Effects of repeated endotoxin injections on prostanoids, hemodynamics, endothelial cells, and survival in ponies

The objectives of this study were to determine the pathophysiological effects of increasing amounts of endotoxin administered intraperitoneally (IP) for 24 hr at which time an intravenous (IV) injection of endotoxin was given. The ability of flunixin meglumine (FM), a nonsteroidal antiinflammatory drug with antiprostaglandin activity, to provide protective effects was also determined. Eight ponies were divided into two groups of four ponies each; one group (untreated) received endotoxin only and the other group (treated) received endotoxin while being treated with flunixin. Hemodynamic and serum prostanoid changes were recorded for 26 hr during which time five IP and one IV endotoxin injections were given. Both groups behaved similarly until the intravenous endotoxin injection at 24 hr. At that time, the protective effects of flunixin became apparent by preventing increases in thromboxane and prostacyclin concentrations and by maintaining cardiac output, systemic arterial blood pressure, and blood flow to critical organs. Electron microscopic examination of pulmonary arteries of untreated animals revealed extensive endothelial cell damage while treatment with FM reduced this damage. A parallel study involving survival time in two groups of eight ponies each was also conducted using the same endotoxin and treatment protocol. At the end of 7 days, two of eight untreated ponies survived while six of eight treated ponies survived. It was concluded that FM prevented the release of prostanoids, maintained hemodynamics and blood flow nearer pre-endotoxin values, reduced vascular endothelial cell damage, and improved survival.