Trichlorfon for Treatment of Cutaneous Habronemosis - Evaluation of Intravenous Regional Perfusion in the Distal Equine Limbs
Background: Equine cutaneous habronemiasis is common in the distal regions of the limbs. Organophosphates, applied systemically, one previously used treatment, which is highly effective, but currently in disuse, due to the risks of intoxica-
tion. Regional perfusion is a potential technique for distal limb wounds, since, in addition to being used in low doses, it prevents systemic circulation of the drug and possible intoxication, and has a lower treatment cost. The current work aimed to perform clinical, laboratory, and venography evaluations of the use of trichlorfon in regional intravenous perfusion, as a possible form of treatment for cutaneous habronemosis in the distal region of equine limbs.
Materials, Methods & Results: Twelve horses were used, divided into two groups, with the left thoracic limb (LTL) being the test limb, and the right thoracic limb (RTL) the control limb. At moment zero (M0), distal radiography and venography were performed. The tourniquet was then loosened and after five minutes, at moment one (M1), the tourniquet was repositioned for 1.25 mg/kg (G1) and 5.5mg/kg (G2) trichlorfon injections into the left thoracic limb, diluted in 20 mL of Ringer's lactate solution, and 20 mL of Ringer's lactate solution was applied to the right thoracic limb. The tourniquet was maintained for 30 minutes after infusion in both groups. At moment two (M2), four days later, blood tests, radiography, and venography were repeated. Every day between M0 and M2, physical examinations were performed, including measurement of the pastern, fetlock, and coronet band, and a lameness examination. There were no significant alterations in clinical parameters, behavior, and appetite. In the blood cell count, there was an increase in leukocytes on D4 in G2, although remaining within the reference values for the species. The biochemical tests showed no alterations. There were no changes in the circumferences evaluated and 4 horses from G2 presented lameness in the LTL and one in the RTL. In the venograms, one G2 animal was noticed to be hypoperfused in all LTL plexuses. Discussion: The use of trichlorfon in regional perfusion at a dose of 1.25 mg/kg demonstrated safety, with no clinical, laboratory, and lameness changes in any of the animals. At the highest dose (5.5 mg/kg), individual reactions were observed, such as different degrees of lameness, swelling, and heat in foot. Serial venographies document the response to treatment used, it was decided to perform the second venography 4 days after the trichlorfon perfusion and the first initial venography evaluation, following the recommendations for the repetition time of the examination and evaluation of the use of the drug. The evaluation of radiographic images of venography, in a grading system created considering the range of contrast in five regions by the three examiners experienced in podiatry and the analysis of radiographic images of limbs of horses, without having participated in the previous procedures was important for the reliability of the assessment. The areas of hypoperfusion observed in the venography were not related to trichlorfon perfusion. It is essential that the application of trichlorfon be performed correctly, intravenously, to avoid reactions such as necrosis, pain, edema, erythema, lameness, and even more severe inflammatory reactions, such as phlegmon and thrombophlebitis. Although a small number of animals were used in this study, trichlorfon regional perfusion of equine limbs, at a dose of 1.25 mg/kg may be a technique appears to be inert to hoof vascularization.
Al-Benna S., O’Boyle C. & Holley J. 2013. Extravasation injuries in adults. ISRN Dermatology. 2013: 856541. DOI: 10.1155/2013/856541
Bras R.J. & Redden R. 2018. Understanding the basic principles of podiatry. The Veterinary Clinics of North America. Equine Practice 34(2): 391-407. DOI: 10.1016/j.cveq.2018.04.015
Cavaliere M.J., Calore E.E., Perez N.M. & Puga F.R. 1996. Miotoxicidade por organofosforados. Revista de Saúde Pública 30(3): 267-272.
Dall'Acqua E.L., Rossi B.G., Couto T.B.M. & Moreira H.M. 2011. Diagnóstico de intoxicação por organofosforados baseado em quadro clínico. Revista Brasileira de Medicina 68(5): 169-175.
Davies H.M.S., Plilip C.J. & Merritt J.S. 2007. Functional anatomy of the equine digit: Determining function from structure. In: Floyd A.E. & Mansmann R.A. (Eds). Equine Podiatry. Philadelphia: Saunders, pp.25-41.
Dória R.G.S., Freitas S.H., Linardi R.L., Mendonça F.S., Arruda L.P., Boabaid F.M. & Valadão C.A.A. 2012. Treatment of phytiosis in equine limbs using intravenous regional perfusion of amphotericin B. Veterinary Surgery. 41(6): 759-765. DOI: 10.1111/j.1532-950X.2012.01019.x
Dória R.G.S., Carvalho M.B., Freitas S.H., Laskoski L.M., Colodel E.M., Mendonça F.S., Silva M.A.G., Grigoletto R. & Fantinato Neto P. 2015. Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb. BMC Veterinary Research. 11(152): 1-7. DOI: 10.1186/s12917-015-0472-z
Fernandez D.G., Mancipe L.C. & Fernandez D.C. 2010. Intoxicación por organosfosforados. Revista Med 18(1): 84-92.
