DENEYSEL KETOZİS OLUŞTURULAN KOYUNLARDA PARENTERAL LİPİT EMÜLSİYONLARININ TEDAVİ ÜZERİNE ETKİLERİNİN ARAŞTIRILMASI
Bu çalısmada, deneysel ketozis oluşturulan koyunlarda % 20’lik total parenteral lipit emülsiyonları’nın (TPLE) % 30 Dekstroz tedavisine karşı etkinliği araştırıldı. Onsekiz adet gebe olmayan ve laktasyon dönemi dışındaki koyunlar her grupta 6 adet koyun olacak şekilde üç gruba ayrıldı. Bütün gruplarda deneysel ketozis oluşturuldu. Bu amaçla koyunların herbirine üç gün boyunca derialtı phlorhizin enjekte edildi (100 mg/kg) ve sınırlı yem (toplam rasyonun ¼’ü) verildi. Tüm gruplarda ketozise ait klinik belirtiler oluşturulduktan sonra birinci gruba kontrol amacıyla % 0,9 NaCl, ikinci gruba standart tedavi amacıyla % 30 Dekstroz ve üçüncü gruba % 20'lik TPLE damar içi yola uygulandı. Dekstroz uygulaması sonrasında NEFA düzeyleri önemli oranda azaldı. Lipit emülsiyonu verilenlerde ise NEFA düzeylerindeki artış istatistikî açıdan önemli bulunmadı (p=0.05). Bu grupta trigliserid ve glukoz düzeyleri TPLE uygulamasını takiben diğer gruplara oranla yüksek bulundu. Koyunlarda ketozise ait klinik belirtiler yalnız lipit emülsiyonu verildikten sonra belirgin olarak düzeldi. Sonuç olarak deneysel açlık ketozisi oluşturulan koyunlarda % 30’luk Dekstrozun NEFA düzeylerini azaltmasına rağmen, % 20 TPLE’nin glikoz ve trigliserid düzeylerinde artış sağlayıp dekstroz uygulamalarına göre enerji açığını kapattığı belirlendi. Bu nedenle TPLE’nın, açlık ketozisinin klinik belirtilerinin düzeltilmesinde etkili olabileceği değerlendirildi.
The Effects of Treatment With Total Parenteral Lipid Emultion in Sheep Experimentally Induced Starvation Ketosis
In this study, the effects of Total Parenteral Lipid Emulsions (TPLE) and 30% Dekstroz was compared to treatment of experimentally induced starvation ketosis in sheep. Eighteen nonpregnant, nonlactating sheep were randomly divided into 3 different study groups each containing six sheep. Subcutan phloryzin (100 mg/ kg) was injected together with feed restriction (1/4 of total ration) to induce the ketosis and lipid mobilisation. After clinical symptoms for ketosis in all groups, for control 0,9% NaCl in first group, 30% Dekstroz in second group IV and 20% TPLE in third group IV were administered to the each sheep in groups. Mean NEFA levels was a tendency to decrease after dextrose administration in group administered dextrose. In TPLE group, mean NEFA levels were not siginificantly higher after TPLE administraion (p=0.05). Mean triglyceride and glucose levels in sheep given TPLE were significantly higher than those of other groups. Clinical signs was recovered after in group given TPLE only. In conclusion, although 30% dextroz treatment was the most effective in decreasing of NEFA level, 20% TPLE inhibited clinical signs of starvation ketozis in sheep by providing urgent energy demand with increase of trigliserid and glucose levels. For this reason, TPLE was evaluated to be effective in correcting the clinical symptoms of fasting ketosis.
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- 1. Bergman EN. Glucose metabolism in ruminants as
related to hypoglycemia and ketosis. Am J Physiol
1973; 215: 865-873.
- 2. Everts H, Kuiper H. Energy intake and pregnancy
toxemia in profilic ewes. Fifth International
Conference on Production Diseases in Farm
Animals, Uppsala-Sweden 1983; pp 133-136.
- 3. Pethick DW, Lindsay DB. Metabolism of ketone
bodies in pregnant sheep. Br J Nutr 1982; 48: 549-
563.
- 4. Baird GD, Heitzman RJ, Hibbitt KG. Effects of
starvation on intermediary metabolism in the
lactating cow. Biochem J 1972; 128: 1311-1318.
- 5. Bergman EN. Glucose metabolism in ruminants as
related to hypoglycemia and ketosis. Am J Physiol
1973; 215: 865-873.
