Histological assessment of β-amyloid precursor protein immunolabelled rectal biopsies aids diagnosis of equine grass sickness

BACKGROUND

An accurate, minimally invasive, ante-mortem diagnostic test for equine grass sickness (EGS) is currently lacking. Although histological examination of haematoxylin and eosin-stained rectal biopsies for chromatolytic neurons is insensitive as a diagnostic test for EGS, we hypothesised that its diagnostic accuracy could be improved by immunolabelling for β-amyloid precursor protein (β-APP), which has increased expression in cranial cervical ganglia (CCG) neuronal perikarya in EGS.

OBJECTIVES

To develop a grading scheme for assessing the distribution and intensity of β-APP immunoreactivity within individual rectal submucosal neurons and subsequently to determine the value of the distribution of different grades of neurons in EGS diagnosis.

STUDY DESIGN

Retrospective case-control diagnostic accuracy study.

METHODS

Initially, a standardised grading scheme was developed and β-APP immunoreactivity in individual neuronal perikarya and axons was compared in sections of CCG and ileum from EGS and control horses. The grading scheme was then refined before being blindly applied to submucosal neurons in rectal biopsies derived from 21 EGS and 23 control horses.

RESULTS

β-APP immunoreactivity was increased in neuronal perikarya and axons in sections of CCG, ileum and rectum from EGS horses compared with controls. For rectal biopsies, a mean immunoreactivity grade exceeding 1.1 was 100% specific and sensitive for EGS, and the presence of at least one neuron with diffuse labelling of the entire cytoplasm (grade 3) was 95% sensitive and 100% specific for EGS.

MAIN LIMITATIONS

Although the diagnostic criteria facilitated the discrimination of the EGS and control biopsies evaluated in this study, further prospective validation using a larger sample set is required.

CONCLUSIONS

Histological assessment of β-APP immunolabelled rectal biopsies is more sensitive than conventional histological examination in EGS diagnosis. Further validation is required before this technique can be advocated for use in clinical decision making.

Equine grass sickness, but not botulism, causes autonomic and enteric neurodegeneration and increases soluble N-ethylmaleimide-sensitive factor attachment receptor protein expression within neuronal perikarya

REASONS FOR PERFORMING STUDY

Equine grass sickness (EGS) is of unknown aetiology. Despite some evidence suggesting that it represents a toxico-infection with Clostridium botulinum types C and/or D, the effect of EGS on the functional targets of botulinum neurotoxins, namely the soluble N-ethylmaleimide-sensitive factor attachment receptor (SNARE) proteins, is unknown. Further, while it is commonly stated that, unlike EGS, equine botulism is not associated with autonomic and enteric neurodegeneration, this has not been definitively assessed.

OBJECTIVES

To determine: 1) whether botulism causes autonomic and enteric neurodegeneration; and 2) the effect of EGS on the expression of SNARE proteins within cranial cervical ganglion (CCG) and enteric neuronal perikarya.

STUDY DESIGN

Descriptive study.

METHODS

Light microscopy was used to compare the morphology of neurons in haematoxylin-eosin stained sections of CCG and ileum from 6 EGS horses, 5 botulism horses and 6 control horses. Immunohistochemistry was used to compare the expression of synaptosomal-associated protein-25, synaptobrevin (Syb) and syntaxin within CCG neurons, and of Syb in enteric neurons, from horses with EGS, horses with botulism and control horses. The concentrations of these SNARE proteins in extracts of CCG from EGS and control horses were compared using quantitative fluorescent western blotting.

RESULTS

EGS, but not botulism, was associated with autonomic and enteric neurodegeneration and with increased immunoreactivity for SNARE proteins within neuronal perikarya. Quantitative fluorescent western blotting confirmed increased concentrations of synaptosomal-associated protein-25, Syb and syntaxin within CCG extracts from EGS vs. control horses, with the increases in the latter 2 proteins being statistically significant.

CONCLUSIONS

The occurrence of autonomic and enteric neurodegeneration, and increased expression of SNARE proteins within neuronal perikarya, in EGS but not botulism, suggests that EGS may not be caused by botulinum neurotoxins. Further investigation of the aetiology of EGS is therefore warranted.

