Comparative Efficacy Evaluation of 10% Sodium Iodide and Potassium Iodide Therapies of Horses With Eipizootic Lymphangitis at Spana Equine Clinic, Bishoftu, Ethiopia

doi:10.21203/rs.3.rs-3480688/v1

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Research Article

Comparative Efficacy Evaluation of 10% Sodium Iodide and Potassium Iodide Therapies of Horses With Eipizootic Lymphangitis at Spana Equine Clinic, Bishoftu, Ethiopia

https://doi.org/10.21203/rs.3.rs-3480688/v1

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Purpose

To identify the comparative effectiveness of different drug combinations and routes of drug administration for epizootic lymphangitis in horses in Bishoftu town, Ethiopia.

Methods

Experimental study was conducted on forty horses with Epizootic lymphangitis. After identification of cases and oral consent from horse’s owner the study were conducted. Selected horses were examined and attributed an EZL in six grading level depending on the severity of the disease. The study was conducted in five different experimental groups in which equal numbers of eight experimental units were assigned.

Results

The presence of EZL was confirmed in a total of forty horses by Giemsa stain. Animals were then included in the trial to assess the comparative effectiveness of different treatment protocols. The analysis of variables of all experimental groups and all variables of the study group (number of nodules, number of discharging nodules, recovered nodules and grade) shows statistical significant (P < 0.05) differences. All experimental units were examined six times with 48 frequencies. Grade was mostly preferred to determine the level of effectiveness of the drug. The statistically significant differences in therapeutic value were observed by pairwise comparison of all groups. The oral KI in combination with topical 4% iodine tincture versus 10% NaI IVRP in combination with topical 4% iodine tincture, 10% NaI through jugular vein in combination with topical 4% iodine tincture and debridement and topical 4% iodine tincture with their respective P values were 0.004, 0.025 and 0.018.

Conclusion

The combination of 10% NaI through jugular vein in combination with topical application of 4% iodine tincture was comparably better effective treatment than other remedies. Most of the horse owners also responded that intravenous injection of the drugs in combination with 4% iodine tincture topically had better therapeutic value than other remedies.

Contralateral

Efficacy

EZL

Equine

Intravenous

Iodide

Our world has about 80% equine populations and 90% of equine populations were found in developing world with 97, 96 and 60% of mules, donkeys and horses respectively. Ethiopia has larger equine population in Africa and eighth in the world. Approximately 2 million horses are found in Ethiopia [1, 2, 3].

Equines have a crucial role in the economy of both urban and rural communities. Most of them are working animals used for transportation and crop production [4, 5]. Husbandry mismanagement and diseases caused by bacteria, viruses, fungi and parasites can compromise the health and welfare of equines. Many of equine disease were described from developed and developing countries of the world. Among these, Histoplasma farciminosum (African farcey, epizootic lymphangitis, equine histoplasmosis, pseudo-farcy, pseudo-glanders) is an economically important contagious mycotic disease of equines [6, 7].

Histoplasma capsulatum variety farciminosum (HCF) is endemic in some countries of Western, North, Northeast Africa, East Africa including Ethiopia, Asia, including India, Pakistan and Japan, where it highly diffused and characterized by humid and hot climates. It is very resistant to both physical and chemical agents. It may survive for up to ten weeks in non-sterile water at 26°C. It is common in Ethiopia, especially in carthorses, affecting an average of 18.8% in warm, humid areas between 1500 and 2300 meters above sea level [4].

Epizootic lymphangitis is one of the infectious diseases causing huge economic losses and low productivity in Ethiopian horses. It is particularly prevalent with the prevalence of 26.2% in carthorses of Bishoftu, Mojo and Adama and cause significant impact on the livelihood of their owners, as a major disease in most parts of Ethiopia [8]. Data for economic losses incurred by it is lacking but one conservative estimate showed that mortality associated losses is about $129 USD incurred per annum per owner [9, 10].

