial hay-steamer. Clinical assessment was performed daily. Full assessment, including airway endoscopy, tracheal mucous scores and maximal change in pleural pressure, was performed on days 1, 5, and 10. Bronchial fluid sampling and cytology were performed on days 1 and 10. Hay core samples were collected pre- and post-steaming and cultured to determine fungal and bacterial concentrations. Statistical analysis was based on data distribution and quantity and performed using SAS®. P-value <0.05 was significant. Steaming significantly decreased the number of bacterial and fungal colony-forming-units in hay. Horses fed non-steamed hay experienced a significant increase in clinical score and a trend towards airway neutrophilia, while parameters were unchanged in horses fed steamed hay. Only horses fed non-steamed hay experienced a significant increase in tracheal mucous score. Horses fed steamed hay gained significantly more weight compared to horses fed non-steamed hay, even though the amount of hay consumed not greater on a dry matter basis. These results indicate that steaming reduces the RAO-affected horse's response to hay which coincides with a reduction in viable fungal content of hay.
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    Evaluation of iohexol clearance to estimate glomerular filtration rate in normal horses
    Wilson, Katherine E. (Virginia Tech, 2006-04-18)
    In adult horses and foals, renal dysfunction can occur as a secondary complication to gastrointestinal disorders, dehydration, septicemia, endotoxemia and nephrotoxic drug administration. Measurement of renal function is an important feature not only in the diagnosis, but also in the prognosis and management of renal disease. Commonly used drugs such as phenylbutazone and gentamicin can be highly nephrotoxic under certain conditions. Estimation of the glomerular filtration rate (GFR), accepted as one of the earliest and most sensitive assessments of renal function, can be determined in horses using standard techniques such as endogenous or exogenous renal creatinine clearance. These techniques can be time consuming, dangerous to perform on fractious patients, require trained personnel and are subject to errors most often associated with improper or incomplete urine collection. Recently, tests using iohexol, a radiographic contrast agent, have been developed to estimate the GFR in human beings, pigs, sheep, dogs, cats and horse foals with results that have been validated by traditional standards. Serum clearance of a substance that is freely filtered by the kidneys without tubular secretion or reabsorption, that is not protein bound, and that is not metabolized, is a measurement of glomerular filtration rate. Iohexol meets all of these requirements and thus its clearance from serum should accurately estimate GFR. Utilization of serum clearance studies for estimation of GFR provides a clinically feasible and reproducible method in order to measure GFR in horses. Other commonly used methods to assess renal function in horses are fraught with inherent and operator error. Serum clearance of iohexol does not necessitate collection of urine and has been shown to be a safe, reproducible method using collection of timed blood samples to assess renal function in humans and animals. The objectives of this project were 1) to determine a method of estimation of GFR based on serum clearance of a substance that meets the requirements of a marker for GFR, and 2) to make the method clinically applicable by developing a method using two blood samples to derive clearance and thus GFR in normal adult horses. Results of this study showed good agreement between GFR derived by exogenous creatinine clearance and serum clearance of iohexol. In addition, GFR values for all horses using either method were within published reference ranges for this species. The results of this study indicate that a single intravenous injection of iohexol at a dose of 150 mg/kg, followed by collection of 2 serum samples at 3 and 4 hours post injection can be used to estimate the GFR in healthy horses.