Epidemiological and postmortem findings in 262 red squirrels (Sciurus vulgaris) in Scotland, 2005 to 2009

Postmortem and virological examinations for squirrelpox virus (SQPV) were carried out on 262 red squirrels (Sciurus vulgaris) found dead or moribund in Scotland between September 2005 and July 2009, to determine the likely causes of death and highlight factors that might be threats to the red squirrel population. Most of the squirrels were submitted from Dumfries and Galloway, and 71 per cent of them were adults. Road traffic accidents, squirrelpox, trauma or starvation were responsible for death in a large proportion (73 per cent) of the squirrels. Thin or emaciated body condition was associated with deaths resulting from pneumonia SQPV infection and starvation, and with the presence of external parasites. There were differences between age groups with regard to the cause of death; a large proportion of juveniles died of starvation, whereas a large proportion of subadults and adults died in road traffic accidents. SQPV infection was associated with the presence of external parasites, but was not associated with the sex of the animals.

Ventroaxial luxation of the apex of the corniculate process of the arytenoid cartilage in resting horses during induced swallowing or nasal occlusion

OBJECTIVE

To report ventroaxial luxation of the apex of the left or right corniculate process of the arytenoid cartilage under the contralateral corniculate process during resting endoscopic examination, and morphologic features of the larynx of 1 affected horse.

STUDY DESIGN

Retrospective study.

ANIMALS

Horses (n=8).

METHODS

Horses had endoscopic examination as part of a survey of Clydesdale horses (n=7), or investigation of poor performance in Thoroughbred horses (1). One Clydesdale was euthanatized and the larynx examined; 4 cadaver larynges from normal horses were also examined.

RESULTS

Ventroaxial luxation of the apex of the left or right corniculate process of the arytenoid cartilage was not detected during quiet breathing but was induced by swallowing or nasal occlusion. Prevalence in Clydesdales was 5.2% (7/133). A Thoroughbred with identical endoscopic appearance of the larynx at rest had progressive ventroaxial luxation of the apex of the arytenoid cartilage during high-speed treadmill endoscopy, associated with abnormal respiratory noise. Necropsy examination of an affected Clydesdale larynx revealed an excessively wide (10 mm) transverse arytenoid ligament that allowed easy separation of the apices of the corniculate processes. In normal cadaver larynges, the apices could not be separated with abaxial traction.

CLINICAL RELEVANCE

The clinical relevance of this laryngeal observation in resting horses is unclear. Ventroaxial luxation of the corniculate process of the arytenoid cartilage during induced swallowing or nasal occlusion in resting horses or during high-speed treadmill exercise may be caused by an abnormally wide transverse arytenoid ligament.

Observations on the Interstitial Cells of Cajal and Neurons in a Recovered Case of Equine Dysautonomia (Grass Sickness)

This paper describes the histopathological and immunohistochemical changes in the central, autonomic and enteric nervous systems in a well-documented case of equine dysautonomia (ED), after the animal had recovered without significant residual clinical signs. Evidence of neuronal degeneration, such as neuronal chromatolysis, glial scars or a decrease in density of neurons, was not observed in the midbrain, pons, medulla oblongata or spinal cord, including the nuclei of cranial nerves III, V, VII, X and XII. In addition, no evidence of muscle denervation or re-innervation, such as group atrophy of clusters of cells or grouping of cells of similar size in the triceps muscle, was observed. These findings support the hypothesis that the chromatolytic motor neurons may not progress to cell death in ED. The autonomic ganglia showed evidence of previous neuronal loss. In the myenteric and submucosal plexuses of the ileum there was significant loss of enteric neurons. However, in the ileum, a continuous network of interstitial cells of Cajal (ICC) was observed by means of immunohistochemical techniques. It is possible that recovery without significant residual clinical signs was associated with lack of damage to, or more likely recovery of, the ICC, which have a pacemaker function in the intestinal tract.

Evaluation of urinalysis as an aid in the diagnosis of equine grass sickness

To determine whether urinalysis can aid the diagnosis of equine grass sickness, samples of urine from 15 horses with acute grass sickness, eight horses with subacute grass sickness, 17 co-grazing horses and 17 stabled control horses were analysed. The samples from all of the horses with grass sickness had a significantly higher specific gravity, higher protein and creatinine concentrations and a significantly lower pH; the samples from the horses with acute grass sickness also had significantly higher glucose concentrations. These differences may support a diagnosis of grass sickness but they are not pathognomonic for the disease.

