The Use of Recombinant Tissue Plasminogen Activator (<scp>rTPA</scp>) in The Treatment of Fibrinous Pleuropneumonia in Horses: 25 Cases (2007–2012)

Tomlinson, Joy E.; Byrne, Ellen; Pusterla, Nicola; Magdesian, K. Gary; Hilton, Hugo G.; McGorum, Bruce; Davis, Elizabeth G.; Schoster, Angelika; Arroyo, Luis; Dunkel, Bettina; Carslake, Harry; Boston, Ray; Johnson, Amy L.

doi:10.1111/jvim.13594

Cited by 20 publications

(11 citation statements)

References 23 publications

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“…A study in horses (n=25) who received treatment with intrapleural tPA for fibrinous pleuropneumonia demonstrated successful treatment with doses ranging from 0.375mg to 20mg of tPA despite typically weighing in excess of 400kg (20). In the MIST-2 protocol, tPA was administered at 10mg and DNase at 5mg, twice daily up to six doses.…”

Section: Discussionmentioning

confidence: 99%

Dose De-escalation of Intrapleural Tissue Plasminogen Activator Therapy for Pleural Infection. The Alteplase Dose Assessment for Pleural Infection Therapy Project

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Dose De-escalation of Intrapleural Tissue Plasminogen Activator Therapy for Pleural Infection. The Alteplase Dose Assessment for Pleural Infection Therapy Project

et al. 2017

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“…; Tomlinson et al . ). This was unsuccessful as the suspected adhesions were later revealed to be the lining of new intra‐abdominal cysts; thus fibrinolysis would have had little effect on their endothelial lining.…”

Section: Discussionmentioning

confidence: 97%

Intra‐abdominal cystic lymphangiomatosis in a Thoroughbred foal

Savage¹,

Cudmore²,

Russell³

et al. 2016

Equine Veterinary Education

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Summary Cystic lymphangiomas are rare malformations of the lymphatics that result in the formation of a cystic mass. Where multiple cysts are seen, the condition is termed cystic lymphangiomatosis. This case describes the diagnosis and unique management of cystic lymphangiomatosis in a 10‐day‐old Thoroughbred foal. Ultrasonography, histopathology and laparoscopy were essential for diagnosis and appreciation of the extent of disease. Ultimately, the cystic lymphangiomatosis was so extensive in this foal that complete surgical excision was considered impossible and the presence of adhesions within the abdomen indicated a very poor long‐term prognosis; the owners elected for euthanasia at age 14 weeks. Although rare, lymphangioma and lymphangiomatosis should be considered as a differential diagnosis for an intra‐abdominal mass in a young horse.

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“…RPE appears to be an uncommon adverse consequence of this treatment, since this horse was the only one of 25 tPA treated horses that developed suspected RPE (Tomlinson et al . ). The authors are unaware of reports of RPE following intrapleural tPA instillation in human patients.…”

Section: Discussionmentioning

confidence: 97%

“…Brief details of this case were included in a review of 25 horses that had received tPA for the treatment of fibrinous pleuropneumonia (Tomlinson et al . ).…”

Section: Introductionmentioning

confidence: 97%

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

McGorum

Stratford

Keen

et al. 2016

Equine Veterinary Education

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This case report describes a 5-year-old pregnant Warmblood mare that was being treated for fibrinous bacterial pleuropneumonia. Since initial attempts to drain and lavage both pleural cavities were ineffective due to the presence of extensive intrapleural fibrin loculations, recombinant human tissue plasminogen activator (tPA) was instilled into both pleural cavities, to promote fibrinolysis and improve drainage. Within 1-2 h of instilling tPA, the horse became distressed, with increasing dyspnoea, tachycardia, pleurodynia and hypoxaemia. At 4 h post tPA instillation, diffuse bilateral pulmonary oedema was evidenced by the onset of widespread audible inspiratory crackles and ultrasonographic ring-down artefacts. Ultrasonography demonstrated that tPA had induced pleural fibrinolysis, thereby removing the restrictive effects of pleural adhesions on lung motion and facilitating lung re-expansion. Re-expansion pulmonary oedema was suspected, although an adverse drug reaction could not be excluded. The complication resolved with nasal oxygen supplementation, and administration of frusemide, meloxicam, morphine and hydroxyethyl starch. Subsequent repetition of intrapleural tPA instillation and thoracic drainage had no apparent adverse effect. The mare was discharged from the hospital and subsequently foaled successfully. The pathogenesis, diagnosis and management of re-expansion pulmonary oedema are reviewed.

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The Use of Recombinant Tissue Plasminogen Activator (rTPA) in The Treatment of Fibrinous Pleuropneumonia in Horses: 25 Cases (2007–2012)

Cited by 20 publications

References 23 publications

Dose De-escalation of Intrapleural Tissue Plasminogen Activator Therapy for Pleural Infection. The Alteplase Dose Assessment for Pleural Infection Therapy Project

Dose De-escalation of Intrapleural Tissue Plasminogen Activator Therapy for Pleural Infection. The Alteplase Dose Assessment for Pleural Infection Therapy Project

Intra‐abdominal cystic lymphangiomatosis in a Thoroughbred foal

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

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