Although EZL has been eradicated from Europe, it is currently prevalent in Ethiopia, with the prevalence of 0% − 39% [11, 12]. The rate of infection of this disease in equines is varying by region. For example in two separate participatory studies conducted in different areas of Ethiopia shows the disease was a high-priority disease [13, 14]. Epizootic Lymphangitis is still a major concern in Ethiopia, where equines are widely employed as working animals. But effective treatment can be unaffordable and unavailable, leading to uncontrolled spread of the organism with significant economic losses. Even successfully treated lesions sometimes recur and Iodides reported to have limited efficacy in moderate to severe cases [15, 16]. Successful EZL control measures are non-existent in Ethiopia, therefore it remains the first priority disease for equine particularly for horses, which affects the socio-economic and welfare of communities who are dependent on carthorse as a means of livelihood [5].

Due to the unavailability of appropriate drug treatment there is currently no veterinary control strategy of this disease. Therefore, comparative effect of different drugs should be studied and the most effective routes of administration evaluated. According to [17], experimental study was conducted on the drug combination of iodides and antibiotics, medicinal plant and antibiotics; it gives the clue for the current drug combination of different forms of iodides. Hadush and colleagues conducted a treatment trial with different drug combination and through different routes, however intravenous regional perfusion alone and with 4% Iodine tincture, sodium or potassium iodide with 4% iodine tincture was not conducted.

The comparative effectiveness of iodides has not been studied so far in Ethiopia. So, to investigate the comparative effectiveness of iodides and test their availability by different routes of administration like jugular vein, radial vein, peros and topically; and different forms of Iodides like NaI alone and in combination with 4% Iodine tincture, KI in combination with 4% Iodine tincture and 4% Iodine tincture alone were used. Intravenous regional perfusion (IVRP) route was also proposed for the first time in Ethiopia as a comparative route of administration. Therefore, the objectives of this study were to identify the comparative effectiveness of different drug combinations and routes of administration for the treatment of epizootic lymphangitis in horses in Bishoftu town Oromia regional state, Ethiopia.

Study area

The current study was conducted in Bishoftu town and its vicinity from October 2020 to August 2021. Bishoftu is located in Adea district, Oromia regional state at 45km Southeast direction from Addis Ababa at 1900 meter above sea level and receiving an annual rainfall of 776 mm with two rainy seasons; March to May short rainy seasons, and June to September main rainy season. The maximum and minimum temperatures are 25 and 10°C, respectively, with a relative humidity of 61.3% (Fig. 1) [18, 19]. The livestock populations of Bishoftu towns are 19,550 cattle, 18,000 small ruminants, 145, 8000 poultry, 2,866 equines and 1987 small holder dairy production [20, 21].

Study design and study population

An experimental study was conducted on forty local horses with typical EZL. These cases were identified at carthorse parking areas and at the SPANA project Veterinary clinic. Animal participation in the study was in line with the oral consent obtained from horse owners. Selected horses were examined and attributed an EZL grade based on six levels grade systems (0–5) depending on the severity of the disease or limb lymphatic extension, number of nodules and number of discharging nodules. Grading criteria were designed with SPANA Society and was given in (Table 1). The study was conducted in five different experimental groups in which equal numbers of eight experimental units (horses) were assigned.

Table 1

Standard of EZL disease grading
Grade	Number of Nodules	Number of discharging nodules	Limb lymphatic extension	Reference
0	0	0	0	SPANA, 2020
1	3–5	0	None
2	5–10	1–2	None
3	10–15	2–5	Mild
4	15–20	5–10	Moderate
5	> 20	> 10	Severe

Sampling method

Epizootic lymphangitis cases were categorized into three levels depending on the number of nodules and discharging nodules. Then the level of disease was categorized as early (1–5), moderate (6–30) and severe > 30 number of nodules and nodule discharging [22]. Moderate cases of EZL in horses were purposely selected for the study after the case was confirmed. Horses with both or one forelimb infected (16 horses) were selected for the IVRP treatment group and horses with EZL lesions in any other body parts (24 horses) were selected for the remaining groups.

In case where both forelimbs were infected, treatment was performed on one forelimb and the contralateral limb was used as a control. In order to limit confounding bias, horses from the same breed, purpose of keeping, range of age and sex were purposively selected and categorized into the five groups. Contralateral groups or horses with EZL lesions on contralateral limbs were selected and categorized into two another groups. In which one forelimb of the horse was considered as exposed group and the contralateral limb as a control group.

