Freestyle Libre in Horses

Hello, Summarians!

A lot of technology can transfer across species. The Freestyle Libre is a perfect example. These are now commonly used in both human and small animal medicine. This study shows how it can be done in horses.

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Libre use in Horses.

This study investigates the feasibility and accuracy of using a Continuous Glucose Monitoring System (CGMS) to monitor interstitial glucose levels in adult horses, specifically in relation to diagnosing insulin dysregulation (IR). The main focus is on the application of CGMS during the combined glucose–insulin tolerance test (CGIT), a critical procedure for detecting IR in horses. The findings reveal that CGMS effectively provides real-time glucose measurements, which correlate well with traditional laboratory methods, though there are some observed time delays in glucose detection during rapid changes in blood glucose levels. 

Horses affected by diseases like equine metabolic syndrome and laminitis, which are linked to insulin dysregulation, benefit from careful monitoring of glucose levels. Obesity in horses, which exacerbates insulin dysfunction, further complicates this. CGMS offers a less invasive alternative to repeated blood sampling, potentially reducing stress in horses and improving the accuracy and ease of monitoring during CGIT. 

Despite some challenges with time delays and discrepancies at certain points, the overall performance of CGMS in both nonobese and obese horses during CGIT shows promising results. This study supports the use of CGMS as a viable tool for monitoring glucose levels and aiding in the diagnosis of IR in horses, suggesting its broader application in veterinary glucose monitoring and research. 

Françoso R, Baccarin RY, de Siqueira RF, Belli CB. Use of FreeStyle Libre for continuous glucose monitoring in adult horses. J Vet Emerg Crit Care. 2024; 34: 123–130. https://doi.org/10.1111/vec.13367 

Bottom line — May be useful to help diagnose insulin resistance in horses.

Onsior vs Metacam in Cats.

This study aimed to evaluate the effects of the timing of NSAID administration on renal function, coagulation, and postoperative pain in young, healthy cats undergoing neutering surgeries. The NSAIDs studied were robenacoxib, which is highly selective for COX-2, and meloxicam, which is preferentially selective for COX-2. The research investigated whether preoperative administration of these NSAIDs would offer better outcomes compared to postoperative administration. 

Key findings from the study include: 

9. Renal Function: There was no significant impact of NSAID type or timing of administration on renal function markers. Plasma renin activity (PRA) increased postoperatively across all groups, suggesting activation of the renin-angiotensin system due to factors such as hypotension or surgical stress, rather than NSAID inhibition of cyclo-oxygenase. 

10. Coagulation: Both NSAIDs did not lead to significant differences in coagulation markers, although meloxicam showed a higher, though not problematic, inhibition of COX-1, which could suggest a higher risk of bleeding compared to robenacoxib. 

11. Postoperative Pain: Cats required earlier postoperative rescue analgesia in the admission groups compared to those where NSAIDs were administered at induction or post-surgery. This suggests that the timing of NSAID administration could influence postoperative pain management, with earlier administration potentially being less effective. 

12. NSAID Pharmacokinetics: The study also highlighted the pharmacokinetic profiles of robenacoxib and meloxicam, noting that peak plasma concentrations occurred well after administration, which could affect their effectiveness depending on the timing relative to surgery. 

The study concluded that while NSAIDs are safe in terms of renal function and coagulation, the timing of administration does not significantly affect these parameters in a clinically meaningful way. However, the timing may influence the requirement for rescue analgesia post-surgery. The study suggests that NSAIDs can be safely used in the perioperative period without significant risk to renal function or coagulation but raises questions about the optimal timing for pain management effectiveness. 

Krekis, A., King, J. N., D’Arcy-Howard, D., Stapleton, N., Elliott, J., & Pelligand, L. (2024). Effect of meloxicam or robenacoxib administration timing on renal function and postoperative analgesia in cats undergoing ovariohysterectomy: A randomized, blinded, controlled clinical trial. Journal of Veterinary Pharmacology and Therapeutics, 47, 175–186. https://doi.org/10.1111/jvp.13427 

Bottom line — Practical study. Cats from the admission group required earlier rescue analgesia than the other groups. One cat may have reacted to Metacam.

Human Study About Antibiotics and Acute Brain Injury.

Traumatic brain injury (TBI) is a significant global health concern that leads to death and disability. Annually, approximately 69 million individuals sustain a TBI, often resulting in long-lasting impairments and high socioeconomic and medical costs. The most common causes of TBI in Europe are falls, particularly among the elderly and young children, with distinct patterns of injury observed across different sexes and age groups. The primary damage from TBI initiates a complex cascade of secondary injuries, including impaired blood flow, inflammation, and cellular death, complicating treatment and recovery. 

TBI management is challenging due to its diverse causes and symptoms. Standard treatments include surgical interventions and monitoring to maintain vital functions, but these approaches often fail to universally improve outcomes. Recent advances in neuromonitoring and neuroimaging have improved patient management, yet the high variability in individual pathophysiology demands tailored therapeutic strategies. 

Antibiotics play a critical role in TBI management by preventing or treating infections, particularly in patients with open wounds or those undergoing surgery. Recent research has also shown that certain antibiotics might offer neuroprotective benefits independent of their antimicrobial properties, potentially through mechanisms like reducing inflammation or microglial activation. Studies in human patients and animal models have explored these effects, particularly with antibiotics like minocycline and doxycycline, which might also impact neuroinflammation and apoptosis. 

Despite these insights, the use of antibiotics in TBI is largely empirical, with a need for more rigorous, evidence-based guidelines. There is a risk of adverse effects, such as antibiotic resistance and gut microbiome disruption, which could further complicate recovery. Future research should focus on defining the most effective therapeutic windows and dosages, as well as understanding the broader implications of antibiotic use, particularly concerning long-term outcomes and the gut-brain axis. 

Ritter K, Somnuke P, Hu L, Griemert EV, Schäfer MKE. Current state of neuroprotective therapy using antibiotics in human traumatic brain injury and animal models. BMC Neurosci. 2024 Feb 29;25(1):10. doi: 10.1186/s12868-024-00851-6. PMID: 38424488; PMCID: PMC10905838. 

Bottom line — Something to consider for all brain injury animals.

Just putting things in perspective …