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    Pharmacokinetic-pharmacodynamic cutoff values for benzylpenicillin in horses to support the establishment of clinical breakpoints for benzylpenicillin antimicrobial susceptibility testing in horses
    Lallemand, Elodie A.; Bousquet-Melou, Alain; Chapuis, Laura; Davis, Jennifer L.; Ferran, Aude A.; Kukanich, Butch; Kuroda, Taisuke; Lacroix, Marlene Z.; Minamijima, Yohei; Olsen, Lena; Pelligand, Ludovic; Portugal, Felipe Ramon; Roques, Beatrice B.; Santschi, Elizabeth M.; Wilson, Katherine E.; Toutain, Pierre-Louis (Frontiers, 2023-10-25)
    Introduction: The aim of this international project was to establish a species-specific Clinical Breakpoint for interpretation of Antimicrobial Susceptibility Testing of benzylpenicillin (BP) in horses. Methods: A population pharmacokinetic model of BP disposition was developed to compute PK/PD cutoff values of BP for different formulations that are commonly used in equine medicine around the world (France, Sweden, USA and Japan). Investigated substances were potassium BP, sodium BP, procaine BP, a combination of procaine BP and benzathine BP and penethamate, a prodrug of BP. Data were collected from 40 horses that provided 63 rich profiles of BP corresponding to a total of 1022 individual BP plasma concentrations. Results: A 3-compartment disposition model was selected. For each of these formulations, the PK/PD cutoff was estimated for different dosage regimens using Monte Carlo simulations. The fAUC/MIC or fT>MIC were calculated with a free BP fraction set at 0.4. For fAUC/MIC, a target value of 72 h (for a 72h treatment) was considered. For fT>MIC, efficacy was assumed when free plasma concentrations were above the explored MIC (0.0625-2 mg/L) for 30 or 40 % of the dosing interval. For continuous infusion, a fT>MIC of 90 % was considered. It was shown that a PK/PD cutoff of 0.25 mg/L can be achieved in 90 % of horses with routine regimen (typically 22,000 IU/kg or 12.4 mg/kg per day) with IM procaine BP once a day (France, Japan, Sweden but not USA1) and with IM sodium BP at 14.07 mg/kg, twice a day or IV sodium BP infusion of 12.4 mg/kg per day. In contrast, penethamate and the combination of procaine BP and benzathine BP were unable to achieve this PK/PD cutoff not even an MIC of 0.125 mg/L. Discussion: The PK/PD cutoff of 0.25 mg/L is one dilution lower than the clinical breakpoint released by the CLSI (0.5 mg/ L). From our simulations, the CLSI clinical breakpoint can be achieved with IM procaine BP twice a day at 22,000 IU i.e. 12.4 mg/kg.
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    Pharmacokinetics and pulmonary distribution of Draxxin® (tulathromycin) in healthy adult horses
    Leventhal, Hannah Rani (Virginia Tech, 2021-10-13)
    The objective of this study was to determine the pharmacokinetics and tolerance of tulathromycin (Draxxin®; 2.5 mg/kg once) after intramuscular (IM), subcutaneous (SC), and slow intravenous (IV) administration to six adult horses. A three-phase design and 4-week washout period were used. Drug concentrations in blood and bronchoalveolar lavage (BAL) samples were determined by ultra-performance liquid chromatography tandem mass spectrometry and pharmacokinetic parameters calculated using noncompartmental analysis. Following SC and IM administration, all horses exhibited sweating, discomfort, and periods of recumbency. As signs were more severe after SC administration this route was only used in 3/6 horses. Intravenous administration of tulathromycin was well tolerated in all horses. Mean bioavailability was 99.4% IM and 115% SC. Mean maximum plasma concentration was 645 ng/ml IM and 373 ng/ ml SC. Mean half-life was 59.8 h, 54.8 h, and 57.9 h for IV, IM, and SC administration, respectively. Mean clearance was 3.25 ml/kg/min, and mean volume of distribution was 16.8 L/kg following IV administration. Drug was detectable in plasma and BAL samples for 120 h following all routes; however, adverse effects may prevent IM use and SC use is not recommended. Tulathromycin may be a practical and affordable antibacterial for use in adult equine patients.
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    Pharmacokinetics and Safety of Acetaminophen in Adult Horses
    Mercer, Melissa Ann (Virginia Tech, 2018-10-15)
    Due to the detrimental side effects of NSAID administration, such as gastrointestinal ulceration and renal papillary necrosis, there is a profound need for clinical pain relief in horses with long term orthopedic disease whereby gastrointestinal side effects are obviated. Acetaminophen is one of the most commonly used analgesic drugs in humans, and is readily available as an inexpensive generic over-the-counter preparation. Acetaminophen has a number of mechanisms of action that differ from NSAIDs, including actions on the serotonergic, opioid, endocannabinoid and lipoxygenase pathways. These alternate pathways may provide greater efficacy against chronic or neuropathic pain in equine patients. Acetaminophen was preferred by physicians over COX-2 and nonselective NSAIDs, even when those drugs were coupled with proton-pump inhibitors to reduce gastrointestinal side effects; due to cost considerations and the occurrence of adverse side effects from those drugs. In horses, acetaminophen has been reported to be efficacious as an adjunct treatment for laminitis in one pony, and was an effective analgesic agent when combined with NSAIDs in a model of inducible foot pain. However, no studies have been performed to validate a dose-response curve in horses. A study recently completed by our group demonstrated rapid absorption following oral administration of acetaminophen. Reported human therapeutic plasma concentrations were achieved within 30 minutes of administration, with no clinical or clinicopathologic evidence of adverse side effects after two weeks of repeated dosing. Dose simulation trials indicate that a change in dosage schedule may be required in order to provide adequate plasma concentrations.
