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Continuous i.v. Infusion of Lidocaine for Treatment of Equine Ileus
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Lidocaine is commonly used in dogs with gastric dilatation-volvulus-complex, a situation which can be compared with ileus in horses. It is often discussed if horses benefit from lidocaine infusions or not. This study has an excellent design: It is a prospective double-blinded placebo-controlled trial including 32 animals - and it gives a clear answer.
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Horses (n=32) with a diagnosis of postoperative ileus (POI) or enteritis and that had refluxed >20 L or had been refluxing for >24 hours were included.
Refluxing horses were administered lidocaine (1.3 mg/kg intravenously [IV] as a bolus followed by a 0.05 mg/kg/min infusion) or saline (0.9% NaCl) solution placebo for 24 hours.
Variables evaluated included volume and duration of reflux, time to 1st fecal passage, signs of pain, analgesic use, heart rate and arrhythmias, respiratory rate, temperature, days of hospitalization, outcome (survival to discharge), and complications.
Results: Of the lidocaine-treated horses, 65% (11/17) stopped refluxing within 30 hours (mean±SD, 15.2±2.4 hours) whereas 27% (4/15) of the saline-treated horses stopped within 30 hours.
Fecal passage was significantly correlated with response to treatment; horses that responded to lidocaine passed feces within 16 hours of starting the infusion.
Compared with placebo treatment, lidocaine treatment resulted in shorter hospitalization time for survivors, equivalent survival to discharge, no clinically significant changes in physical or laboratory variables, and no difference in the rate of incisional infections, jugular thrombosis, laminitis, or diarrhea. Muscle fasciculations occurred in 3 lidocaine-treated horses (18%).
Conclusion: IV lidocaine significantly improved the clinical course in refluxing horses with minimal side effects. At the infusion rate studied, IV lidocaine is safe and should be considered for the treatment of equine ileus.
Source: MALONE, ERIN, ENSINK, JOS, TURNER, TRACY, WILSON, JULIE, ANDREWS, FRANK, KEEGAN, KEVIN & LUMSDEN, JONATHAN (2006): Intravenous Continuous Infusion of Lidocaine for Treatment of Equine Ileus. In: Veterinary Surgery 35 (1), 60-66.
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Theiler´s disease in a Trakehner caused by contaminated tetanus vaccine
An 11‐year‐old Trakehner gelding was presented for evaluation of lethargy, decreased appetite, mild icterus, and elevated hepatic enzyme activities. Physical examination, serum chemistry results, and liver biopsy histopathologic findings were supportive of Theiler`s disease. Polymerase chain reaction (PCR) testing results of serum and liver tissue were positive for nonprimate (equine) hepacivirus (NPHV) and a novel equine parvovirus‐hepatitis virus (EqPV‐H). A serious and finally fatal problem, caused by contaminated vaccine.
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