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Originally Posted by docicu3
Good to see you IC.....hope the world is treating you well.
A couple of small points, you already know, I thought might add to what's been said above....
1) Lasix is a sulfur containing diuretic far more similar to Bumex, which is another sulfur containing loop diuretic, than Premarin which is a conjugated estrogen or hormone commonly used in gynecology to limit menstral bleeding by a whole different mechanism. I guess the common thread is the limiting of bleeding to avoid the dreaded 3rd time bleed and a horses forced retirement.
Lasix first works by a) increasing the capacitance of any lung or making more small pipes or cappilaries while holding the same amount of blood in pulmonary circulation, thus lowering pressure in the horse's or human's lungs.
If given IV these effects take place in 20 minutes and last for six hours hence the name. The second effect or b) is to abolish the electrical/osmotic gradient in the kidney cell or nephron responsible for holding on to free water when inhibited a triggering of a fairly massive diuresis of very dilute urine will follow.
It blows my mind that the CHRB compares Lasix to premarin by substitution without making the public aware as Premarin is no where near as effective as a diuretic ..........very very bizarre!!
The metabolic alkalosis it causes does give a horse an advantage racing in that it takes longer and further in a race for a lasix horse to become acidotic or uncomfortable in competition which is another way of saying for it to develop a lactic acidosis because for some period it is neutralizing the acid generated in competition. Further considerations pertaining to aerobic or anaerobic metabolism add more or less to the mechanism above......phew!!
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Hey man, it's been awhile. Haven't seen you around here much lately.
You are one of the only doctors I've ever known (albeit online in this case) that doesn't have an overly inflated sense of self-importance.