Anaphylactoid reaction caused by sodium ceftriaxone in two horses experimentally infected by Borrelia burgdorferi.
BACKGROUND
Lyme borreliosis is a disease transmitted by ticks to mammals, especially in horses and humans. Caused by a spirochete Borrelia burgdorferi, it can result in lameness, arthritis, carditis, dermatitis and neurological signs. Anaphylactoid reactions are severe responses caused by direct action of substances (drugs, toxins), which can pose risks to life. Still poorly documented in horses, these reactions are caused by the effects of inflammatory mediators such as histamine, kinins and arachidonic acid metabolites. The last two are the most clinically relevant for the species.


METHODS
The simultaneous occurrence of anaphylactoid reaction in two horses experimentally infected by Borrelia burgdorferi undergoing intravenous treatment with ceftriaxone sodium is reported. It was administered 4.7 × 10(8) spirochetes intradermal and subcutaneous applications in both horses to evaluate clinical aspects of the Lyme disease, 95 days before the application of sodium ceftriaxone. During the administration, one horse (a gelding) showed immediate and severe anaphylactoid symptoms such as urticaria, dyspnea, tachycardia, and eyelid edema, which were controlled by injecting dexamethasone. After 1 day, it expressed signs of abdominal discomfort, caused by severe bloat, which was treated surgically via celiotomy. Subsequently, this gelding had piroplasmosis and severe anemia, requiring treatment with an antimicrobial and blood transfusion. Second horse (a mare) showed signs of hypotension during the application of the antibiotic, which disappeared only when the application was interrupted. Days after the event, the mare developed moderate large colon bloat, which was treated with medication only. Subsequently the mare was evolved into the prodromal phase of laminitis in one of the forelimbs, which was treated for 10 days with non-steroidal anti-inflammatory and rheology modifying drugs and cryotherapy.


CONCLUSIONS
From the two cases presented here, it does appear that sodium ceftriaxone can induce anaphylactoid reactions in horses infected by Borrelia burgdorferi, which may evolve into colic syndrome, laminitis and the occurrence of opportunistic infections. However, further evidence should be collected in order to draw definite conclusions.
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. basile.roberta@gmail.com.
Roberta Carvalho
RC
Basile
Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, Brazil. gabirivera@gmail.com.
Gabriela Gomes
GG
Rivera
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. la3barrels@hotmail.com.
Lara Antoniassi
LA
Del Rio
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. talissadebonis@hotmail.com.
Talissa Camargo Mantovani
TC
de Bonis
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. gabrielwestern1@hotmail.com.
Gabriel Paiva Domingues
GP
do Amaral
Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, Brazil. edsonhv@fcav.unesp.br.
Edson
E
Giangrecco
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. gferraz@fcav.unesp.br.
Guilherme
G
Ferraz
Faculdade de Medicina da Universidade de São Paulo FMUSP, Departamento de Reumatologia, São Paulo, Brazil. natayoshinari@gmail.com.
Natalino Hajime
NH
Yoshinari
Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, Brazil. pacanola@fcav.unesp.br.
Paulo Aléscio
PA
Canola
Faculdade de Ciências Agrárias e Veterinárias, UNESP - Univ Estadual Paulista, Campus Jaboticabal, Departamento de Morfologia e Fisiologia Animal, Laboratório de Farmacologia e Fisiologia do Exercício Equino (LAFEQ), Jaboticabal, SP, 14884-900, Brazil. aqueiroz@fcav.unesp.br.
Antonio
A
Queiroz Neto
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000707:Anaphylaxis / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D025065:Borrelia burgdorferi; D002443:Ceftriaxone / Q000009:adverse effects* / Q000627:therapeutic use; D003085:Colic / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000662:veterinary; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary; D006724:Hoof and Claw; D006734:Horse Diseases / Q000139:chemically induced* / Q000382:microbiology; D006736:Horses; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary; D008193:Lyme Disease / Q000188:drug therapy*; D008297:Male
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002443:Ceftriaxone; D003907:Dexamethasone