ISSN: 0253-8318 (PRINT), 2074-7764 (ONLINE)
RESEARCH ARTICLE Effects of Minimum and Maximum Doses of Furosemide on Fractional Shortening Parameter in Echocardiography of the New Zealand White Rabbit Roham Vali, Mohammad Nasrollahzadeh Masouleh* and Siamak Mashhady Rafie1 Department of Radiology; 1Department of Small Animal Internal Medicine, Faculty of Specialized veterinary Science, Science and Research Branch, Islamic Azad University, Tehran, Iran *Corresponding author: mnmasouleh@srbiau.ac.ir A B S T R A C T
There is no data on the effect of maximum and minimum doses of furosemide on
heart's work performance and amount of fractional shortening (FS) in
echocardiography of rabbit. This study was designed to validate probability of the
Key words:
mentionable effect. Twenty-four healthy female New Zealand white rabbits were
divided into four equal groups. Maximum and minimum doses of furosemide were
used for the first and second groups and the injection solution for the third and
fourth groups was sodium chloride 0.9% which had the same calculated volumes of
furosemide for the first two groups, respectively. The left ventricle FS in statutory
times (0, 2, 5, 15, 30 minutes) was determined by echocardiography. Measurements
of Mean±SD, maximum and minimum amounts for FS values in all groups before injection and in statutory times were calculated. Statistical analysis revealed non-significant correlation between the means of FS. The results of this study showed that furosemide can be used as a diuretic agent for preparing a window approach in abdominal ultrasonography examination with no harmful effect on cardiac function.
To Cite This Article: Vali R, MN Masouleh and SM Rafie, 2013. Effects of minimum and maximum doses of furosemide on fractional shortening parameter in echocardiography of the New Zealand white rabbit. Pak Vet J, 33(2): 218-220. INTRODUCTION
ventricles (Fontes-Sousa et al., 2009). Fractional shortening
(end-diastolic diameter minus end-systolic diameter divided
Furosemide is one of the most commonly used drugs in
by end-diastolic diameter) is a measureable parameter that
clinical medicine (Suzuki et al., 2011). It is the most potent
can determine ventricular function (Fontes-Sousa et al.,
and most common diuretic used in heart failure (Pichette
and Du-Souich, 1996; Peddle et al., 2012). Congestive heart
In routine ultrasonography exams, the sonologist can
failure has been reported in pet rabbits (Lord et al., 2011).
use the furosemide as a diuretic agent to finding a good
Furosemide a loop diuretic, acts on the loop of henle of the
window for abdominal investigations, but in the case of
nephron by reversibly inhibiting the sodium/potassium/
presence of cardiac disease and probability of the
chloride co-transfer. This action increases the amount of
furosemide influence on cardiac function, what can the
water in the tubule and subsequently increasing the urinary
clinician do? As the amount of potassium reduction in
volume and decreasing the blood volume (Alván et al.,
therapeutic doses of furosemide is unclear, this study was
1990). It is used for the treatment of canine pulmonary
designed to measure the amount of potassium reduction and
edema secondary to left heart failure (Peddle et al., 2012).
interaction effects on cardiac function. In addition the
Increase of the urinary volume and distention of urinary
probability of difference on the effects of the maximum and
bladder can be useful in diagnosis of this organ's diseases
minimum doses of furosemide on cardiac function was
and finding an appropriate window in abdominal determined. ultrasonography. The dose of furosemide in rabbits is 5-
10mg/kg body weight, and the routes of administration are
MATERIALS AND METHODS
subcutaneously (SC), intramuscularly (IM) and
intravenously IV (Carpenter et al., 2004).
Twenty-four healthy female New Zealand white rabbits
Echocardiography is a non-invasive technique used for
weighing (1.51±0.21kg) in four equal groups were used.
the evaluation of cardiac structure and function such as
Rabbits were healthy and free from any sign of
Pak Vet J, 2013, 33(2): 218-220.
cardiovascular or respiratory tract diseases on the basis of
Zealand white rabbits are summarized in Table 1.
the physical examination which included careful thoracic
Minimum, maximum, mean+SD before injection in 24
auscultation. The animals were housed individually in
female New Zealand white rabbits was 32, 53 and
cages in a controlled environment, at temperature of 20-
40.8±6.1. Potassium concentrations before injection and
25°C, with 12 hours of light and 12 hours of dark cycle,
after injection (min 60) are summarized in Table 2.
and were fed a standard pellet diet and adequate water.