One limb treated with 10% NaI IVRP only and contralateral limb used as control (debridement and topical IT). One limb treated with 10% NaI IVRP in combination with 4% Iodine tincture topically, and contralateral limb used as control (debridement and topical IT). Treatment limb was purposively selected depending on absences of nodules at treatment site.

Data included age, sex, body condition, number of nodules; peasant association from which horse comes, the site of infection and the grade of the disease were collected. Grading is based on the number of nodules, number of discharging nodules and limb lymphatic extension. Upon presentation of horse number of nodules on each forelimb or other body parts were counted and recorded, nodules discharge was recorded, visual evidence of lymphatic spread was recorded and grades of limbs and severity of the disease were provided based on the standards (Table 2).

Table 2

Overall means of the grade across experimental groups at the end of trial.
Experimental group	Overall grade mean	Standard deviation	Frequency
DIod	2.666	0.952	48
IVRP	2.979	0.978	48
IVRPIT	2.562	0.848	48
JUI	2.687	1.169	48
KII	3.375	1.453	48
Total	2.854	1.131	240

Treatment protocol

Systemic treatment (i.e. IV 10% NaI, Oral KI), local IVRP of 10% NaI and topical treatment, i.e. debridement and application of Iodine tincture were issued clinician guidance. Only clinician can prescribe and administer the drugs. For this study the proportion of concentration or dilution of drugs in order to formulate safe treatment drug were performed only by in charge veterinarian [23].

Intravenous regional perfusion protocol

Before treatment, animals were well restrained using nose twitch and in aggressive horse sedatives were used [23]. Restraining of the horses, especially for IVRP was done by sedation of horse with a mixture of Detomidine Hydrochloride (Medesedan) and Butorphanol (Butador) at a dosage of 0.012 and 0.025 milligram per kilogram (mg/kg) intravenously with their respective dosages.

Commander as a tourniquet was applied to the randomly selected ante brachium (proximal radius) of the animal, site of injection was shaved and disinfected with 70% alcohol and using a 20 gauge butterfly catheter kit, 30ml of 10% NaI was administered after the intravenous set was filled with blood. 1ml/s administration was via radial vein and slowly. The tourniquet was left in place for 30 minutes. Treatment was administered every 7 days and grading of each limb or other body parts was recorded at each examination [22].

Jugular vein administration of sodium Iodide protocol

An injectable form of 10% NaI through the jugular vein and IVRP as aseptically prepared from 90 milliliter normal saline and 10 grams of sodium Iodide powder [24]. However, in current study, 100ml of 10% NaI was injected through the jugular vein weekly for six weeks.

Oral administration of potassium iodide protocol

For the current study, 100 mg/kg of KI were administered orally by mixing with fruska or concentrate feed for five consecutive days and followed by 120 mg/kg of KI through the same route every other day for up to six weeks [25].

Topical application of iodine tincture protocol

After horses were restrained in the crush, the lesions were washed with water and soap. Wound areas were shaved and nodules containing pus were drained. Subsequently, 4% iodine tincture was topically applied daily. 4% Iodine tincture was prepared from 1.5 kg of KI, 1 kg of crystal Iodine, 20 liters of 70% alcohol and 5 liters of water mixed together [22]. The study were obtained ethical clearance (Ref. No.VM/ERC/08/04/13/2021) from the Animal Research, Ethical Review Committee (ARERC) of Addis Ababa University, College of Veterinary Medicine and Agriculture (Annex 1).

Questionnaire survey

Quantitative and qualitative types of questionnaire were collected from carthorse owners through the closed type of questionnaire format. Information likes the management practices, owner perception of their horses and efficacy of the drug were assessed. The aim of the study was briefed for the owners and asked for their voluntariness before the interview. A total of 40 carthorse owners were interviewed with local languages (Afan Oromo and Amharic) for the easiness of questionnaire for owners, even if the questionnaire format was prepared with English.

Laboratory confirmation

A pus sample was aspirated from an un-ruptured nodule by a sterile needle and syringe after the wound area was aseptically prepared by washing with water and soap, shaving around the nodule and disinfecting with 70% alcohol. The pus sample was placed on a microscope slide and mixed together in order to obtain smear uniformly. Then the smear was fixed with 98.8% methanol for 2 to 3 minutes and air dried. Giemsa reagent was added to the fixed slide and stayed for 30 minutes, then washed under tap water and left until dried.

