Effects of mosapride citrate, metoclopramide hydrochloride, lidocaine hydrochloride, and cisapride citrate on equine gastric emptying, small intestinal and caecal motility

Objective

Although extensive work has been done to elucidate the beneficial and unfavorable effects of gastrointestinal prokinetic agents in humans, little is known on the effects of these agents in horses. In this study, we compared the effects of mosapride, metoclopramide, cisapride, and lidocaine on equine gastric emptying, jejunal and caecal motility and evaluated these agents’ adverse drug reactions (ADRs).

Animals

Seven healthy adult Thoroughbreds.

Procedure

Mosapride 1.0 mg/kg and 2.0 mg/kg, metoclopramide 0.2 mg/kg, and cisapride 1.0 mg/kg were dissolved in 100 mL distilled water for oral administration. Lidocaine 1.3 mg/kg was mixed with 500 mL saline for a 30-min intravenous infusion. Oral administration of 100 mL distilled water was used as control. Gastric emptying was evaluated using ¹³CO₂ breath test, and jejunal and caecal motility was assessed by electrointestinography.

Results

The present study demonstrates that mosapride at doses of 1.0 mg/kg and 2.0 mg/kg facilitates gastric emptying in horses. Improved jejunal motility was observed following administration of mosapride (1.0 mg/kg and 2.0 mg/kg), metoclopramide (0.2 mg/kg), and cisapride (1.0 mg/kg). Similarly, improved caecal motility was observed following administration of mosapride (2.0 mg/kg).

Conclusions and clinical relevance

This study shows that among the prokinetic agents studied here, only mosapride (2.0 mg/kg) promotes jejunal and caecal motility in horses. Considering mosapride ADRs profile, it is believed that this compound is useful in the treatment of diseases associated with decreased GI motility, including postoperative ileus.     

Effect of an indwelling nasogastric tube on gastric emptying rates of liquids in horses

OBJECTIVE: To evaluate the effect of an indwelling nasogastric tube on gastric emptying of liquids in horses. ANIMALS: 9 healthy adult horses. PROCEDURE: A randomized block crossover design was used. For treatment group horses, a nasogastric tube was placed and 18 hours later, acetaminophen was administered; the nasogastric tube remained in place until the experiment was complete. For control group horses, a nasogastric tube was passed into t stomach, acetaminophen was administered, and the nasogastric tube was removed immediately. Serial blood samples were collected 15 minutes before and after administration of acetaminophen. Serum concentration of acetaminophen was determined by use of fluorescence polarization immunoassay. The variables, time to maximum acetaminophen concentration (Tmax) and the appearance constant for acetaminophen (Kapp), were determined. The values for Kapp and Tmax in horses with and without prolonged nasogastric tube placement were compared. RESULTS: No significant difference was found in Kapp between horses with and without prolonged nasogastric tube placement; the median difference in Kapp was 0.01 min(-1) (range, -0.48 to 0.80 min(-1). No significant difference was found in Tmax between horses with and without prolonged nasogastric tube placement; the median difference in Tmax was 5 minutes (range, -30 to 50 minutes). Reanalysis of data following the removal of possible outlier values from 1 horse resulted in a significant difference in Tmax between horses with and without prolonged nasogastric tube placement. CONCLUSIONS AND CLINICAL RELEVANCE: Although no clinically important impact of 18 hours of nasogastric intubation was found on gastric emptying in healthy was found among horses.     

Prokinetic effect of the 5-HT4R agonist mosapride on canine gastric motility

We assessed prokinetic action of gastroprokinetic agent, mosapride in dogs. Open-label cross-over study. Six healthy beagles were administered single oral mosapride at doses of 0.5, 0.75, 1, and 2 mg/kg 30 min prior to feeding, followed by 1-week interval. The motility index (MI) of gastric contraction was ultrasonographically evaluated by change rate of antral area and contraction number. Significant increases in MI were observed at doses of 0.75 mg/kg (mean ± SEM, 11.11 ± 0.19), 1 mg/kg (11.65 ± 0.34), and 2 mg/kg (12.04 ± 0.34), compared with that of the control (9.37 ± 0.51). Mosapride administration (2.0 mg/kg, BID) for 1 week had no adverse effects on blood tests or health of the animals. In conclusion, 0.75 to 2 mg/kg of mosapride produces gastric prokinetic actions without adverse effects.     

