Furosemide Continuous Rate Infusion in the Horse: Evaluation of Enhanced Efficacy and Reduced Side Effects and Hypomagnesemia in the Horse- A Retrospective Study of 401 Cases

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dc.contributor.advisor Sarah Gardner, Committee Chair en_US
dc.contributor.advisor Samuel Jones, Committee Member en_US
dc.contributor.advisor Clarke Atkins, Committee Member en_US
dc.contributor.author Johansson, Anna Maria en_US
dc.date.accessioned 2010-04-02T17:58:13Z
dc.date.available 2010-04-02T17:58:13Z
dc.date.issued 2003-03-26 en_US
dc.identifier.other etd-03252003-131824 en_US
dc.identifier.uri http://www.lib.ncsu.edu/resolver/1840.16/767
dc.description.abstract Continuous rate infusion (CRI) of furosemide is considered a superior method of administration to intermittent administration (IA) in humans. This study examined whether furosemide CRI, compared to IA, would increase diuretic efficacy with decreased fluid and electrolyte fluctuations and activation of the renin-angiotensin-aldosterone system (RAAS) in the horse. Five mares were used in a crossover design study. During a 24-hour period each horse received a total of 3 mg/kg furosemide by either CRI (0.12 mg/kg/h preceded by a loading dose of 0.12 mg/kg IV) or IA (1mg/kg q8h IV). Urine volume and concentrations of electrolytes, aldosterone, and furosemide in urine were recorded. Serial blood samples were obtained and analyzed for hematocrit, total solids, electrolytes, and furosemide. Although we were not able to demonstrate a statistically significant difference in urine volume over 24 hours between methods, this study demonstrated that CRI of furosemide produces a more uniform urine flow, and decreases fluctuations in plasma volume and suppresses renal concentrating ability throughout the infusion period. Importantly, there was significantly greater urine output after CRI in the first 8 hours. More K, Ca and Cl were excreted after CRI. There was no significant difference in aldosterone excretion between methods. The furosemide disposition data conformed to a two-compartment model with elimination half-lives of 1.35 and 0.47 hours for CRI and IA, respectively. The area under the excretion rate curve, indicating exposure of the renal tubules to furosemide, was 1,285.7 and 184.2 ml*mg/ml for CRI and IA, respectively. The second study was initiated to identify the signalment and clinical variables potentially associated with hypomagnesemia in horses evaluated at the NCSU-CVM veterinary teaching hospital between January 1999 and May 2001. A nested case reference study (nested case-control study) was conducted to examine the potential relationship between hypomagnesemia and signalment, serum chemistry panel analyses, number of hospitalization days, discharge status, and diagnosis.1 A series of independent and multivariable logistic regression models were used to assess the potential association of each variable with low total serum magnesium values. Of all horses included in the study, 48.7% had total serum magnesium values below the normal reference range. Hypomagnesemia was more likely to occur in horses older than one month of age. Colic, acute diarrhea, other gastrointestinal disease, infectious respiratory disease, and multi-organ system disease were associated with hypomagnesemia in adult horses, while diarrhea in foals reduced the risk of hypomagnesemia. Overall there was no relationship between hypomagnesemia and mortality, but horses with colic and hypomagnesemia were more likely to survive than horses with colic and normal or elevated total magnesium. Among horses that survived, hypomagnesemia at admission was associated with a longer hospitalization period. en_US
dc.rights I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to NC State University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. en_US
dc.subject Lasix en_US
dc.subject frusemide en_US
dc.subject Magnesium en_US
dc.subject electrolyte en_US
dc.subject fluid balance en_US
dc.subject fluid balance en_US
dc.subject electrolyte en_US
dc.subject equine en_US
dc.subject Loop diuretic en_US
dc.title Furosemide Continuous Rate Infusion in the Horse: Evaluation of Enhanced Efficacy and Reduced Side Effects and Hypomagnesemia in the Horse- A Retrospective Study of 401 Cases en_US
dc.degree.name MS en_US
dc.degree.level thesis en_US
dc.degree.discipline Comparative Biomedical Sciences en_US


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