Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb.
Authors: Dória Renata G S, Carvalho Mariana B, Freitas Silvio H, Laskoski Luciane M, Colodel Edson M, Mendonça Fábio S, Silva Marco A G, Grigoletto Renan, Fantinato Neto Paulo
Journal: BMC veterinary research
Summary
Pythiosis remains a notoriously difficult infection to treat in equine practice, often requiring aggressive intervention. This Brazilian study evaluated intravenous regional limb perfusion (IRLP) using amphotericin B dissolved in 10% dimethylsulfoxide as a treatment approach, administering the protocol as a single procedure to 15 affected horses and monitoring clinical, haematological and biochemical outcomes over the subsequent weeks. All 15 horses achieved complete lesion resolution within 6–9 weeks post-treatment, with no complications at the venipuncture site; notably, the marked leucocytosis and anaemia present before treatment resolved following the procedure, whilst serum biochemistry remained stable. This finding is significant for practitioners dealing with pythiosis cases: IRLP using this drug combination offers a technically straightforward, cost-effective alternative to more invasive surgical approaches, and the single-treatment protocol demonstrates substantial efficacy without the systemic adverse effects that sometimes accompany systemic antifungal therapy. Given the historically poor prognosis associated with pythiosis in equine limbs, this technique warrants consideration as a first-line intervention before resorting to amputation or protracted multimodal protocols.
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Practical Takeaways
- •IRLP with amphotericin B in DMSO is an effective single-treatment option for limb pythiosis with 100% success rate in this case series
- •The technique is relatively inexpensive and easy to perform with no reported local or systemic complications
- •Monitor pre-treatment blood work (CBC, biochemistry) as infections typically present with anemia and leucocytosis that should normalize post-treatment
Key Findings
- •All 15 horses achieved complete lesion resolution within 6-9 weeks following a single intravenous regional limb perfusion treatment with amphotericin B in 10% DMSO
- •No complications were observed at venipuncture sites
- •Pre-treatment anemia and marked leucocytosis resolved following treatment with no significant serum biochemistry changes