Quantitative detection of atropine-delayed gastric emptying in the horse by the 13C-octanoic acid breath test

The 13C-octanoic acid breath test has been correlated significantly to radioscintigraphy for measurement of gastric emptying indices in healthy horses. The objective of this study was to investigate the validity of the test for measurement of equine delayed gastric emptying, prior to its potential clinical application for this purpose. A model of atropine-induced gastroparesis was used. Gastric emptying rate was measured twice in 8 horses using concurrent radioscintigraphy and/or breath test after treatment i.v. with either atropine (0.035 mg/kg bwt) or saline in randomised order. Analysis of both data sets demonstrated that the atropine treatment had caused a significant delay in gastric emptying rate. Paired breath test data showed an atropine-induced delay in gastric half-emptying time (t 1/2), with no overlap in the 99% CI range (P < 0.001). Significant correlations were found between scintigraphy and 13C-octanoic acid breath test for calculation of both t 1/2 (P < 0.01) and lag phase duration (P < 0.05) in the atropine-delayed emptying results. The mean (s.d.) bias in breath test t 1/2 when compared with scintigraphy was 1.78 (0.58) h. The results demonstrated that the 13C-octanoic acid breath test was an effective diagnostic modality for the measurement of equine delayed gastric emptying. The technique offers advantages to existing methods for clinical investigation, as it is noninvasive, not radioactive, quantitative and requires minimal equipment or training to perform.     

Role of prokinetic drugs for treatment of postoperative ileus in the horse

All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses considered to be at greater risk of developing a persistent ileus, the use of prokinetic agents should be considered. Agents that may be used to improve gastrointestinal motility include adrenergic receptor antagonists, cholinergic agonists, benzamides, dopamine antagonists, macrolide antimicrobials, opiate receptor agonists and antagonists, somatostatin analogues and local anaesthetics. There are limited studies into the use of these agents in the horse. Until further research provides more information on motility disorders following intestinal surgery and the efficacy of prokinetic agents in this species, only selective use of some of these drugs can be recommended.     

Evaluation of the effect of ranitidine on gastroduodenal contractile activity and gastric emptying in horses

Objective-To determine the effect of ranitidine on gastric emptying in horses. Animals-11 adult horses. Procedures-In vitro, isolated muscle strips from the pyloric antrum and duodenum of 5 horses were suspended in baths and attached to isometric force transducers. Once stable spontaneous contractions were observed, ranitidine or diluent was added at cumulative increasing concentrations. Isometric stress responses were compared. In vivo, 6 horses were assigned to a group in a prospective randomized crossover study design with a wash-out period of 2 weeks between trials. Ranitidine (2.2 mg/kg) or saline (0.9% NaCl) solution was administered IV, and 15 minutes later, acetaminophen (20 mg/kg), diluted in 400 mL of water, was administered via nasogastric tube to evaluate the liquid phase of gastric emptying. Serum acetaminophen concentration was measured at several time points for 3 hours by use of liquid chromatography tandem mass spectrometry. Frequency of defecation was recorded during the 3 hours of the study. Results-Ranitidine increased the contractile activity of the pyloric antrum smooth muscle at a concentration of 10(4) M. No significant effect of ranitidine on plasma kinetics of acetaminophen was identified. Frequency of defecation did not differ between groups. Conclusions and Clinical Relevance-Ranitidine did increase gastric motility in vitro, but no effect on liquid phase gastric emptying was identified in healthy horses by use of the acetaminophen absorption model. Results do not support the use of ranitidine to promote gastric emptying.     

The effect of occlusal equilibration on sport horse performance

The objective of this study was to investigate the effect of routine dental occlusal equilibration treatment on dressage horse performance. Sixteen horses (11 treated; 5 untreated) ridden by a single rider performed a standardized dressage test twice and were scored by two experienced dressage judges according to recognized movements and rider cues. All horses were sedated and a full-mouth speculum was used to facilitate a complete oral examination. Treated horses had dental equilibration performed using a motorized dental instrument. The horses performed a second test 48-hours after dental equilibration, exactly as the baseline test, with the judges and rider blinded as to treatment group. The total test score as well as the individual movement scores were evaluated for equality of variance and statistical tests were applied to determine the influence of treatment. There was no significant improvement in the test score of horses that had received occlusal equilibration.     

Effect of mosapride on prednisolone-induced gastric mucosal injury and gastric-emptying disorder in dog

Previous report demonstrated that prokinetic agent mosapride has anti-ulcerogenic action in rat-indomethacin gastric mucosal injury model. Here, we assessed the prophylactic effect of mosapride on gastric mucosal injury and emptying disorder induced by prednisolone in dogs. Crossover study design was employed. Six healthy beagles were administered prednisolone alone (2 mg/kg, twice a day [BID] subcutaneously) and prednisolone with mosapride (1 mg/kg, BID, orally), followed by an interval of at least 6 weeks. In each treatment, gastric mucosal injury was scored endoscopically according to the modified Lanza scale, and gastric emptying was assessed with (13)C-octanoic acid breath test. The incidence of gastrointestinal adverse events was also investigated. Coadministration of mosapride with prednisolone significantly (P<0.05) reduced the gastric mucosal injury score (mean ± SD, 17.67 ± 6.96), compared with that of prednisolone treatment alone (25.50 ± 13.03). Prednisolone treatment delayed the half-emptying time (184 ± 45 min) compared with that of controls (137 ± 19 min), and coadministration of mosapride improved this gastric-emptying delay (143 ± 29 min). Furthermore, the incidence of the gastrointestinal adverse event vomiting became less frequent upon coadministration with mosapride. In addition to its prokinetic action, our study suggests that mosapride has an anti-ulcerogenic action in dogs. The use of mosapride in combination with prednisolone is effective for attenuating prednisolone-induced gastrointestinal adverse events.     