Under oil immersion microscopy, the yeast phase of HCF features is gram-positive, round to oval with one edge wider and the other bluntly pointed in shape with a halo unstained capsule-like structure with blood cells and outer layer of the halo/unstained capsule-like structure stained blue with Giemsa stain. The HCF can exist freely in cytoplasm (indicated by arrow A) or intracellularly within the macrophages as individual or in groups (indicated by arrow B) (Fig. 2).

Data Analysis

Data collected from both questionnaire and experimental study was stored in Microsoft excel spreadsheets. Analysis of variance (one way ANOVA) using STATA Version 16 Statistical Software [26] was used to compare the differences of grade means among and within groups. An independent t-test was used to compare two groups of contralateral groups and two variables of all experimental groups per follow up period. The analysis was done by F test, which determined its significance by P-value and 95% confidence interval. High F value or P value less than 0.05 indicated there was higher difference between the means implies between groups and statistically significant.

Comparative analysis of all experimental groups

The presence of EZL was confirmed in a total of forty (40/40) horses by Giemsa stain. These animals were then included in the trial to assess the comparative effectiveness of different treatment protocols. The analysis of variables of all experimental groups and all variables of the study group (number of nodules, number of discharging nodules, recovered nodules and grade) shows there were statistically significant (P < 0.05) differences. Each of the eight experimental units in one experimental group was examined six times as indicated with 48 frequencies (Table 2). Grade was more preferred to determine the level of effectiveness of the drug other than study variables.

The statistically significant differences in their therapeutic value were observed by pairwise comparison (as a post hock analysis) of all groups. Those were found between oral KI in combination with topical 4% iodine tincture versus 10% NaI IVRP in combination with topical 4% iodine tincture, 10% NaI through jugular vein in combination with topical 4% iodine tincture and debridement and topical 4% iodine tincture with their P values were 0.004, 0.025 and 0.018 respectively (Table 3).

Table 3

Analysis of variance by grades
Source	SS	df	MS	F	Prob > F
Between groups	20.875	4	5.218	4.30	0.002
Within groups	285.020	235	1.212	4.30	0.002
Total	305.895	239	1.279

Experimental group analysed separately

Comparison of the means of a grade between before and after treatment of all experimental groups revealed the differences (Table 5) and (Fig. 3). However, statistical significant (P = 0.001) difference in therapeutic value was observed only in 10% NaI through jugular vein in combination with topical 4% iodine tincture (Table 4).

Table 4

Grades pairwise analysis of all experimental groups
Row mean-Col. mean	DIod	IVRP	IVRPIT	JUI
IVRP	0.312 1.000
IVRPIT	-0.104 1.000	-0.416 0.651
JUI	0.020 1.000	-0.291 1.000	0.125 1.000
KII	0.708 0.018	0.395 0.796	0.812 0.004	0.687 0.025

Key: the group’s first row indicate, the difference of row mean less column (col.) mean and the second row indicate P values

Table 5

Mean comparisons of EZL treatments at start and end of the follow up period.
Exper. Groups	Variable	Week 1 Mean ± SD	Week 6 Mean ± SD	95% CI	P value
IVRP	Grade	3 ± 0.92	2.625 ± 0.92	1.86, 3.39	0.429
DIod		2.5 ± 0.53	2.625 ± 1.59	1.29, 3.96	0.836
IVRPIT		2.875 ± 0.83	2.125 ± 0.99	1.29, 2.95	0.123
JUI		3.5 ± 0.75	1.75 ± 0.88	1.01, 2.49	0.001
KII		3.5 ± 0.53	3 ± 2.14	1.21, 4.79	0.534

Key: exper. Groups=Experimental groups, SD =standard deviation

After treatment mean was less before treatment mean of all groups were 0.125, -0.35, -0.5, -0.75 and − 1.75 with the respective experimental drug of topical 4% iodine tincture, 10% NaI IVRP, (oral KI, 10% NaI IVRP and 10% NaI through jugular vein) in combination with 4% iodine tincture topically. So, the least mean (-1.75) was for 10% NaI through the jugular vein with topical 4% iodine tincture, which is preferred more.