Liver and biliary system pathology in equine dysautonomia (grass sickness)

Hepatocellular and hepatobiliary damage was assessed in equine acute, subacute and chronic grass sickness cases (AGS, SAGS, CGS). Histopathological analysis showed that even in some early AGS cases enlarged hepatocytes, hepatocyte vacuolation indicative of lipid accumulation (steatosis), intrahepatocyte, canalicular and periportal deposition of pigments, frequent leucocyte infiltration and cholangitis occurred. Analysis of serum indicated significantly increased levels of unconjugated bilirubin in all groups and conjugated bilirubin in AGS and SAGS groups, increased levels of bile acids in some individuals from each group and significantly increased levels of glutamate dehydrogenase (GLDH) in AGS and SAGS cases. Conjugated bilirubin was significantly elevated in urine of AGS and SAGS cases. The evidence suggests that abnormal liver function involving moderate hepatocellular pathology in conjunction with steatosis and cholestasis may contribute to the pathogenesis of GS.

Heparin, platelet aggregation, neutrophils, and cardiopulmonary bypass

Cardiopulmonary bypass (CPB) is associated with both neutrophil activation and failure of platelets to form large stable aggregates. We aimed to determine the effects of heparin and of neutrophil activation on platelet aggregation in whole blood. Fourteen patients undergoing routine aortocoronary bypass grafting and NSAID-free for over 7 days were studied before and after heparinisation, and at end-CPB. Whole blood, anticoagulated with rHirudin, was stirred for 3 minutes, and macroaggregation in response to collagen (0.6 microg. mL(-1)) or the neutrophil stimulant fMLP (10(-7)M) was determined by whole blood impedance aggregometry. Microaggregation was measured by counting unaggregated single platelets (corrected for haemodilution). The blood of volunteers was studied in vitro.

PATIENTS

Before CPB, heparin effectively abolished platelet macroaggregation induced by collagen (20.5 to 1.4 Ohms) or fMLP (3.9 to 0 Ohms (p<0.0001). CPB had no additional effect. Heparinisation also reduced the platelet count from 127 (110-170) to 95 (64-117). The inhibition of macroaggregation could not be reversed by ex vivo heparinase.

VOLUNTEERS

In vitro, the same heparin concentration, as measured in vivo (4 micromL(-1)), inhibited collagen-induced macroaggregation (20.3 to 14.7 Omega), but this effect was less than that observed ex vivo and was reversed by heparinase. In vitro heparin promoted fMLP macroaggregation (2.9 to 8.6 Omega). The inhibition of macroaggregation resulted from heparinisation, per se, rather than CPB and was insensitive to heparinase. There was less inhibition by in vitro heparin, which was reversible by heparinase, indicating a direct effect of heparin in vitro. The disparate findings are suggestive of an indirect action by heparin in vivo on macroaggregation, although heparin had a small direct stimulatory action on microaggregation.

Clinicopathological features of equine primary hepatic disease: a review of 50 cases

The clinicopathological features of 50 cases of equine hepatic disease were reviewed. There was a wide range of clinical signs and at least 50 per cent of the animals exhibited either dull demeanour, anorexia, abdominal pain, cerebral dysfunction and/or weight loss. Life-threatening complications of hepatic failure recorded were: gastric impaction in 10 cases, bilateral laryngeal paralysis in seven cases and coagulopathy in five cases. All the cases had high activities of gamma-glutamyl transferase (GGT) and most had high activities of glutamate dehydrogenase (GLDH) and high concentrations of bile acids. Fewer of the horses had abnormal concentrations of bilirubin, albumin and globulin. The horses that were euthanased or died had significantly higher concentrations of GGT, GLDH and bile acids than the survivors. There were biochemical data for 18 cases with signs of hepatic encephalopathy, all of them had plasma ammonia levels greater than 90 micromol/litre but this was not significantly correlated with the clinical severity of the condition. Half of the cases with hepatic encephalopathy were hyperglycaemic, none was hypoglycaemic, and none had abnormally low levels of plasma urea.

