J. Biomedical Science and Engineering, 2011, 4, 29-33
doi:10.4236/jbise.2011.41004 Published Online January 2011 (http://www.SciRP.org/journal/jbise/
JBiSE
).
Published Online January 2011 in SciRes. http://www.scirp.org/journal/JBiSE
Effect of flunixin meglumine alone and in combination on
haemodynamics during bovine endotoxic shock and after
treatment
Digvijay Singh, Satish Kumar Bansal, Gurbrinderjit Singh Ghumman
Department of Veterinary Physiology & Biochemistry, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sci-
ences University, Ludhiana, India.
Email: digvijay231@rediffmail.com
Received 21 July 2010; revised 26 August 2010; accepted 30 August 2010.
ABSTRACT
To investigate the effect of Flunixin meglumine- a
NSAID; alone and in combination with hypertonic
saline on endotoxemic buffalo calves, two groups of
five apparently healthy male buffalo calves aged be-
tween 6-8 months were subjected to I.V. infusion of
E.coli endotoxin at the rate of 5μg/kg BW per hour
for 3 hours. A highly significant (P < 0.01) fall in
mean systolic,diastolic, pulse, mean arterial pressure
(M.A.P), central venous pressure (C.V.P) and haemo-
globin was observed till the end of endotoxin infusion
while respiratory rate was significantly elevated
along with a non-significant alteration in rectal tem-
perature and hematocrit during the infusion of en-
dotoxin. Immediately at the end of endotoxin infusion,
flunixin meglumine at the rate of 1.1 mg/kg B.W was
infused i.v. in group-I animals and group-II animals
were infused with hypertonic saline solution (H.S.S.)
at the rate of 4 ml/Kg BW as one time infusion fol-
lowed by flunixin meglumine at the rate of 1.1 mg/kg
B.W which resulted in increase of various parameters
either to normal or very close to normal value while
the rectal temperature and haematocrit decreased
non-significantly throughout the observation period
of 7 hours. No improvement in Hb and respiration
was observed consequent to FM administration. Both
treatments successfully raised systolic, diastolic, pulse
pressure, C.V.P & M.A.P to normal pre-infusion val-
ues. From the results of the present investigation, it
can be concluded that i.v. infusion of FM alone and in
combination with hypertonic saline solution in en-
dotoxemic buffalo calves effectively restores the
various hemodynamic parameters close to normal
pre-infusion values and it can be used as immediate
resuscitation measure to provide the clinician valu-
able time to plan further long term treatment.
Keywords: Buffalo Calves; Flunixin Meglumine;
Haemodynamics; Hypertonic Saline; Endotoxic Shock
1. INTRODUCTION
Endotoxemia is a potentially devastating complication of
several diseases of cattle e.g. enteric disease, septicemia,
metritis, mastitis and pneumonia [1]. Endotoxemia is a
life threatening inflammatory condition which can lead
to shock, multiple organ failure, suppression of immune
system and wound healing processes [2]. After gaining
access to the circulation, endotoxin causes a variety of
adverse effects including cardiovascular compromise,
lactic acidiosis, leukopenia, glucose dyshomeostasis,
hemostatic alteration, gastrointestinal,respiratory and
renal disturbances. The traditional treatment for en-
dotoxemic animals attempts to support cardiac and pul-
monary function, eliminate causative microbes and
modulate the production of endogenous mediators.
While hypertonic saline is cheap, easily available and
has been reported to bring immediate beneficial effects
which are transient [3], flunixin meglumine inhibits the
release of endogenous inflammatory mediators. The
present investigation was carried out to elucidate the
effects of flunixin meglumine- a NSAID alone and in
combination with hypertonic saline solution on hemo-
dynamics of endotoxemic buffalo calves.