The mean of all groups was different and decreases at different weeks of follow up period while the control group mean was increases after two to four weeks of follow up period and start to decreases slightly (Fig. 4). These was justified in all experimental groups there were a coalescent nodules and discharging nodules, however only one combination of drugs show statistically efficacious.

Contralateral groups

Comparison of the means of parameters at week 1 and 6 for contralateral group

The two variables t-test analysis of 10% NaI through IVRP in combination with topical 4% iodine tincture versus the control group (topical 4% iodine tincture) indicates a mean difference between at start and end of the follow up period (Table 5). But, the mean difference was statistically not significant (P > 0.05).

Separate analysis of contralateral groups.

The analysis of 10% NaI through IVRP with its control (topical, 4% iodine tincture) indicates a mean difference. Statistically significant (P = 0.005) difference was observed by grade. However recovered nodules of the groups were statistically insignificant (Table 6). The 10% NaI IVRP in combination with topical 4% IT and its control (4% IT) shows mean difference (Table 7), but statistical significance was not observed (P > 0.05). The limb lymphatic extensions of all contralateral groups at the start, middle and end of the follow up period were not statistically significant (P > 0.05) (Table 8).

Table 6

Mean comparisons for contralateral groups before and after treatment.
Ex. groups	Variable	Week 1 Mean ± SD	Week 6 Mean ± SD	95% CI	P value
IVRP	Grade	3 ± 1	2.66 ± 1.15	-0.20, 5.53	0.725
Control		3.66 ± 0.57	4 ± 1	1.51, 6.48	0.643
IVRPIT		3 ± 1	2.66 ± 1.52	-1.12, 6.46	0.767
Control		2.66 ± 0.57	4 ± 1	1.51, 6.48	0.116

Key: IVRP (10% NaI through IVRP), ITRP (4% iodine tincture as a control for IVRP), ITRPIT (4% iodine tincture/control group of 10% NaI through IVRP and 4% iodine tincture topically (IVRPIT)).

Table 7

Mean comparisons of EZL indicators for contralateral groups and their control
Group	Observation	Mean	Std. dev.	95% CL		P value
IVRP	3	3	1.08	2.46	3.53	0.005
ITRP	3	3.94	0.80	0.80	3.54	0.005
Combined	6	3.47	1.05	3.11	3.82
IVRPIT	3	2.88	0.96	2.41	3.36	0.119
ITRPIT	3	3.38	0.91	2.93	3.84	0.119
Combined	6	3.13	0.96	2.81	3.46

Table 8

Limb lymphatic extension for all contralateral groups.
Experimental group	Week	None	Mild	Moderate	Severe	P value
IVRP ITRP IVRPIT ITRPIT	1	1(8.33)	1(8.33)	1(8.33)	0	0.731
		0	1(8.33)	2(16.67)	0
		1(8.33)	1(8.33)	1(8.33)	0
		1(8.33)	2(16.67)	0	0
	3	1(8.33)	1(8.33)	0	1(8.33)	0.740
		0	1(8.33)	1(8.33)	1(8.33)
		1(8.33)	1(8.33)	1(8.33)	0
		0	1(8.33)	2(16.67)	0
	6	2(16.67)	0	1(8.33)	0	0.672
		0	1(8.33)	1(8.33)	1(8.33)
		1(8.33)	1(8.33)	1(8.33)	0
		0	1(8.33)	1(8.33)	1(8.33)

Questioner survey results

All study horses were carted horses and the entire respondent explained that horses are most affected, and they feel the pain of their Horses and always feeding and watering their Horses. Accordingly, most respondents (93.5%) were aware of EZL; gives rest for the diseased horse, treat at veterinary clinics, manage separately at home and feed with fruska and straw (Table 9A). The suspected variable including management practice, types of feeding and severity of the disease were not show statistical significant (P > 0.05) differences (Table 9B).