A case-control study of grass sickness (equine dysautonomia) in the United Kingdom

A case-control study was performed to investigate the epidemiology of grass sickness in the United Kingdom from 1992 to 1995. Data were collected by means of postal questionnaire when cases of grass sickness were identified. Sets of three questionnaires were posted to owners of, or veterinary surgeons attending, cases of grass sickness, with a request to provide information on the case, on one healthy animal on the same premises as the case and on another healthy animal on other premises. Controls were matched to cases by date of onset. After univariate analyses, the probability of grass sickness in horses was modelled using conditional logistic regression techniques. Young animals were found to be at increased rick of grass sickness and females were less likely to become affected, as were animals that had a history of contact with previous cases of the disease. The probability of grass sickness was higher in animals that were on premises where grass sickness had previously occurred, particularly if this was recent. Animals were at particular risk of disease if they changed fields within the previous 2 weeks; the risk thereafter reduced with time. The disease had a seasonal pattern, with a peak from April to June. More than 95% of cases had access to grazing, and 66% occurred after 2 week periods of predominantly dry weather.

Long-term prospects for horses with grass sickness (dysautonomia)

Responses to questionnaires were received from 31 owners of horses or ponies treated for chronic grass sickness (dysautonomia). Contrary to previous opinions the respondents indicated that the majority of the animals were capable of strenuous work, had regained the weight they had lost and, apart from a few residual problems such as difficulty in coping with dry fibrous food, had returned to a normal life. They had recovered slowly and had involved the owners in considerable extra work, but all the owners indicated that they considered the effort to have been worthwhile.

An evaluation of the use of cisapride in horses with chronic grass sickness (equine dysautonomia)

A clinical trial was carried out to determine the effect of cisapride on rate of passage of digesta and clinical parameters in horses with chronic grass sickness. Sixteen horses were given intramuscular cisapride (0.1 mg kg-1 three times daily) (group I), and 15 received oral cisapride (0.8 mg kg-1 three times daily) (group O). A liquid-phase marker (cobalt-EDTA) and a solid-phase marker (polystyrene pellets) were given by stomach tube at the beginning of each of three consecutive 7 day periods, i.e., before, during and after cisapride therapy. Seven horses in each group completed the rate of passage trial; the remainder provided clinical data only. The rate of passage was found to be significantly faster after cisapride therapy than before. Comparison with data from 20 normal animals showed a trend towards normal rates of passage after therapy. In cases that died during the trial, the caecum and large colon were the main sites of pellet retention. Dry matter intake was significantly higher after therapy than before in group O and dry matter output was higher after treatment than before in both groups. Gut auscultation score increased in both groups in the periods during and after cisapride administration but heart rate was unaffected. Diarrhoea and colic occurred in each group but its occurrence was not associated with cisapride therapy. The results suggest that by increasing gut motility, cisapride is of benefit in the management of selected cases of chronic grass sickness.

Recovery of horses from dysautonomia (grass sickness)

The outcome for 35 horses with chronic dysautonomia which were kept in the hospital at the Royal (Dick) School of Veterinary Studies and subsequently returned to their owners is recorded. They constituted 42.7 per cent of the 82 chronic cases seen between 1991 and 1994; the other 47 horses were euthanased while in hospital. Of the 35 animals returned to their owners four died and 27 were available for follow up; of these 27, 12 were working competitively and six were being trained for future competitive work. It takes at least a year before it is clear whether a horse can compete successfully again but all the surviving animals were capable of being ridden. Some of the horses suffered excessive sweating, had difficulty in swallowing some foodstuffs, or had coat changes for long periods after returning to a normal weight.

Small intestine and small colon neuropathy in equine dysautonomia (grass sickness)

The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribution of the damage was uniform within a segment of the intestine. In fatal cases of dysautonomia, the clinical severity and duration of illness seems, in most instances, to be related to the amount of neuronal disruption occurring in the jejunum. Severe disruption results in acute/subacute dysautonomia, while milder damage leads to the chronic form. No case of dysautonomia was encountered in which enteric neuron loss and damage occurred without significant neuronal disruption also occurring in the coeliacomesenteric ganglia. Heal neuronal damage and loss are not invariably worse than that in the jejunum, and the possible reasons for this, together with the relationship between neuronal damage and possible causes of dysautonomia, are discussed.

