Einsatz von Bisphosphonaten beim Pferd – eine Literaturübersicht

Zusammenfassung

Tiludronsäure bzw. Clodronsäure führt bei einigen Pferden mit Podotrochlosesyndrom zur Linderung der Lahmheit. Der Therapieeffekt tritt meist 2–6 Monate nach Gabe des Medikaments ein. Bei Pferden ohne Verbesserung der Lahmheit kann eine Folgebehandlung doch noch die Lahmheit verringern. Pferde mit einer Erkrankungsdauer von weniger als 6 Monaten haben eine bessere Chance auf Behandlungserfolg. Bisphosphonate (BP) können Nierenschäden hervorrufen, weshalb es sich empfiehlt, die Nierenfunktion vor und nach der Behandlung zu untersuchen. Pferde mit Nierenschäden sollten nicht mit BP behandelt werden, weil diese Substanzen eine weitere Beeinträchtigung der Nierenfunktion verursachen können. Deshalb sollen BP auch nicht zusammen mit nichtsteroidalen Antiphlogistika oder anderen nephrotoxischen Medikamenten verabreicht werden. Eine der häufigsten Nebenwirkungen nach BP-Applikation ist Kolik. Eine konservative Behandlung mit Führen im Schritt reicht meist aus. Falls eine medikamentöse Behandlung nötig wird, sollte diese mit N-Butylscopolamin, Xylazin, Detomidin oder Butorphanol (möglicherweise auch in Kombinationen) erfolgen. Die Verabreichung nichtsteroidaler Antiphlogistika wird nicht empfohlen. Bei Auftreten von Muskelfaszikulationen sollten die Plasmaelektrolytwerte bestimmt werden. Die Verabreichungsweise von BP-Produkten sollte den Empfehlungen der Herstellerfirmen folgen. Lokale Applikationen wie intraartikuläre Injektionen oder Verabreichung per Stauungsinfusion an den distalen Gliedmaßen sind möglicherweise schädlich und zurzeit nicht zu empfehlen.

Summary

Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2–6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promote deterioration of their renal status. Furthermore, BP should not be administered concurrently with non-steroidal antiinflammatory medications or other nephrotoxic drugs. One of the most common side effects of BP treatment in the horse is development of colic signs, which usually resolves with hand walking. In cases where medical treatment is warranted, N-butylscopolamine, xylazine, detomidine or butorphanol should be administered alone or in combination. The treatment with non-steroidal antiinflammatory medications is not recommended. In horses with muscle fasciculations, plasma electrolyte concentrations should be determined. The route of administration for BP should follow manufacturer recommendations, as local applications such as intraarticular injections or administration via regional limb perfusion may not be safe and are thus currently not recommended.

Schlüsselwörter

Tiludronat - Tiludronsäure - Clodronat - Clodronsäure - Equiden - Pharmakologie - Podotrochlose - Osteoarthritis

Keywords

Tiludronate - tiludronic acid - clodronate - clodronic acid - horse - pharmacology - navicular syndrome - osteoarthritis

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