Blood samples were obtained from saphenous vein, Table 1: Values (mean±SD) fractional shortening in al groups before
(min 0) and after injection of drug at various intervals
twenty-four hours before injection of furosemide and
echocardiography examination and at Minute 60 after
injection. These samples were collected for determining
plasma potassium concentration and differences before
and after the injection. The normal range of potassium is
3.7-6.8 meq/l (Carpenter et al., 2004). The weight of each
rabbit was recorded prior to injection of furosemide. The
rabbits of the first and second group received maximum
(10mg/kg) and minimum (5mg/kg) dosage of furosemide
respectively (SC injection). The rabbits of third and fourth
1=Group1 received maximum dose of furosemide; 2=Group 2 received
group received SC injections of sodium chloride 0.9% as
minimum dose of furosemide; 3=Group 3 received maximum dose of
specified for the first and second group. Feeding was
sodium chloride; 4= Group 4 received minimum dose of sodium
withheld a few hours before echocardiography chloride.
examination to reduce abdominal distension from Table 2: Potassium concentration (Means±SD) before and after drug
intestinal fill, which could mechanically compress the
diaphragm and lungs, particularly when the abdomen is
compressed during the segment of echocardiography
examination in which the images were obtained via the
Imaging technique: Rabbits were placed in right lateral
recumbency to obtain right parasternal view, over a gap in
There are several reasons that the New Zealand
the tabletop through which the ultrasound probe was
white rabbits are a good model for cardiovascular
brought from below and placed on a shaved area on the
research, such as; the ability to perform repeated
anterior aspect of the lower portion of the right thoracic
measurements in the same animal, low cost to procure and
wall. Echocardiography measurements were obtained maintain, easy approach to arterial and venous system,
from standard views (Boon, 2011). Transthoracic 2-
relatively large heart size in relation to thoracic volume,
dimensional and M-mode echocardiography were The possibility of using standard recording equipment and
performed by using an ultrasonography system (Acuson,
easy management of the rabbits, as a result, these rabbits
Cyprus) equipped with a 3-7 MHz (7v3c) neonate are commonly used in cardiac research (Salemi et al.,
transducer. From the right parasternal short-axis view, 2-
2005; Fontes-Sousa et al., 2006). In addition their
dimensional guided m-mode tracing was made just below
similarity to humans with regard to cardiac anatomy,
the mitral valve at the level of the papillary muscles for
physiology and age related changes, are other reasons for
measurements of the left ventricular internal diameter
using rabbits in these kinds of research (Fontes-Sousa et
(LVID), in diastole and systole (Dimitrov et al., 2011).
Fractional shortening was calculated from measurements
Fractional shortening parameter has been determined
for the LVID in systole and diastole by use of the
for the mouse, Syrian hamster, rabbit, guinea pig and
Chinchilla (Table 3). In the present study, the mean of FS
FS (%) = [(LVIDd – LVIDs)/LVIDd] 100 (Fontes-
value in all groups before injection is about (40.8±6.1).
Sousa et al., 2006; 2009). In our study calculations of the
This value compared with the results of other studies on
FS were easily obtained in all of the animals, before
rabbits has shown an increase (table3). This difference
injection (min0) and at 2, 5, 15 and 30 minutes after
could be due to the use of anesthetic drugs, since research
injection by use of ultrasound system software. All data
has shown that anesthetic drugs may reduce fractional
about each rabbit was recorded. Measurements of mean,
shortening (Yang et al., 1999; Baumgartner et al., 2010;
standard deviation of (FS) before injection and in Pelosi et al., 2011). No significant correlation was found
statutory times were calculated for all rabbits. Statistical
between means of FS values before injection and at 2,5,15
procedures for comparison between mean of FS (min 0)
and 30 minutes after injection by using independent-
and mean at 2, 5, 15 and 30 minutes after injection were
sample t-test, and the p-level for statistical significance
done by using independent-sample t-test. Statistical was set at 0.05 (Table 1).
differences were considered significant at P<0.05.
Normal serum potassium levels are between 3.7 and
6.8 mEq/L (Carpenter et al., 2004; Bielecka-Dabrowa et RESULTS AND DISCUSSION al., 2012). In our study Means of serum potassium
concentration before injection and after injection (min 60)
In the present study, none of the animals died during
in all groups was compared and no significant correlation
or after the study. Values for FS before injection (min 0)
was found, (Table 2). Although potassium concentration
and after injection (2, 5, 15 and 30 minutes) in 24 New
reduced after injection, drug type and dose has no
Pak Vet J, 2013, 33(2): 218-220.