The equine enteric nervous system--neuron characterization and distribution in adults and juveniles

A study of myenteric and submucosal plexuses was undertaken in the jejunum and ileum of horses and ponies in which no clinical or pathological evidence of intestinal abnormality was apparent. Complete transverse sections of the intestine, stained by a modified haematoxylin and eosin method, were examined using up to 20 sequential sections per animal. Information was gathered from adult, juvenile and fetal equidae. In adults, the longitudinal muscle layers were thinner than the circular muscle layers and the ileum had thicker layers compared to the jejunum. In adults, the submucosal plexus had more neurons per section than the myenteric plexus by mean ratios of 1:3 in the jejunum and 1:1.9 in the ileum. In juveniles, the ratios were respectively 1:1.8 and 1:1.5 and in the fetus 1:2.5 and 1:1.3. The three-dimensional distribution of neurons in both plexuses varied from animal to animal and no consistent pattern was observed. Groups of neurons contained between one and 42 cells per section examined and their length in a cranio-caudal direction varied from 10 to over 100 microns. There were few statistical differences observed between the cranial, middle and caudal portions of either the jejunum or the ileum when neuron groups or neuron numbers per section were examined in 10 adult animals.

Patterns of feeding and behaviour in horses recovering from dysautonomia (grass sickness)

Three horses suffering from grass sickness were treated successfully but showed clinical signs which varied in severity and duration. They were all characterised by marked and often erratic changes in behaviour and appetite.

Histopathology of the brain-stem nuclei of horses with "Mal seco", an equine dysautonomia

"Mal seco" is a disease of unknown aetiology affecting horses in Argentina. It is similar to grass sickness, a primary dysautonomia of horses in Europe. A histopathological study of the brain stem nuclei of three horses with "mal seco" was performed. Changes were found that consisted of chromatolysis, cytoplasmic vacuoles, eosinophilic sphaeroids, and pyknotic and eccentric nuclei. These changes were most severe at the oculomotor, vestibular and abducent nuclei. The results provide further evidence to suggest that "mal seco" and grass sickness may be the same disease.

Decrease in the alpha 1-proteinase inhibitor Spi3 in equine bronchoalveolar lavage fluid

The alpha 1-proteinase inhibitors of trypsin, Spi1, Spi3A, and Spi3B, in bronchoalveolar lavage fluid (BALF) and serum of horses were separated by electrophoresis, and their proportions were quantified in 12 control horses and 12 with chronic obstructive pulmonary disease (COPD). A significantly lower proportion of Spi3B (P < 0.05) and higher proportion of Spi1 (P < 0.02 to P < 0.01) were detected in BALF, compared with serum, in control and COPD-affected horses and appeared to be attributable to reduced Spi3 activity in BALF. There was no significant difference between the control and COPD groups in this respect, indicating that the decrease in Spi3 may be a physiologic phenomenon. The differences observed may be associated with proteolytic damage to or preferential complex formation by Spi3.

Quantitation of alpha-1 proteinase inhibitor in the pulmonary epithelial lining fluid of horses with chronic obstructive pulmonary disease

The concentration of alpha-1 proteinase inhibitor (API) was measured in the pulmonary epithelial lining fluid (PELF) of horses with chronic obstructive pulmonary disease (COPD) while they had clinical signs and while they had none. The concentrations of total protein, albumin and API were significantly higher in the PELF of animals with clinical signs of COPD. The correlation between albumin and API in the PELF suggested that most of the API was derived from the serum.

Molecular weight alterations of alpha-1 proteinase inhibitor in equine bronchoalveolar lavage fluid

The equine alpha-1 proteinase inhibitor (alpha 1PI) system differs from that of man in that the equine system consists of four closely-linked genes (Spi1-Spi4) whereas in man, a single gene encodes for alpha 1PI. We have previously found differences in the proportion of the Spi proteins in equine serum and bronchoalveolar lavage fluid (BALF). We therefore wished to determine whether, as reported in man, there was any molecular weight difference between the Spi proteins in serum and BALF. alpha 1PI and albumin from equine BALF migrated further towards the anode compared with serum alpha 1PI on native polyacrylamide gel electrophoresis (PAGE) although the difference was only significant for alpha 1PI. Sodium dodecyl sulphate-PAGE (SDS-PAGE) showed that a mean decrease in molecular weight of 1.5 kDa for alpha 1PI and 1.3 kDa for albumin had occurred in BALF. These findings were observed in control animals and in those with symptomatic or asymptomatic chronic obstructive pulmonary disease. The mechanism of this decrease in molecular weight of alpha 1PI is likely to differ from reports of alpha 1PI cleavage by bacterial proteinases in man since the molecular weight change was relatively small and loss of trypsin inhibitory activity did not occur. Nor, in our system, was there evidence of bacterial infection. Damage by endogenous proteinases or glycosidases at a site other than the reactive site may be involved but the resultant effect on the efficiency of the antiproteinase screen of the lower respiratory tract is uncertain.

