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Intravenous Continuous Infusion of Lidocaine for Treatment of Equine Ileus

Authors

  • ERIN MALONE DVM PhD Diplomate ACVS,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • JOS ENSINK DVM PhD Diplomate ECVS,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • TRACY TURNER DVM MS Diplomate ACVS,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • JULIE WILSON DVM Diplomate ACVIM,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • FRANK ANDREWS DVM MS Diplomate ACVIM,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • KEVIN KEEGAN DVM Diplomate ACVS,

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • JONATHAN LUMSDEN BVSc MS Diplomate ACVS

    1. From the Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN
    2. the Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands
    3. the Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN
    4. the Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
    5. Anoka Equine Veterinary Services, Anoka, MN
    6. Randwick Equine Centre, Sydney, Australia
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  • This was a multicenter study with the reported cases submitted from the University of Minnesota, Utrecht University, University of Tennessee, University of Missouri, and Michigan State University.

  • Presented in part at the Fifth Equine Colic Symposium, Athens, GA, September 25–28, 1994.

Address reprint requests to: Erin Malone, DVM PhD Diplomate ACVS, Department of Veterinary Population Medicine, 225K VMC, 1365 Gortner Ave, St Paul, MN 55108. E-mail: malon001@tc.umm.edu

Abstract

Objective— To determine if intravenous lidocaine is useful and safe as a treatment for equine ileus.

Study Design— Prospective double-blinded placebo-controlled trial.

Study Population— Horses (n=32) with a diagnosis of postoperative ileus (POI) or enteritis and that had refluxed >20 L or had been refluxing for >24 hours.

Methods— Refluxing horses were administered lidocaine (1.3 mg/kg intravenously [IV] as a bolus followed by a 0.05 mg/kg/min infusion) or saline (0.9% NaCl) solution placebo for 24 hours. Variables evaluated included volume and duration of reflux, time to 1st fecal passage, signs of pain, analgesic use, heart rate and arrhythmias, respiratory rate, temperature, days of hospitalization, outcome (survival to discharge), and complications.

Results— Of the lidocaine-treated horses, 65% (11/17) stopped refluxing within 30 hours (mean±SD, 15.2±2.4 hours) whereas 27% (4/15) of the saline-treated horses stopped within 30 hours. Fecal passage was significantly correlated with response to treatment; horses that responded to lidocaine passed feces within 16 hours of starting the infusion. Compared with placebo treatment, lidocaine treatment resulted in shorter hospitalization time for survivors, equivalent survival to discharge, no clinically significant changes in physical or laboratory variables, and no difference in the rate of incisional infections, jugular thrombosis, laminitis, or diarrhea. Muscle fasciculations occurred in 3 lidocaine-treated horses (18%).

Conclusion— IV lidocaine significantly improved the clinical course in refluxing horses with minimal side effects.

Clinical Relevance— At the infusion rate studied, IV lidocaine is safe and should be considered for the treatment of equine ileus.

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