Table3: Values for Fractional shortening in rodents as reported by various workers
Nasrol ahzadeh-Masouleh et al. (2010)
significant effect on serum potassium before and after
Boon JA, 2011. The two dimensional echocardiographic exam. In:
injection. This reduction could be due to furosemide
Hanbook of Veterinary Echocardiography, 2nd Ed, John Wiley & Sons, Chichester, UK; pp: 37-90.
administration, because diuretics like furosemide are Carpenter JW, TY Mashima and DJ Rupiper (eds), 2004. Exotic Animal
known to inhibit sodium and chloride co-transport from
Formulary, 3rd Ed, WB Saunders, Philadelphia, USA, pp: 428.
the luminal side of thick ascending limb of the loop of
Cetin N, E Cetin and M Toker, 2005. Echocardiographic variables in
Henle. The increased electrolyte excretion will then
healthy guineapigs anaesthetized with ketamine-xylazine.Lab Anim, 39:100-106.
increase tubular flow and urinary volume. The effect on
Dimitrov R, D Vladova, K Stamatova, D Kostov and M Stefanov, 2011.
potassium is considered to be transient and mainly
Transthoracal two-dimensional ultrasonographic anatomical study
secondary to increase tubular flow (Alván et al., 1990).
of the heart in the rabbit (Oryctolagus cuniculus).Trakia J Sci, 9: 45-
Drugs such as furosemide may precipitate hypokalemia by
Fontes-Sousa AP, C Brás-Silva, C Moura, JC Areias and AF Leite-
accelerating renal loss (Bielecka-Dabrowa et al., 2012).
Moreira, 2006. M-mode and Doppler echocardiographic reference
There are three types of hypokalemia. In mild
values for male New Zealand white rabbits. Am J Vet Res, 67:
hypokalemia potassium concentration is 3-3.5mEq/L and
most often asymptomatic. In moderate hypokalemia Fontes-Sousa AP, C Moura, CS Carneiro, A Teixeira-Pinto, JC Areias potassium concentration is 2.5-3.5mEq/L and non specific
and AF Leite-Moreira, 2009. Echocardiographic evaluation including tissue Doppler imaging in New Zealand white rabbits sedated with
symptoms like weakness, malaise and constipation appear
ketamine and midazolam. Vet J, 181: 326-331.
as well. Potassium concentration in severe hypokalemia is
Linde A, NJ Summerfield, M Johnston, T Melgarejo, A Keffer and E Ivey,
below 2.5 mEq/L and cardiac arrhythmias increase
2004. Echocardiography in the chinchil a. J VetIntern Med, 18:
(Rastegar and Soleimani, 2001). Changes in the potassium
Lord B, C Devine and S Smith, 2011. Congestive heart failure in two pet
concentration in this study are in normal range of serum
potassium concentration (3.7 to 6.8 mEq/L) and it has no
Nasrollahzade MM, ORS Amlashi, MS Ghaffari and MR Paryani, 2010.
Effect of maximum and minimum dose of atropine on fractional
shortening parameter of rabbit echocardiography. J Vet Clin Res, 1:
Conclusion: In conclusion, the results of this study
Peddle GD, GE Singletary, CA Reynolds, DJ Trafny, MC Machen and
indicate that a single dose of furesemide administration in
MA Oyama, 2012. Effect of torsemide and furosemide on clinical,
therapeutic doses (minimum or maximum) has no
laboratory, radiographic and quality of life variables in dogs with
significant effect on reducing the potassium concentration
heart failure secondary to mitral valve disease. J Vet Cardiol, 14: 253-259.
and changes in the Fractional shortening parameter. The
Pelosi A, L St John, L Gaymer, D Ferguson, SK Goyal, GS Abela and J
results of this study conclude that furosemide can be used
Rubinstein, 2011. Cardiac tissue Doppler and tissue velocity
for preparing a window approach in abdominal
imaging in anesthetized New Zealand white rabbits. J Am Assoc
ultrasonography with no harmful effect on mechanical
Pichette V and P Du-Souich, 1996. Role of the kidneys in the metabolism
cardiac performance and only prolonged furosemide
of furosemide: Its inhibition by probenecid. J Am Soc Nephrol, 7:
administration, may induce reduction of serum potassium
Rastegar A and M Soleimani, 2001. Hypokalemia and hyperkalemia.
Salemi VM, AM Bilate, FJ Ramires, MH Picard, DM Gregio, J Kalil, EC
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