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    Single dose pharmacokinetics of pimobendan in healthy horses
    Jula, Catherine Antonia (Virginia Tech, 2024-08-27)
    Few drugs are available to treat congestive heart failure and other cardiac diseases in horses. Pimobendan is an inodilator drug approved as Vetmedin® for treatment of canine cardiac disease. Previous research shows that pimobendan increases heart rate and contractility following intravenous administration in horses. The pharmacokinetics of oral pimobendan have not been investigated in horses. The hypothesis of this study was that pimobendan would be absorbed following oral administration to healthy adult horses and reach concentrations known to be therapeutic in other species. Additional objectives were to compare the absorption of compounded pimobendan capsules (C) and suspension (S) to Vetmedin® (V) and determine the effects of sample site on plasma drug concentrations in a pilot study using two horses. These two horses received C, S, or V (0.5 mg/kg via oral syringe, once) following a minimum 10 hour fast, using a crossover design with a minimum 1-week washout period. Samples were collected simultaneously from lateral thoracic and jugular catheters before and after drug administration at predetermined time points. Differences between formulation and sample site were analyzed by one-way ANOVA. After evaluation of the data from the initial 2 horses, an additional 4 horses received pimobendan, in the form of Vetmedin tablets® (V), in a similar manner. Only jugular samples were collected at the same predetermined time points. Plasma concentrations were determined by ultraperformance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) and pharmacokinetic parameters determined by noncompartmental analysis. No significant differences were noted between formulations or sample site (P < 0.05). Concentrations in compounded formulations were 88%(S) and 90%(C) of label. For V, mean (±SD) maximum plasma concentration (Cmax) was 4.96 ± 2.13 ng/mL at 2.17 ± 0.98 hours, and area under the curve (AUC0-∞) was 22.1 ± 8.8*ng/mL. Concentration of the active metabolite of pimobendan, o-desmethyl-pimobendan, was below the limit of detection (0.07ng/mL) for all samples. At 0.5mg/kg orally, pimobendan plasma concentrations were considerably lower than reported in dogs and other species. There was no evidence of oral transmucosal absorption. Pimobendan was poorly absorbed in horses, regardless of formulation, and appears unlikely to have clinical effects.
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    Use of Glucose Monitoring Systems in Horses
    Malik, Caitlin Elyse (Virginia Tech, 2022-08-31)
    Traditional methods of blood glucose monitoring involve obtaining samples for measurement via laboratory methodology or point of care devices and require invasive collection techniques such as capillary stick, venipuncture, or the placement of intravenous catheters. Limitations of traditional methods include the limited information provided by intermittent testing and the stress associated with restraint and discomfort experienced by patients. The snapshot nature of the provided information restricts a clinician's ability to truly monitor trends in glucose concentrations over an extended period of time, influencing clinical decision making. The stress of invasive sampling can cause stress hyperglycemia in many veterinary species, complicating interpretation. Continuous interstitial glucose monitoring technology is widely used in the human medical field due to the expansive information provided in a minimally invasive manner. In recent years, the device technology has advanced and cost has improved, prompting application of these devices into the veterinary sector. Studies have shown good agreement between newer glucose monitoring systems and traditional methods in small animal patients with diabetes mellitus, allowing veterinarians to obtain comprehensive glucose data with minimal stress and discomfort to the patient. However, information regarding the use of this new technology in equine medicine is limited. The following study describes the evaluation of two widely available glucose monitoring systems, the Dexcom G6 and the FreeStyle Libre, in healthy adult horses.