Use of clinical measurements to predict the outcome in chronic cases of grass sickness (equine dysautonomia)

Forty-five cases of chronic grass sickness were given scores for selected clinical measurements when they were first examined, to assess their value in predicting survival. Sixteen cases survived. The clinical scores for the degree of dysphagia, appetite, colic and the degree of reduction in gut sounds were significantly lower in the survivors than in the non-survivors. In addition, only the non-survivors had severe rhinitis. Ponies were significantly less likely to survive than cob types.

Autonomic neurone degeneration in equine dysautonomia (grass sickness)

Histological investigations were undertaken on four sympathetic autonomic ganglia and on the myenteric and sub-mucosal plexuses of the jejunum in healthy animals, in naturally occurring cases of acute, sub-acute and chronic equine dysautonomia and in ponies in which neuronal damage had been induced by the injection of acute grass sickness sera. The degree of neuronal damage is related to the type of dysautonomia. The coeliac-mesenteric ganglion reacts differently from other ganglia and is less severely damaged in cases of short duration. Extensive experimentally induced damage to the coeliac-mesenteric ganglion, even when jejunal damage is also present, is not associated with clinical illness. It is proposed that the rate of autonomic neurone loss and the extent of the damage may both influence the clinical manifestations of grass sickness.

Clinical equine dysautonomia and autonomic neuron damage

Damage to the neurons of selected autonomic ganglia was quantified in relation to the severity of the clinical signs shown in acute, subacute and chronic cases of dysautonomia (grass sickness). No connection between the clinical severity of acute or subacute dysautonomia and the amount of neuronal damage in the superior cervical, stellate and coeliaco-mesenteric ganglia could be demonstrated. However, a higher proportion of normal neurons were found in chronic cases. Jejunal submucosal neuronal damage was correlated with clinical severity but further work is required to confirm this finding and to establish how widespread the alimentary neuronal lesions are in dysautonomia of different severities.

The relationship between meteorological features and equine grass sickness (dysautonomia)

Local weather patterns associated with 15 outbreaks of equine grass sickness in eastern Scotland were studied. The majority showed a trend toward cooler drier weather associated with irregular ground frosts. This would not preclude the hypothesis that fungi might be connected with the aetiology of grass sickness.

Clinical and biochemical features of grass sickness (equine dysautonomia)

An attempt has been made to assess the diagnostic value of clinical features seen at initial examination of horses with grass sickness, colic cases and cases submitted as possible grass sickness but diagnosed subsequently as some other condition. There appears to be no single pathognomonic sign for grass sickness. A range of signs has been associated with grass sickness but these are of value only when related to the length of illness and the history. Biochemical tests related to intestinal tissue damage, stress and dehydration were evaluated and most were found to be of value in diagnosing acute grass sickness. No evidence was found relating selected mineral or vitamin deficiencies to grass sickness, nor were protein changes specific. A marked fall in glutathione peroxidase values was associated with grazing rather than disease.

A comparative study of normal equine populations and those with grass sickness (dysautonomia) in eastern Scotland

A retrospective survey was made of premises in eastern Scotland on which at least two cases of grass sickness had occurred between 1970 and 1987. For comparison, a further survey of 49 equine establishments, on which no grass sickness had been recorded, was conducted from 1986 to 1988. The results indicated that younger animals are more susceptible, especially those in good physical condition grazing full-time in the spring or early summer. Movement to new grazing increases the risk of grass sickness and identifiable stress may contribute. The nature of the establishment governed the animals' condition during the summer, but it did not appear to influence the prevalence of grass sickness. However, riding schools and livery establishments which experienced the disease kept, on average, significantly more animals than unaffected premises of the same type. No relationship was found between supplementary feeding or stage of pasture growth and grass sickness. The results of the survey support the hypothesis that the causal agent of grass sickness is associated with grazing but multiple factors may influence the expression of illness.