2. MATERIALS AND METHODS
Normal healthy male buffalo calves (10) divided into
two groups of 5 each, aged between 6-8 months with
body weight range 70-110 kg procured from local mar-
ket were dewormed a week before the experiment with
fenbendazol at the rate of 5 mg/kg B.W.The E-coli en-
dotoxin(lyophilized, phenol extracted 0111:B4 lipopoly-
saccharide, SIGMA chemicals, USA) was reconstituted
by dissolving it in 0.9% normal saline to make a
stock-solution of 1 mg/ml. Endotoxin concentration of 5
D. V. Singh et al. / J. Biomedical Science and Engineering 4 (2011) 29-33
Copyright © 2011 SciRes. JBiSE
30
μg/ml was prepared by dissolving 1 ml of stock solution
in 199 ml of normal saline. Endotoxin was I/v infused in
the animals at the rate of 5 μg/kg BW/ hr for 3 hrs was
followed immediately with infusion of flunixin meglu-
mine at the rate of 1.1 mg/kg BW in group-I and with
hypertonic saline solution (7.2%Nacl acq.) at the rate of
4 ml/Kg. BW followed by flunixin meglumine at the rate
of 1.1 mg/kg BW in group-II as one time infusion.
The animals were casted in right lateral recumbency
on the operation table. Before endotoxin infusion, an
area over the jugular furrow was shaved and disinfected
with savlon. The local anaesthetic lignocaine (2%) at the
rate of 90 ml was injected subcutanaeously and intra-
muscularly before catheterization of the carotid artery
and jugular vein to alleviate pain. The skin was incised
to expose and catheterize the carotid artery and jugular
vein. Siliconized polyethylene catheter was inserted into
the carotid artery and was connected to mercury ma-
nometer through a 3-way cannula with stop cork for the
record of arterial blood pressure. The jugular vein was
catherterized and attached to the saline manometer
(Ramson’s scientific and surgical India Pvt. Ltd,
Agra-India) for the record of CVP and administration of
endotoxin and flunixin meglumine.
Packed cell volume was estimated by microhaemotocrit
method while Hb was measured by cyannomethaemoglo-
bin method by the use of spectrophotometer by colorimet-
ric method at 540 mm [4]. Body temperature was re-
corded by using standard clinical thermometer from the
rectum of the animal. Thermometer was in touch with the
mucosa for one minute during every observation.
The data were pooled and analyzed using Completely
Randomized Design ANOVA and t-test [5]. All the val-
ues obtained were compared with the pre-infusion nor-
mal values within the group.
3. RESULTS AND DISCUSSION
The I.V. infusion of endotoxin in animals led to the de-
velopment of clinical symptoms of restlessness, respira-
tory distress characterized by labored and abdominal
respiration, diarrhea and profuse salivation. The animals
closed their eyes and struggled intermittently with the
progression of endotoxin infusion. On i.v. infusion of
hypertonic saline solution and flunixin meglumine, all
the animals opened their eyes and were alert. A profuse
urination was observed one hour after hypertonic saline
solution infusion in group-II animals.
The normal mean systolic pressure was observed to be
161.2 ± 11.36 mmHg (Table 1) and 154.40 ± 4.07
mmHg (Table 2) which is slightly higher than 145.60 ±
17.3 to 146.60 ± 2.78 mmHg as reported in buffalo
calves [3]. The mean systolic pressure decreased imme-
diately after endotoxin infusion. An increase in systolic
pressure was seen on treatment with flunixin meglumine
(FM) and it remained non-significantly below the nor-
mal values (Table 1, Figure 1). Similar results have
been reported by Singh et al., 2005 [6].
The normal mean diastolic pressure was 124.00 ±
13.18 mmHg (Table 1) and 110.80 ± 4.45 mmHg. (Ta-
ble 2) which is close to 118.0 ± 7.80 to 122.40 ± 7.4
mmHg as reported. [3]. The diastolic pressure was sig-
nificantly (P < 0.01) lower at 3rd hour of start of en-
dotoxin infusion (Table 1). Similar results have been
reported in buffalo calves [3,6]. After flunixin meglu-
mine treatment, the diastolic pressure reached slightly
above normal value at the end of the experiment i.e. 7th
hour of observation (Table 1).
The normal pulse pressure was 35.20 ± 5.60 mmHg
(Table 1) and 44.0 + 8.10 mmHg (Table 2). Apart from
a general decline in pulse pressure, a significantly (P <
0.01) lower pulse pressure was observed at 3 hour of
start of endotoxin which after treatment increased and
was non-significantly lower than the normal pre-infusion
level throughout the period of observation in group-1
while in group-2 pulse pressure was significantly below
normal pre-infusion values throughout the observation
period. Endotoxin infusion lowered the pulse pressure
and treatment with flunixin meglumine led to an increase
in pulse pressure, yet it was still lower then the normal
value at the end of the experiment (Table 1).
