Abstract
BackgroundTreatment for horses with pythiosis of a limb is challenging. This study aims to evaluate the effects of administering amphotericin B in a 10 % solution of dimethylsulfoxide by intravenous regional limb perfusion (IRLP) to treat horses for cutaneous pythiosis of a limb.ResultsAll 15 of the horses treated had complete resolutions of their lesion between 6 to 9 weeks after a single IRLP treatment. No complications were observed at the site of venipuncture for IRLP. Before initiation of treatment, there was anemia and marked leucocytosis which resolved following treatment. Serum biochemistry showed no significant changes.ConclusionsIRLP administration of amphotericin B in a 10 % DMSO solution was easily performed, relatively inexpensive and an effective treatment for treating horses for pythiosis of a limb and resolved the infection with no complications.
Highlights
Treatment for horses with pythiosis of a limb is challenging
Dória et al [5] reported that intravenous regional limb perfusion (IRLP) with amphotericin B is effective for treating horses with a cutaneous lesion of pythiosis of a limb
We hypothesized that better results with fewer complications might be achieved if dimethylsulfoxide (DMSO) is added to the perfusate when amphotericin B is administered by IRLP as a treatment for pythiosis of a limb
Summary
Treatment for horses with pythiosis of a limb is challenging. This study aims to evaluate the effects of administering amphotericin B in a 10 % solution of dimethylsulfoxide by intravenous regional limb perfusion (IRLP) to treat horses for cutaneous pythiosis of a limb. Administered antifungal drugs, such as potassium or sodium iodide, ketoconazole, miconazole, fluconazole, itraconazole, and amphotericin B, have been administered with or without the surgical excision of the lesion to improve outcomes [1,2,3] These drugs are considered hazardous and are expensive when administered systemically to horses, and because Pythium insidiosum is not a true fungus, this protistal organism has increased resistance to most available antifungal agents [3, 4]. Studies have shown that intravenous administration of DMSO results in vascular dilation and increased flow of blood through experimentally created cutaneous flaps [6,7,8,9] Such properties associated with its ability to penetrate biological membranes provide a rationale for its use in conjunction with an antifungal drug for regional limb perfusion [10]
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