The results of current study identified that 10% NaI through jugular vein in combination with topical 4% iodine tincture had a significantly higher therapeutic value on EZL cases as compared to other remedies. This was supported by[17] who found that the combination of NaI and penstrip had a better therapeutic effect on EZL as compared to other remedies.[27] had also reported that NaI had better therapeutic value on EZL than other iodides because of its antifungal and antibacterial effect. The effectiveness of 10% NaI through the jugular vein in combination with topical 4% iodine tincture might be due to the jugular vein administration enhances its overall distribution to all organs, organ system and site of action immediately and subsequently, the 4% iodine tincture applied externally may also acts as antifungal and antiseptics to mitigate the EZL and prevent secondary complication of the affected area.

The response of oral KI in combination with topical 4% iodine tincture was observed after the 3rd week, due to administer orally, its concentration at the site of action could be minimal with a consequent reduction in its antimicrobial activity. But, oral KI in combination with topical 4% iodine tincture shows the side effect of iodides like inappetence due to inflammation and itching of oral mucosa, mucous exudate and lacrimation from eye. This finding agrees with the report of [17]. The response for 10% NaI through (jugular and radial vein) in combination with topical 4% iodine tincture, almost before the 2nd week and jugular route signifies a greater response. This indicates 10% NaI intravenously through jugular vein in combination with topical 4% iodine tincture was comparatively most effective, safer and respond to HCF more quickly than other remedies.

The contralateral group of 10% NaI IVRP and its control (topical 4% iodine tincture) indicates a significant difference and 10% NaI IVRP shows more therapeutic value. This finding agrees IVRP is widely used in treatments of distal limb infections in horses and suggested to be more efficacious and safer than systemic antimicrobial administration, when treating limb infections [28]. This indicates the NaI IVRP will obtain better treatment results than simply applying iodine.

This difference might be due to continues eruption of new nodules in its control group and HCF can travel through the lymphatic system and may exist in the other organ/lymphatic vessels for the eruption of new nodules according to its incubation period. But, no eruptions of new nodules (localize the lesions) in treatments group. This localizing might be due to the application of commander as tourniquet for 30 minutes enhances the perfusion of the drugs to its site of action within that minute. The questioner survey gathered from all horse owners also depicts the more effectiveness of NaI with iodine tinctures in jugular vein. That means less than 0.001 by statistical value and 77.5% in proportion (Table 9B).

Table 9

Response of cart horse owners (A) and relative proportions in all groups (B).
Questions	Categories	Proportions	Total %
Know EZL		37(93.5)	93.5
More affected	Horse	40(100)	100
Purpose of keeping	Cart horse	40(100)	100
Treatment regime	Veterinary clinic	33(82.5)	95
Treatment regime	Tradition	5(12.5)	95
Treatment drug	KI + IT	8(20)	100
	IT	8(20)
	NaI + IT	16(40)
	NaI	8(20)
Drugs which gives most recovery	KI + IT	5(12.5)	100
	NaI + IT	31(77.5)
	IT	3(7.5)
	The same	1(2.5)
Pain of animals feeling		40(100)	100
Recovery period	< 1 month	9(22.5)	100
	1–2 month	10(25)
	1–3 month	18(45)
	> 3 month	3(7.5)
Giving rest		39(97.5)	97.5
How manage them	Separately at home	33(82.5)	100
	Separately outside	6(15)
	With others	1(2.5)
If EZL severe and severe	Abandon	14(35)	100
	Keep up to live	18(45)
	Report to SPANA	8(20)
Feeding and watering	Daily	40(100)	100
Type of feeding	Fruisca	1(2.5)	100
	Fruisca and straw	33(82.5)
	Fruisca and feed	6(15)

Significance of the experiment

This experiment assesses the level of effectiveness for different drugs and drug combination and points out the comparatively most effective drug of EZL to be 10% NaI through the jugular vein in combination with topical 4% iodine tincture. An interesting point identified by this study concerning IVRP technique was that EZL infection was localized lesions (no further eruption of new nodules) however, its therapeutic value was insignificant.

Limitation of the experiment

In this study, there were different limitations. Drop out of the different study unit due to the inability of their owners to return back per day and weekly; other study units were also left back due to oral KI in combination with topical 4% iodine tincture side effects; like their horses refuses to ingest the KI with feed and show the sign of depression. All drop outs were replaced with another study unit. With oral KI in combination with topical 4% iodine tincture drug, one horse also shows the sign of Iodinism (inflammation of oral mucosa, mucous discharge from eyes, inappetence and depression) and excluded from the study group and replaced with another horse.