The normal MAP (Mean arterial pressure) was found
to be 135.73 ± 12.02 (table 1) and 126.52 ± 3.35 mmHg
which is similar to 130.00 ± 6.4 mm Hg [6] but lower
than 153.88 ± 2.00 mmHg [7]. The fall in MAP
throughout endotoxin infusion was significant i.e., upto
3rd hour and after infusion of Flunixin meglumine, it was
slightly higher than the normal value at the end of the
experiment (Table 1). The fall in MAP during endotoxin
infusion may be due to the release of 6 -Keto pros-
taglandin-F1-α [8]. The rise in MAP after HSS infusion
may be due to the fact that HSS infusion increases the
plasma osmolality and osmiotically draws intracellular
and interstitial water into vascular space. The consequent
plasma volume expansion is 3 ml for every 1 ml of hy-
pertonic saline solution infused [9]. This rapid plasma
volume expansion increases the cardiac output and the
mean arterial pressure. Hypertonic saline may also elicit
a beneficial effect through reduction of endothelial
swelling which results in narrowed vessel diameter with
increased hydraulic resistance making perfusion of tis-
sues more difficult. According to Olson et al. (1995)
[10], in response to endotoxin, through the action of a
membrane bound enzyme prostaglandin synthase, ara-
chidonic acid is converted to cyclicendoperoxidases i.e.,
PGG2 and PGH2 which are rapidly converted into
ThromboxaneA2 (TXA2) and PGI2. PGI2 is a potent sys-
temic vasodilator which could contribute to endotoxin-
induced systemic hypotension and lethality. The rise in
D. V. Singh et al. / J. Biomedical Science and Engineering 4 (2011) 29-33
Copyright © 2011 SciRes.
31
JBiSE
Table 1. Different haemodynamic parameters at different stages of endotoxic shock and after treatment with flunixin meglumine.
(Group-I).
Endotoxic Shock After Tr eatment
Parameter 0 hr 1 hr 2 hr 3 hr 4 hr 5 hr 6 hr 7 hr
Systolic pressure
(mmHg) 161.20 ± 11.36 122.80* ± 11.02 123.60* ± 2.79111.60* ± 3.49154.00 ± 9.01158.40 ± 7.76 157.20 ± 7.63 155.60 ± 7.93
Diastolic pressure
(mmHg) 124.00 ± 13.18 98.00 ± 14.94 100.00 ± 8.1793.20* ± 5.08122.40 ± 4.80129.20 ± 8.64 132.40 ± 10.17 126.40 ± 12.02
Pulse pressure
(mmHg) 35.20 ± 5.60 24.80 ± 5.82 23.60 ± 6.1118.40* ± 3.5431.60 ± 4.1229.20 ± 4.22 24.80 ± 3.93 29.20 ± 6.56
Mean Arterial
pressure (mmHg) 135.73 ± 12.02 106.26* ± 13.48 107.86* ± 6.23 101.33* ± 5.34132.93 ± 8.04139.06 ± 0.10 140.66 ± 9.21 136.13 ± 10.38
Central venous
pressure (Cm) 3.10 ± 0.93 -0.90*± 1.25 -0.70* ± 1.41-0.20* ± 1.984.50 ± 1.062.80 ± 1.59 1.50 ± 1.48 -0.60 ± 1.36
Respiration rate
(movt/min) 11.80 ± 1.20 10.20 ± 1.74 21.40* ± 2.4621.00* ± 1.6114.80 ± 1.1614.80 ± 1.50 14.60 ± 1.86 14.60 ± 1.43
Body temperature
(°F) 100.88 ± 0.69 100.32 ± 0.95 100.72 ± 0.99100.76 ± 0.97100.32 ± 0.83100.18 ± 0.75 100.22 ± 0.80 100.32 ± 0.72
Hematocrit
(PCV) (%) 35.20 ± 1.43 34.20 ± 1.20 33.00 ± 1.1432.20 ± 1.2433.40 ± 1.2933.80 ± 0.97 33.40 ± 1.17 33.80 ± 1.07
Hemoglobin
(g1 dl) 12.51 ± 0.28 12.19 ± 0.25 11.87 ± 0.2411.57* ± 0.1811.97 ± 0.1412.36 ± 0.20 11.97 ± 0.10 12.01 ± 0.08
*Significant at 1% level; No. of animals = 5.