- 6. Bickhardt K, Henze P, Sallmann HP. GlucoseStoffwechselsto¨ rungen bei erwachsenen Schafen
und ihre Behandlungen. DVG Tagung
‘‘Krankheiten Der Kleinen Wiederka¨uer, Giessen
1993: 92–100.
- 7. Henze P, Pickhardt K, Fuhrmann H, Salman HP.
Spontaneous pregnancy toxemia (ketosis) in
sheep and the role of insulin. J Vet Med 1998; A45:
255-266.
- 8. Laffel L. Ketone Bodies: a Review of physiology,
pathophysiology and application of monitoring to
diabetes. Diabetes Metab Res Rev 1999; 15: 412-426.
- 9. Mitchell GA, Kassovska-Bratinova S, Boukaftane Y,
et al. Medical aspects of ketone body metabolism.
Clin Invest Med 1995; 18: 193-216.
- 10. Ranaweera A, Ford EJ, Evans J. Gluconeogenesis
from glycerol by ketotic sheep pregnant with
twins. Res Vet Sci 1981; 30: 303-808.
- 11. Lyle RR, Deboer G, Mılls SE, et al. Glucose kinetics,
plasma metabolites, and endocrine responses
during experimental ketosis in steers. J Dairy Sci
1984; 67: 2255-2264.
- 12. Aslan V, Astı RN, Tiftik AM, Eksen M. Effect of
niacin on blood metabolities, Rumen protozoa,
insulin levels and fatty liver in experimentally
induced ketosis in ewes. SÜ Vet Fak Der 1988;4:
109-121.
- 13. Başoğlu A, Turgut K, Eksen M, ve ark. Effect of
phlorihizin-induced ketozis on riboflavin and
niacin levels on sheep. SÜ Vet Fak Derg 1993; 9:
58-63.
- 14. Waitzberg DL, Torrinhas RS, Jacintho TM. New
Parenteral Lipid Emulsions for Clinical Use. J
Parenter Enteral Nutr 2006; 30: 351-367.
- 15. Gültekin F, Alagözlü H. Nutrisyon parenteral beslenme. T Klin Tıp Bilimleri 1993;13: 28-36.
- 16. Picard J, Ward C, Zumpe R, et al. Guidelines and
the adoption of lipid rescue therapy for local
anaesthetic toxicity. Anaesthesia 2009; 64: 122–
125.
- 17. Kayıpmaz AE, Gülalp B, Benli S. Lipofilik ajan
toksisitesinde yeni ufuklar. JAEM 2011; 80-85.
- 18. Ozcan MS, Weinberg G. Intravenous lipid emulsion
for the treatment of drug toxicity. J Intensive Care
Med 2014; 29: 59-70.
- 19. Muller SH, Diaz JH, Kaye AD. Clinical applications
of intravenous lipid emulsion therapy. J Anesth
2015; 29: 920-926.
- 20. Heitmann RN, Dawes DJ, Sensenig SC. Hepatic
ketogenesis and peripheral ketone body
utilization in the ruminant. J. Nutr 1987; 117:
1174-1180.
- 21. Baird GD, Heitzmaa RJ. Mode of action of a
glucocorticoid on bovine intermediary
metabolism Possible role in controlling hepatic
ketogenesis. Biochim Biophys Acta 1971; 252:184
-198.
- 22. Ranaweera A, Ford EJ, Evans J. Gluconeogenesis
from glycerol by ketotic sheep pregnant with
twins. Res Vet Sci 1981; 30: 303-808.
- 23. Marteniuk JV, Herdt TH. Pregnancy toxemia and
ketosis of ewes and does. Vet Clin North Am Food
Anim Pract 1988; 4: 307-315.
- 24. Jeffrey M, Higgins RJ. Brain lesions of naturally
occurring pregnancy toxemia of sheep. Vet Pathol
1992; 29: 301-307.
- 25. Ferris TF, Herdson PB, Dunnill MS, Lee MR.
Toxemia of pregnancy in sheep: a clinical,
physiological, and pathological study. J Clin Invest
1969; 48: 1643-1655.
- 26. Wastney ME, Wolff JE, Bickerstaffe R. Glucose
turnover and hepatocyte glucose production of
starved and toxaemic pregnant sheep. Aust J Biol
Sci 1983; 36: 271-284.
- 27. Sigurdsson H. The effects of pregnancy and feding
on the insulin and glucose concentration in blood
of ewes in late pregnanacy. Acta Vet Scand 1988;
29: 401-405.
- 28. Harmeyer J, Schlumbohm C. Pregnancy impairs
ketone body disposal in late gestating ewes:
implications for onset of pregnancy toxaemia. Res
Vet Sci 2006; 81: 254-264.