Kramer J. 2006. Distal limb perfusion. In: Wilson D.A., Kramer J., Constantinescu G.M. & Branson, K.R. (Eds). Manual of Equine Field Surgery. Philadelphia: Saunders, pp.55-59.
Kumar V., Abbas A.K., Fausto N. & Aster J.C. 2010. Cellular responses to stress and toxic insults: Adaptation, injury, and death. In: Kumar V., Abbas A.K., Fausto N. & Aster J.C. (Eds). Robbins and Cotran Pathologic Basis of Disease, 8.ed., Philadelphia: Saunders Elsevier, pp.3-42.
Lacerda Neto J.C., Pessoa J.M., D’utra Vaz B.B. & Marques L.C. 1993. Tratamento da habronemose cutânea dos equídeos com uso intravenoso de solução de trichlorfon à 2,5% associado a aplicação tópica de polímero de condensação do ácido metacreososulfônico com metanal. Arquivo Brasileiro de Medicina Veteterinária e Zootecnia 45(1): 27-34.
Logas D.B. & Barbet, J.L. 1999. Diseases characterized by granulomatous, draining nodules or masses. In: Colahan, P.T., Merrit, A.M., Moore, J.N. and Mayhew, I.G. (Eds). Equine Medicine and Surgery. 5.ed. Missouri: Mosby, pp.1883-1894.
Lopes W.D.Z, Carvalho R.S., Gracioli D.P., Oliveira P.V., Pereira V., Martinez A.C. & Mazzucatto B.C. 2014. Intoxicação aguda por triclorfon em caprinos tratados com a dose terapêutica. Pesquisa Veterinária Brasileira 32(2): 114-118. DOI: 10.1590/S0100-736X2014000200003
Pille F., Baere S., Ceelen L., Dewulf J., Croubels S., Gasthuys F., Baccker P. & Martens, A. 2005. Synovial fluid and plasma concentrations of ceftiofur after regional intravenous perfusion in the horse. Veterinary. Surgery 34(6): 610-617. DOI: 10.1111/j.1532-950X.2005.00095.x.
Redden R.F. 2001. A technique for performing digital venography in the standing horse. Equine Veterinary Education. 13(3): 128-134. DOI: 10.1111/j.2042-3292.2001.tb00077.x
Richardson D.W. 2003. Local antimicrobial delivery in equine orthopedics. In: Proceedings of the 13th Annual American College of Veterinary Surgeons Veterinary Symposium. (Washington-DC, USA). pp. 162-163.
Rubio-Martínez L.M. & Cruz A.M. 2006. Antimicrobial regional limb perfusion in horses. Journal of the American Veterinary Medical Association. 228(5): 706-712. DOI: 10.2460/javma.228.5.706
Rucker A., Redden R.F., Arthur E.G., Reed S.K., Hill B.W., Dziuban, E.M. & Renfro D.C. 2006. How to perform the digital venogram. Proccedings of the 52nd Annual Convention of the AAEP (San Antonio, Texas, USA). pp.526-530. Available at: https://www.ivis.org/library/aaep/aaep-annual-convention-san-antonio-2006/how-to-perform-digital-venogram (Accessed: 14 June 2021).
Rucker A. 2010. Clinical applications of digital venography. Journal of Equine Veterinary Science 30(9): 491-503. DOI: 10.1016/j.jevs.2010.07.016
Sales J.V.F. 2017. Alterações venográficas podais em equinos. 30f. Brasília, Distrito Federal. Dissertação (Mestrado em Saúde Animal) – Programa de Pós-Graduação em Saúde Animal, Universidade de Brasília.
Scott D.W. & Miller Jr W.H. 2011. Parasitic Disease. In: Equine Dermatology, 2.ed. Missouri: Elsevier Saunders, pp.212-250.
Thomassian A. 2005. Afecções da pele. In: Enfermidades dos Cavalos. 4.ed. São Paulo: Varela, pp.27-50.
How to Cite
This journal provides open access to all of its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. Such access is associated with increased readership and increased citation of an author's work. For more information on this approach, see the Public Knowledge Project and Directory of Open Access Journals.
We define open access journals as journals that use a funding model that does not charge readers or their institutions for access. From the BOAI definition of "open access" we take the right of users to "read, download, copy, distribute, print, search, or link to the full texts of these articles" as mandatory for a journal to be included in the directory.
La Red y Portal Iberoamericano de Revistas Científicas de Veterinaria de Libre Acceso reúne a las principales publicaciones científicas editadas en España, Portugal, Latino América y otros países del ámbito latino