Conclusion and recommendations

As a whole, the combination of 10% NaI through jugular vein in combination with topical application of 4% iodine tincture was comparably better effective treatment of horse EZL than other remedies. Between the drug combination of 10% NaI IVRP in combination with topical 4% iodine tincture; and 10% NaI IVRP and oral KI in combination with topical 4% iodine tinctures were almost no therapeutic difference. Most of the horse owners also responded that intravenous injection of the drugs in combination with 4% iodine tincture topically had better therapeutic value than other others. Therefore, depending on the above conclusion the following recommendations were forwarded:

Further study should be conducted on the effectiveness and toxicity level of 10% NaI through jugular vein in combination with topical 4% iodine tincture.
All Veterinarians and health extension workers should create awareness for farmers, especially working animal’s owners about the best management practice of their animals.
All concerned body should have to strive for EZL vaccine development in order to conserve the life of equines and the socio-economy of all stakeholders.

Ethics approval and consent to participate

Researchers were obtained ethical clearance (Ref. No. VM/ERC/08/04/13/2021) from research committee of Addis Ababa university, collage of veterinary medicine and agriculture and all the study participants were informed about the purpose of the study and consent were obtained from horses owner to perform experiments on their horses. The protocol of the study was reviewed and approved by Research Ethics and Review Committee of Addis Ababa University guideline and regulations.

Funding

The authors would like to acknowledge the financial support SPANA project. However, the funding body had no part in the design of the study and collection, analysis, and interpretation of data, and in writing the manuscript.

Competing interests

There were no conflicts of interest in this work

Consent for publication

Not applicable

Availability of data and materials

Up on requirements data that supporting this article will be available from the corresponding author.

Consent statement

Informed consent was obtained from horse’s owner to perform experiments on their horses.

Authors’ contributions

Kumisa Mideksa, Zerihun Asefa, Hanna Zewdu, Reta Tesfaye, Matilde Merridale-Punter and Ben Sturgeon are prepared the proposal and did experiments and questionnaire survey and

Kumisa Mideksa and Tolesa Negasa they did data entry, data analysis and writing the results.

Acknowledgements

The authors would like acknowledge SPANA project for their contribution materials and reagent for this research.