Table 2. Different haemodynamic parameters during different stages of endotoxic shock and after treatment with hypertonic saline
and Flunixin meglumine. (Group-II).
Endotoxic Shock After Tr eatment
Parameter 0 hr 1 hr 2 hr 3 hr 4 hr 5 hr 6 hr 7 hr
Systolic pressure
(mmHg) 154.40 ± 4.07 129.6* ± 10.30 89.60* ± 10.2592.80* ± 7.12134.60 ± 6.44137.60 ± 7.83 138.00 ± 10.10 138.00 ± 10.15
Diastolic pressure
(mmHg) 110.80 ± 4.45 101.20 ± 5.59 77.20* ± 7.7571.20* ± 5.05108.80 ± 9.90106.40 ± 6.06 113.20 ± 7.24 111.60 ± 6.67
Pulse pressure
(mmHg) 44.00 ± 8.10 30.00 ± 6.40 14.40* ± 2.4520.80* ± 3.3525.60* ± 4.4829.20* ± 14.10 26.80* ± 13.40 28.40* ± 14.20
Mean Arterial
pressure (MAP)
(mmHg)
126.52 ± 3.35 108.2* ± 5.35 81.54* ± 8.5578.04* ± 5.24117.24 ± 8.06116.10 ± 6.07 122.00 ± 7.75 120.50 ± 7.45
Central venous
pressure (Cm) 5.20 ± 2.81 3.90* ± 2.66 2.10* ± 0.713.50* ± 3.216.50 ± 1.946.10 ± 1.93 5.20 ± 1.90 4.40 ± 3.06
Respiration rate
(movt/min) 10.80 ± 2.15 12.80 ± 2.07 14.40 ± 1.6516.40 ± 3.3516.40 ± 3.3513.60 ± 1.25 16.00 ± 2.28 15.40 ± 3.03
Body temperature
(°F) 99.0 ± 0.84 99.2 ± 0.95 100.6 ± 0.82100.5 ± 0.8792.4 ± 2.0399.2 ± 0.20 99.9 ± 0.20 98.1 ± 1.70
Hematocrit
(PCV) (%) 30.4 ± 1.70 30.0 ± 1.38 28.4 ± 1.6025.8* ± 1.4924.4* ± 1.8526.6* ± 1.32 26.0* ± 1.64 26.6 ± 1.34
Hemoglobin
(g/dl) 11.30 ± 0.19 10.8 ± 0.76 9.95 ± 0.628.69* ± 0.727.92* ± 0.768.55* ± 0.57 9.08* ± 0.47 8.77* ± 0.61
*Significant at 1% level; No. Of animals in each group = 5.
D. V. Singh et al. / J. Biomedical Science and Engineering 4 (2011) 29-33
Copyright © 2011 SciRes. JBiSE
32
Figure 1. Blood pressure pattern during endotoxin infusion and after Flunixin meglumine infusion in an endotoxemic buffalo calf.
MAP after Flunixin meglumine may be due to the fact
that NSAIDS like flunixin meglumine, Ketoprofen and
Ketorolac are cyclo oxygenase inhibitor and prevents the
formation of prostaglandins including PGI2 and hence
improves tissue perfusion [1].
The normal CVP was 3.10 ± 0.93 cm (Table 1) and
5.20 ± 2.81 cm saline (Table 2) which is lower than
8.30 ± 1.67 cm [11]. There was a significant fall in CVP
throughout endotoxin infusion from 1st to 3rd hour (Table
1 and 2). The fall in CVP may be due to peripheral pool-
ing of blood [6]. According to Singh (1979), [12] failure
of capacitance changes due to lack of venous constric-
tion contributes to reduction in CVP. After Flunixin me-
glumine, CVP showed a marked increase at 4 hour (Ta-
ble 1) and its level was non-significantly lower than the
pre-infusion value. Similar findings have been reported
by [13] but in group-2, CVP was above normal
pre-infusion level at 4, 5 and 6 hour indicating beneficial
effect of the infusion of hypertonic saline followed by
flunixin meglumine.
