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  Discussion on Research Summary: Gentamicin / Amikacin and Joint Toxicity
Author Message
Moderator:
DrO

Posted on Sunday, Mar 24, 2013 - 12:50 pm:

It is a common practice to inject a small amount of antibiotic, frequently one of these two aminoglycosides, with intra-articular medicines as a preventive for infection. Findings here suggest this is not a good idea.
DrO

Equine Vet J. 2013 Jan 11.
The effects of therapeutic concentrations of gentamicin, amikacin and hyaluronic acid on cultured bone marrow-derived equine mesenchymal stem cells.
Bohannon LK, Owens SD, Walker NJ, Carrade DD, Galuppo LD, Borjesson DL.

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, USA.
Abstract

REASONS FOR PERFORMING STUDY:
Joint inflammation and septic arthritis are both potential complications of intra-articular injections of bone marrow-derived mesenchymal stem cells (BM-MSCs). Clinicians may prophylactically co-inject BM-MSCs admixed with either antimicrobials or hyaluronic acid; however, the effect of these agents on cultured BM-MSCs is unknown.

OBJECTIVE:
To determine the effects of therapeutic levels of gentamicin, amikacin and hyaluronic acid on cultured equine BM-MSCs in vitro.

STUDY DESIGN:
In vitro experimental study.

METHODS:
Equine BM-MSCs from 4 healthy mature horses were isolated. Cultured BM-MSCs from each donor were incubated with gentamicin (150 mg), amikacin (250 mg), hyaluronic acid (22 mg) or 1% penicillin/streptomycin (control) under sterile conditions. Mesenchymal stem cells viability, proliferation, mediator secretion and culture media pH were measured.

RESULTS:
Incubation of BM-MSCs with gentamicin resulted in >95% MSC death after 45 min, and incubation of BM-MSCs with amikacin resulted in >95% MSC death after 2 h. Incubation of BM-MSCs with hyaluronic acid or penicillin/streptomycin (control) for up to 6 h resulted in sustained BM-MSC viability of 80% and >93%, respectively. All additives resulted in decreased media pH in the first minute; however, the pH then remained constant over the 6 h incubation period. No significant differences in BM-MSC proliferation or mediator secretion between the penicillin/streptomycin (control) and cells treated with hyaluronic acid were observed.

CONCLUSION:
Therapeutic concentrations of aminoglycoside antimicrobials are toxic to cultured equine BM-MSCs. The effects of hyaluronic acid on cultured MSC viability, proliferation and mediator secretion are minimal.

POTENTIAL RELEVANCE:
Based on these findings, the mixing of aminoglycoside antimicrobials and cultured equine BM-MSCs prior to therapeutic use is not recommended.
Member:
mrose

Posted on Sunday, Mar 24, 2013 - 1:35 pm:

Hmm.. interesting. All the vets I know do mix antibiotic with these injections.
Member:
rtrotter

Posted on Sunday, Mar 24, 2013 - 7:49 pm:

Having been around racehorses for most of my adult life. I was around before Hylauronic acid was used as an ongoing therapy. Steroids were used almost exclusively until it was found that these were actually harming a horses joints with long term use.

The hylauronic acid was a step in the right direction but to do its work correctly it inevitably caused a significant reaction in the joint being treated and required more downtime before the horse could be put back to work.I think trainer complaints about the required downtime caused the vets to come up with a compromise. To cut down the downtime both small amounts of steroids(although much less than before, kept the reaction down) and antibiotics were added to the injections.

I think it was more of a lack of patience and knowledge on how the acid worked than really needing anything mixed it with it. But, downtime was not what the trainers wanted and these days horses are injected and are back jogging, training and racing in just a few days.

I'd rather give my horses the time they need to heal and as I have said before my preference is not to inject at all, only because I've seen too many problems due to infections from injections.

Rachelle
Member:
mrose

Posted on Monday, Mar 25, 2013 - 11:50 am:

Rachelle, I agree to a point; however, the Adaquin injections have really helped me keep our old stallion happy and less sore. He's been retired for some time now, and his hocks and joints weren't REALLY bad, but he was sore. With the injections, he can be lightly ridden and doesn't seem sore. I guess like everything, there is a place for injections when used in moderation. Waseem did have hock injections for awhile, but they worried me ( anytime anything goes into a joint capsule it worried me) so we switched to just the Adaquin.
Member:
rtrotter

Posted on Monday, Mar 25, 2013 - 1:02 pm:

Actually Sara we agree here. I am not opposed to IM injections if they help. I am opposed to joint injections. I.e when my colt was having an issue with his back, I injected him on his accupuncture points with Iodine after a chiropractic adjustment and it helped him tremendously.

I would rather use something that will treat the whole horse(which is what the Adequan IM does). I have had quite a bit of success over the years with OCD pellets as well.

I too am afraid of the joint injections, I think once that joint is breached in any way it just opens up the possibilities for having a problem. No matter how careful one tries to be.
Member:
mrose

Posted on Monday, Mar 25, 2013 - 1:39 pm:

Rachelle, guess we do agree. :>)

Which OCD pellets have you used?
Member:
rtrotter

Posted on Monday, Mar 25, 2013 - 2:26 pm:

Sara,

The OCD pellets is the brand name. They were created by a vet Dr. Beebe. I have used them on all of my horses at different points in their lives and I have not had any problems. Here is the website and you can read all about them. www.ocdpellets.com.

I've posted about these before, I am not sure why they work so well but they do. They have a buy one get one free offer, so it may be worth it to try it to see if it would work on your horses. If anything it may extend the time in between Adequan injections.

I had one horse quite a number of years ago that I was injecting about every three weeks, she was so bad. I started her on a double dose(loading dose)and once I started I did not have to inject her again, made my day.
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