Endebu B. 2000. Comparative Studies on the Occurrence and Distribution of Epizootic lymphangitis and Ulcerative Lymphangitis in Ethiopia. The International Journal of Applied Research 15:1.
Pritchard J, Lindberg A, Main D, and Whay H. 2005. Assessment of the Welfare of working horses, mule and donkeys, using health and behavioral pattern. Preventive Veterinary Medicine 69: 265-283.
Anon, 2014. Federal Democratic Republic of Ethiopia. Central Statistical Agency: Agricultural Survey.
Abdisa T. 2017. Review on Equine Epizootic Lymphangitis and its Impact in Ethiopia. Journal of Veterinary Medicine Research 4(5): 1087.
Hadush B, Michaelay M, Menghistu H, Abebe N, Genzebu A, Bitsue H, Afera B, Duguma B, Gugsa G, and Ameni G. 2020. Epidemiology of Epizootic lymphangitis of Carthorses in northern Ethiopia using conventional diagnostic methods and nested polymerase chain reaction. BMC Veterinary Research 16:375. https://doi.org/10.1186/s12917-020-02582-2.
Pal M. 2007. Veterinary and Medical Mycology. 2nd Edition. Indian Council of Agricultural Research, New Delhi, India. P 2.
Firaw S and Pal M. 2015. Clinical and microbiological observations on strangles in donkey. Haryana Veterinarian 54(1): 64-66.
Ameni G. and Siyoum F. 2002. Study on Epizootic lymphangitis in cart horses in Ethiopia Journal of veterinary Science 3(2):135-139.
Hadush B, Biratu D, Taddele H, Tesfaye D, and Ameni G. 2014. Bacterial contaminants isolated from lesions of equine histoplasmosis in cart horses of Mekelle town, northern Ethiopia. Revue de Medecine Veterinaire 165 (1-2), 25-30.
Dereje W, Hagos A and Assegedech S. 2015. Pathology of Epizootic Lymphangitis in Carthorses in Central Ethiopia, Oromia Regional State, Ethiopia.
Ameni G. 2006. Epidemiology of Equine Histoplasmosis (Epizootic lymphangitis), in cart horses in Ethiopia. Veterinary Journal 172:160-165.
Scantlebury C, Zerfu A, Pinchbeck G, Reed K, Gebreab F, Aklilu N, Mideksa K, Christley R. 2015. Participatory appraisal of the impact of Epizootic lymphangitis in Ethiopia. Preventive Veterinaary Medicine 120:265 276.
Asfaw R. Pal M. and Ameni G. 2012. Prevalence of epizootic lymphangitis in cart horses in south west Shewa of Oromia region, Ethiopia. International Journal of Livestock Research 2:146-151.
Stringer A, Christley R, Bell C, Gebreab F, Tefera G, Jones K, Trawford A, Pinchbeck GL. 2016. Owner reported diseases of working equids in Central Ethiopia. Equine Veterinary Journal 27(8). http://dx.doi.org/10 .1111/evj.12633.
Drug Administration and Control Agency 2006. Epizootic lymphangitis. In Standard Treatment Guidelines for Veterinary Clinics, (1st edn), p. 210-212.
OIE. 2019. Epizootic lymphangitis. www.cfsph.iastate.edu. December.
Hadush B, Ameni G and Medhin G. 2008. Equine histoplasmosis: Treatment trial in cart horses in Central Ethiopia. Tropical Animal Health Production 40: 407–411.
NMSA, National Meteorological Service Agency, Addis Ababa, Ethiopia (2003).
NMA, National Metereology Agency, 2007. Annual report on Temprature and Rainfall distribution for Akaki, Bishoftu and Chefe Donsa, Addis Ababa Ethiopia.
IPMS, Improving productivity and market success of Ethiopian farmers, 2005. Ada'a-liben woreda pilot learning site diagnosis and program design. IPMS, Addis Ababa Ethiopia.
BTLA, Bishoftu town livestock agenc, 2021. General information about Bishoftu town.
SPANA, 2020. Standard of the EZL disease grading. SPANA Ethiopia project of Addis Ababa University in Bishoftu town.
Hulme J. 2002. SPANA guides to animal care part I p 2-8.
Al-Ani F. 1999. Epizootic lymphangitis in horses: a review of the literature. Review Science Technology 18(3):691-699.
Scantlebury C and Reed K. 2009. Epizootic Lymphangitis. Review Chapter in Peer reviewed textbook; 'Infectious Diseases of the Horse' edited by T.S. Mair & R.E. 15(56) P 397 .
STATA, (2019).
Aiello S. and Mays A. 1998. The Merck Veterinary Manual. Merck and CO INC White House Station, USA, 8th ed, 1796.
Schoonover M, Moser D, Young J, Payton M and Holbrook T. 2017. Effects of tourniquet number and exsanguination on amikacin concentrations in the radiocarpal and distal interphalangeal joints after low volume intravenous regional limbperfusion in horses.Veterinary Surgeon 46: 675–682.

No competing interests reported.

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Comparative Efficacy Evaluation of 10% Sodium Iodide and Potassium Iodide Therapies of Horses With Eipizootic Lymphangitis at Spana Equine Clinic, Bishoftu, Ethiopia

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Version 1

Abstract

Purpose

Methods

Results

Conclusion

Figures

Introduction

Material and Methods

Study area

Study design and study population

Sampling method

Treatment protocol

Intravenous regional perfusion protocol

Jugular vein administration of sodium Iodide protocol

Oral administration of potassium iodide protocol

Topical application of iodine tincture protocol

Questionnaire survey

Laboratory confirmation

Data Analysis

RESULTS

Comparative analysis of all experimental groups

Experimental group analysed separately

Contralateral groups

Comparison of the means of parameters at week 1 and 6 for contralateral group

Questioner survey results

Discussions

Significance of the experiment

Limitation of the experiment

Conclusion and recommendations

Declarations

References

Additional Declarations

Status:

Version 1