The effect of large doses of thiamine on the horse

Extract

In conjunction with a trial to determine the effect of nematode infestation upon the liveweight gain and wool production of young sheep (Brunsdon, unpublished), information was sought on the seasonal succession and availability on pasture of infective larvae of the principal trichostrongyle genera parasitic in sheep. Data were collected in the form of nematode populations found at postmortem examination of Romney lambs, previously maintained worm-free, which were exposed to risk of parasitism in the field. A series of these lambs ran with the flock in the above-mentioned trial and served as indicators of the abundance of infective larvae on the pasture.     

Review of gastric rupture in the horse

Gastrointestinal rupture is an important cause and complication of equine colic. The stomach is the most commonly affected segment in the gastrointestinal tract involved in gastrointestinal rupture. Gastric rupture can be primary or secondary; however, unless prodromal clinical signs are identified, localised and corrected, the resulting peritoneal contamination with feed, intestinal secretions and bacteria is invariably fatal. Causes for gastric rupture may be known or idiopathic; however, factors that predispose a horse to gastric rupture are poorly understood. Further research is needed to identify underlying causes and pathophysiology of gastric rupture to prevent it from occurring.     

The effect of laryngoplasty on pharyngeal function in the horse.

Using fluoroscopic techniques and videotape recordings, a study of normal deglutition was made in 2 ponies. Paryngeal function was studied at intervals after laryngoplasty on 1 animal and after a sham technique on the other. Two clinical cases of laryngeal paralysis, which had been treated by laryngoplasty, were also examined. In the 2 experimental ponies, liquid food passed into the lower respiratory tract post-operatively. One of the clinical cases appeared to swallow solid food normally, but some food material entered the larynx of the other horse. It is suggested that pharyngeal dysfunction, as well as over-abduction of the arytenoid cartilage, might be involved in causing the chronic post-operative cough which the experiment was designed to investigate.     

Suspected chronic gastric volvulus in a dog with normal gastric emptying of liquids

A 10-year-old German Shepherd Dog with intermittent eructation, borborygmi, flatulence, abdominal bloating, and vomiting was found to have gastric volvulus. Gastric emptying of liquids (determined with a modified emptying-time technique) was normal. Circumcostal gastropexy vastly reduced clinical signs and resulted in weight gain.     

The effect of exercise on blood metabolite levels in the horse.

The effects of exercise of different intensities on blood concentrations of glucose, lactate, pyruvate, free fatty acids and glycerol were studied in a group of clinically normal horses. Blood lactate, pyruvate and lactate/pyruvate ratio increased during exercise, particularly during galloping. These changes occurred within the first 12-15 seconds of exercise indicating that anaerobic metabolic pathways are brought into use very quickly in the strenuously exercising horse. Since blood glycerol levels were significantly increased during exercise body lipids were also mobilised. At the same time, free fatty acid levels increased during cantering but decreased during galloping indicating increased fat oxidation during strenuous exercise. It was concluded that both lipids and carbohydrates are as important energy sources in the exercising horse as in other species.     

Effects of lipopolysaccharide and phenylbutazone on gastric contents in the horse

REASONS FOR PERFORMING STUDY: Endotoxaemia causes a disruption of gastrointestinal motility in the horse but there is no information on its effects on gastric secretion. Lipopolysaccharide (LPS) administration is known to affect gastric secretion in other species. HYPOTHESIS: That LPS, a toxic component of Gram-negative bacteria, would reduce gastric acid secretion and that pretreatment with phenylbutazone (PBZ) would block the effects of LPS. METHODS: The effects of LPS and PBZ on gastric contents were investigated in fasted, mature horses, with permanent gastric cannulae. Horses were pretreated with either saline or PBZ 15 mins before a 60 min infusion of either LPS or saline. Gastric contents were collected at 15 min intervals for 3 h, beginning 15 mins after the start of the LPS or saline infusion. RESULTS: Lipopolysaccharide significantly decreased gastric acid output, [K+] and potassium output and increased [Na+] and sodium output. Phenylbutazone did not affect basal gastric acid secretion but decreased LPS-induced changes in the secreted volume, [Na+] and sodium output. CONCLUSIONS: This study provides evidence that LPS affects gastric acid secretion in the horse and that these LPS-induced changes are mediated, in part, by prostaglandins. POTENTIAL RELEVANCE: Lipopolysaccharide administration can induce changes in the composition of gastric contents in the horse but further work is needed to determine the source of these changes.