Summary Case reports demonstrating a return to sinus rhythm from sustained ventricular tachycardia (VT) are limited. VT is uncommon in horses but can be life threatening and has been reported in horses with primary gastrointestinal disease. Treatment is recommended if there is poor perfusion, if heart rate exceeds 100 beats/min, if multiform/polymorphic complexes or torsades des pointes is present. Lidocaine or magnesium sulfate is the first‐line medication. In this case, a 19‐year‐old Warmblood gelding with a history of exploratory laparotomy presented with an irregularly irregular cardiac rhythm and heart rate of 80 beats/min. ECG demonstrated VT with a heart rate of 75 beats/min. As the horse was already receiving a lidocaine bolus, the VT was treated with multiple boluses of intravenous magnesium sulfate over a period of several hours. This converted the VT to normal sinus rhythm (NSR) with heart rate of 44 beats/min and the horse remained in NSR until discharge 8 days later.
Despite reports of the successful isolation of primary equine hepatocytes, there are no published data regarding the successful cryopreservation of these isolated cells. In this study, a detailed description of the procedures for isolation, cryopreservation, and recovery of equine hepatocytes are presented. Furthermore, the intrinsic clearance (Clint) and production of metabolites for three drugs were compared between freshly isolated and recovered cryopreserved hepatocytes. Primary equine hepatocytes were isolated using a two‐step collagenase perfusion method, with an average cell yield of 2.47 ± 2.62 × 106 cells/g of perfused liver tissue and viability of 84.1 ± 2.62%. These cells were cryopreserved with William's medium E containing 10% fetal bovine serum with 10% DMSO. The viability of recovered cells, after a 30% Percoll gradient, was 77 ± 11% and estimated recovery rate was approximately 27%. These purified cells were used to determine the in vitro Clint of three drugs used in equine medicine; omeprazole, flunixin, and phenylbutazone, via the substrate depletion method. Cryopreserved suspensions gave a comparable estimation of Clint compared to fresh cells for these three drugs as well as producing the same metabolites. This work paves the way for establishing a bank of cryopreserved equine hepatocytes that can be used for estimating pharmacokinetic parameters such as the hepatic metabolic in vivo clearance of a drug as well as producing horse‐specific drug metabolites.
Introduction Equine glandular gastric disease (EGGD) is a common condition causing signs of gastric pain although lesions are highly variable in their appearance. The only definitive method to diagnose EGGD ante‐mortem is gastroscopy. The current recommended method for describing these lesions is the European College of Equine Internal Medicine (ECEIM) guidelines; however, repeatability between users is variable. This study aimed to validate the reliability of lesion descriptions using ECEIM consensus guidelines, using four blinded equine internal medicine diplomates. Methods Ninety‐two horses with EGGD with pre‐ and post‐treatment gastroscopy images were identified using the electronic record at a UK equine hospital between 2012 and 2019. Eight horses were excluded due to non‐diagnostic images. Four blinded observers used the recommended grading system to describe images and outcomes. Intraclass correlation coefficients and Krippendorff's alpha were used to determine reliability and agreement, respectively. Results Intraclass correlation coefficient for severity was 0.782 (95% confidence interval [CI] 0.722–0.832), for distribution was 0.671 (95% CI 0.540–0.763), for the descriptor raised was 0.635 (95% CI 0.479–0.741), fibrinosuppurative was 0.745 (95% CI 0.651–0.812), haemorrhagic was 0.648 (95% CI 0.513–0.744), hyperaemic was 0.389 (95% CI 0.232–0.522) and for outcome was 0.677 (95% CI 0.559–0.770). Krippendorff's alpha for severity was 0.466 (95% CI 0.466–0.418), for distribution was 0.304 (95% CI 0.234–0.374), for the descriptor raised was 0.268 (95% CI 0.207–0.329), fibrinosuppurative was 0.406 (95% CI 0.347–0.463), haemorrhagic was 0.287 (95% CI 0.229–0.344), hyperaemic was 0.112 (95% CI 0.034–0.188) and for outcome was 0.315 (95% CI 0.218–0.408). There was moderate reliability determined between observers using intra‐class correlation coefficients and unacceptable agreement determined between observers using Krippendorff's alpha. Discussion These results suggest that the current grading system is not comparable between observers, indicating the need to review the grading system or define more robust criteria.
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