Peer-reviewed veterinary case report
Side effects of polymyxin B treatment in healthy horses
By van Spijk, Julia N et al.·Published in Journal of veterinary internal medicine·2022·Equine Department·View original on PubMed →
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Original publication title: Adverse effects of polymyxin B administration to healthy horses.
- Species:
- horse
Plain-English summary
A group of healthy horses was given a medication called polymyxin B to treat a serious condition, but it caused some of them to develop temporary ataxia, which is a lack of coordination. The horses showed increased ataxia scores while receiving the medication, especially when it was given alongside gentamicin, another drug. After stopping the treatment, their coordination improved. The study highlighted that while polymyxin B can be effective, it may lead to side effects, particularly when combined with gentamicin.
People also search for: horse ataxia treatment · polymyxin B side effects in horses · gentamicin for horses
Abstract
BACKGROUND: Polymyxin B (PolyB) is used to treat endotoxemia in horses; neurologic and nephrogenic adverse effects occur in humans. OBJECTIVES: To describe PolyB adverse effects in horses. ANIMALS: Five healthy horses (ataxia 0/5), 1 horse with cervical osteoarthritis (ataxia 1/5). METHODS: Prospective blinded randomized cross-over trial; 3-weeks wash out. Horses received PolyB (PolyB 6000 IU/kg IV, 7 doses q12h, n = 6) and PolyB/gentamicin (PolyB 6000 IU/kg IV, q12h 7 doses; gentamicin 10 mg/kg IV q24h 4 doses n = 4, or q12-24 h 5 doses because of an additional erroneous dose, n = 2). Daily neurological examinations were video recorded, and ataxia graded by 3 observers. Urine status, urinary GGT/creatinine ratio, plasma creatinine, and urea were assessed every other day, EMG daily. Mixed model analysis was used to evaluate factors associated with ataxia grade and [PolyB]. RESULTS: Median ataxia score increased from 0/5 (range 0-2/5) to 2/5 (range 1-3/5) during administration and declined to 0.5/5 (range 0-2/5) after cessation. Gentamicin co-administration (P < .01, effect size: .8), number of PolyB doses (P < .001, effect size: .6), and time since last PolyB dose (P < .001, effect size: .5) had a significant effect on ataxia grades, while horse, day, [Genta], [PolyB], and [PolyB]did not. Gentamicin co-administration and [Genta] Chad no effect on median [PolyB] C(4.67 and 4.89 μg/ml for PolyB and PolyB/gentamicin, respectively). Urinary GGT/creatinine ratio was elevated in 3/6 horses receiving PolyB/gentamicin. The EMG remained unchanged. CONCLUSIONS AND CLINICAL IMPORTANCE: PolyB caused transient ataxia, worsening with cumulative PolyB doses and gentamicin co-administration. Nephrotoxicity of PolyB was only evident when gentamicin was co-administered.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35801274/