The normal respiration rate was 11.80 ± 1.20 movt./
min (Table 1) and 10.80 ± 2.15 movt./min. (Table 2)
which is close to 7.20 ± 0.47 to 9.20 ± 1.36 movt/min as
reported by Singh et al., 2002 [3]. Under the influence of
endotoxin, the respiration rate increased significantly
and after flunixin meglumine infusion its value was
non-significantly higher than the normal at 7th hour (ta-
ble 1). Similar effect of endotoxin on respiration rate has
earlier been reported in mature cattle and cow calves
[1,14]. The markedly elevated respiratory rate in group-I
observed throughout the endotoxin infusion upto 3 hours
indicated severe effects of endotoxin which may be due
to the fact that cattle in comparison to other species have
more abundant smooth muscle in the pulmonary vascu-
lar tree which may partially or completely explain so
extreme response of lungs of cattle to endotoxin leading
to pulmonary edema, atelactasis and respiratory acidosis.
This is true not only for calves but also for mature cattle
and the onset of clinical respiratory signs can be detected
minutes after E. coli endotoxin administration [3].
The normal body temperature was observed to be
100.88 ± 0.69°F (Table 1) and 99.0 ± 0.84°F (Table 2)
which is lower than 102.2°F as reported earlier [15]. There
was a non-significant decrease in body temperature with
in normal range during endotoxin infusion and after
treatment with Flunixin meglumine. The normal PCV
was found to be 35.20 ± 1.43% (Table 1) and 30.40 ±
1.70% (Table 2) which was similar to 29.0 ± 4.0% to
35.0 ± 6.0% [15]. Non-significant decrease in PCV was
seen during endotoxin infusion and after infusion of
Flunixin meglumine (Table 1). Similar findings have
been reported in neonatal calves by [1]. Flunixin me-
glumine infusion treatment did not change PCV signifi-
cantly (Table 1).
The normal haemoglobin was 12.51 ± 0.28 g% (Table
1) and 11.30 ± 0.19 g% (Table 2) which is close to 9.5 ±
1.30 to 11.40 ± 1.80 g% [15] and 10.44 ± 0.36 to 11.40 ±
0.38 g % [6]. The mean Hb level showed a significant
decrease at 3rd hour of start of endotoxin infusion in both
groups. After FM treatment, the Hb reached close to
normal value (Table 1). A significant (P < 0.01) fall in
hematocrit and hemoglobin was observed at 3, 4, 5 and 6
hours after start of endotoxin infusion in group-2 en-
dotoxemic buffalo calves which may be due to the
hemodilution caused by hypertonic saline as i.v. infusion
of HSS causes rapid expansion in plasma volume and
redistribution of the cardiac output towards the splanch-
nic circulation in calves given E. coli endotoxin [13].
The i.v.infusion of flunixin meglumine not only suc-
cessfully raised systolic, diastolic, pulse and mean arte-
rial pressure to normal pre-infusion value (Figure 1) but
alleviated the clinical symptoms developed due to en-
dotoxin infusion observed earlier. Flunixin meglumine is
a cyclo-oxyoenase inhibitor and prevents the formation
of prostaglandins, responsible for inflammatory response
[16,1]. The Non steroidal anti inflammatory drugs like
flunixin meglumine are beneficial in the management of
endotoxemia and when used in combination with hyper-
tonic saline solution, it has the additional advantage of
bringing CVP to level above pre-infusion levels for
D. V. Singh et al. / J. Biomedical Science and Engineering 4 (2011) 29-33
Copyright © 2011 SciRes. JBiSE
33
some time.
From the results of the present investigation, it can be
concluded that I.V. infusion of Flunixin meglumine
alone and in combination with hypertonic saline solution
in endotoxemic buffalo calves effectively restores the
various hemodynamic parameters like systolic, diastolic,
mean arterial and central venous pressure and body
temperature close to or non-significantly below normal
pre-infusion values thereby providing immediate resus-
citation thus providing clinician valuable time to plan
further long time treatment.
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