@MISC{Duesterdieck-zellmer14title:intravenous, author = {Katja F. Duesterdieck-zellmer}, title = {Title: Intravenous Regional limb Perfusion with Tiludronate in Horses Abstract approved:}, year = {2014} }
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Abstract
Intravenous regional limb perfusion (IVRLP) with tiludronate is a commonly used treatment for distal limb orthopedic disease in horses, but doses and protocols are anecdotal. IVRLP exposes articular cartilage within the perfused area to tiludronate, raising concerns about safety of this treatment, as high tiludronate concentrations (≥19mg/L) were harmful for cartilage in vitro. This is the first study to evaluate synovial fluid tiludronate concentrations following IVRLP to determine safety for articular cartilage in horses. Synovial fluid cytology variables and tiludronate concentrations were evaluated in the navicular bursa, coffin and fetlock joints following IVRLP of one front limb with low dose (0.5mg, n=6) or high dose (50mg, n=6) tiludronate. The contralateral limb was perfused with saline as a control. Synovial fluid samples were taken 1 week prior and 30 minutes following IVRLP from all structures and 24 hours post-perfusion from coffin and fetlock joints. Synovial fluid tiludronate concentrations were lower in limbs perfused with 0.5mg in all synovial structures (metacarpophalangeal joint = 3.7 ± 1.5 mg/L, distal interphalangeal joint = 16.3 ± 1.9 mg/L, navicular bursa = 6.0 ± 1.9 mg/L) than in limbs perfused with 50 mg (metacarpophalangeal joint = 0.04 ± 0.02 mg/L,