Effect of intra-arterial cisplatin on dorsal hoof wall tissue of isolated perfused equine limbs.
Authors: Reinthaler B, Gabner S, Apprich V, Jehle M, Licka T
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Intra-arterial Cisplatin and Equine Hoof Wall Safety Hoof canker presents a genuine clinical challenge, and whilst topical cisplatin shows promise, the repeated handling of this cytotoxic agent during bandage changes raises occupational health concerns—prompting investigation into whether intra-arterial delivery might offer a safer alternative. Reinthaler and colleagues perfused isolated equine forelimbs (n=13; nine treatment, four control) with either cisplatin-enriched autologous plasma (14 mg/600 ml) or control plasma over eight hours, then examined dorsal hoof wall tissue using histology, immunohistochemistry for laminin (basement membrane integrity) and Ki-67 (cell proliferation). Although the structural appearance of primary and secondary epidermal lamellae remained unchanged, cisplatin treatment caused significant damage to the basal membrane, evidenced by substantially weaker laminin staining in treated samples (54% weak, 37% moderate, 9% strong) compared to controls (12% weak, 53% moderate, 35% strong; p=0.005), whilst cell proliferation markers were unaffected. The critical finding here is that even brief cisplatin exposure—just 20 minutes—compromises basement membrane integrity, raising substantial laminitis risk and suggesting that intra-arterial administration, despite its occupational safety advantages, carries a considerable and previously unquantified threat to hoof lamellar health. Before considering this approach clinically, practitioners should weigh whether the reduced exposure hazard for handlers justifies accepting a potentially serious complication in the patient itself.
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Practical Takeaways
- •Intra-arterial cisplatin for hoof canker treatment poses significant laminitis risk and should not be used in live horses based on these findings of basal membrane damage
- •Topical cisplatin application remains the safer alternative to intra-arterial administration, despite requiring more frequent bandage changes and hazmat handling
- •Horses with hoof canker may benefit from exploring non-cisplatin treatment protocols or refined surgical debridement approaches to avoid this drug's systemic vascular complications
Key Findings
- •Intra-arterial cisplatin infusion (14 mg/600 ml) caused significant basal membrane damage with 54% weak laminin staining in treated limbs vs 12% in controls (p=0.005)
- •Primary and secondary epidermal lamellae structure were not significantly affected by cisplatin treatment
- •Ki-67 positive basal cell counts in primary epidermal lamellae showed no significant difference between cisplatin and control groups
- •Short-term cisplatin exposure creates considerable risk of laminitis through basal membrane compromise, contradicting its potential use for hoof canker treatment