Acute phase proteins in grass sickness (equine dysautonomia)

Four acute phase proteins were assayed in the serum of normal horses and those with acute, subacute and chronic grass sickness, colic and inflammatory conditions, in order to investigate their diagnostic value in grass sickness. The grass sickness and inflammation group had a significantly increased haptoglobin concentration (P less than 0.01-P less than 0.001). Orosomucoid was elevated in acute, subacute and chronic grass sickness and inflammation (P less than 0.001, P less than 0.001, P less than 0.05 and P less than 0.05, respectively). Highest concentrations of haptoglobin and orosomucoid were recorded in subacute grass sickness. Ceruloplasmin was significantly higher in acute grass sickness cases than all other groups except the colic group (P less than 0.05-P less than 0.01). alpha 2-macroglobulin was significantly higher in acute grass sickness than normal, colic and chronic grass sickness cases (P less than 0.01, P less than 0.05 and P less than 0.05). The time scale of changes suggests that the stimulus to haptoglobin and orosomucoid synthesis occurs at the onset of clinical signs whereas the increase in ceruloplasmin and alpha 2-macroglobulin is more likely to reflect haemoconcentration.

Analysis of peritoneal fluid as a diagnostic aid in grass sickness (equine dysautonomia)

The analysis of peritoneal fluid is of value in the differential diagnosis of equine colic but its characteristics have not been evaluated in grass sickness. Peritoneal fluid was collected from 15 normal horses and from 11 cases of medical colic, 11 cases of surgical colic, 20 cases of acute grass sickness and 13 cases of subacute grass sickness. The fluid was analysed for its appearance, total and differential white cell count, specific gravity, total protein concentration and total and intestinal alkaline phosphatase activity. Fluid from cases of medical colic was normal in these respects. Surgical cases were unique in having bloodstained fluid with a high alkaline phosphatase activity. Grass sickness cases had a higher specific gravity and protein content than the cases of medical colic although the appearance of the fluid was similar. Grass sickness cases were distinguishable from cases of surgical colic on the basis of the appearance of the fluid and its lower alkaline phosphatase activity.

Secondary gastric impaction associated with ragwort poisoning in three ponies

Poisoning with Senecio jacobaea (ragwort) is a common cause of chronic liver disease in horses in Britain. The major clinical signs are the result of hepatic failure but gastric impaction has recently been associated with the disease. The present paper describes three cases of secondary gastric impaction associated with ragwort poisoning. In each case the impaction was the cause of death or necessitated euthanasia.

Serum lipids and lipoproteins in equine colic and grass sickness

Serum total lipids, lipoprotein fractions, triglycerides, cholesterol, phospholipids and free fatty acids were measured in horses with acute, subacute and chronic grass sickness (equine dysautonomia) and in colic cases. The values were compared with those of normal grazing and stabled horses. A marked individual variation occurred, but total lipids, triglycerides and free fatty acids were significantly higher than normal in grass sickness and colic cases with cholesterol was significantly higher than normal in grass sickness cases only. Pre-beta lipoprotein was significantly increased in colic and subacute grass sickness although all abnormal groups showed this fraction which was absent from normal horses. The percentage of alpha 2b lipoprotein was significantly higher in colic and grass sickness. The changes described are typical of those occurring in fat mobilisation in the horse and are considered to be due to a number of factors including decreased food intake, cortisol and catecholamine release and insulin resistance.

An improved method for the study of equine haptoglobin heterogeneity

Equine serum haptoglobin was separated by polyacrylamide gel isoelectric focusing and visualized by protein staining or Western blotting. Conventional protein staining revealed up to three bands in the pI range 4.17 to 4.44. The blotting technique, however, showed an anodal group of 8 to 10 bands with a pI range of 4.11 to 4.52 and a cathodal group of 4 to 6 bands with a range of 4.55 to 5.14. The blotting method revealed that equine haptoglobin migrates outside the prealbumin area, in contrast to previous reports.

An improved TLC method for the detection of flunixin in equine serum

A method for flunixin detection in equine serum extracts involving thin layer chromatography, spraying the chromatogram with alkaline sodium hypochlorite solution and heating with a detection limit of 50 ng ml-1 is described.

Caecal intussusception in two ponies

One case of caecocaecal intussusception (case 1) and one case of caecocolic intussusception (case 2) in ponies are described. Case 1 showed mild abdominal discomfort for seven days followed by sudden death whereas case 2 showed continuous moderate pain for three weeks. At post mortem examination, case 1 showed intussusception of the base of the caecum into the body whereas in case 2, the entire caecum had invaginated into the right ventral colon. Histopathological examination showed that the lesions in both animals had been present for a long time.