Interobserver Variation in the Diagnosis of Neurologic Abnormalities in the Horse

BACKGROUND

The diagnosis of equine protozoal myeloencephalitis (EPM) relies heavily on the clinical examination. The accurate identification of neurologic signs during a clinical examination is critical to the interpretation of laboratory results.

OBJECTIVE

To investigate the level of agreement between board-certified veterinary internists when performing neurologic examinations in horses.

ANIMALS

Ninety-seven horses admitted to the Veterinary Teaching Hospital at The Ohio State University from December 1997 to June 1998.

METHODS

A prospective epidemiologic research design was used. Horses enrolled in the study were examined by the internist responsible for care of the horse, and later by an internist who was not aware of the presenting complaint or other patient history. Data were analyzed by descriptive statistics, and kappa (K) statistics were calculated to assess interobserver agreement.

RESULTS

Ninety-seven horses were enrolled in the study. Overall, examiners, also referred to as observers, agreed that 60/97 (61.9%) were clinically abnormal, 21/97 (21.6%) were clinically normal, and the status of 16/97 (16.5%) of horses was contested. There was complete agreement among the examiners with regard to cranial nerve signs and involuntary movements. Disagreement involving severity of clinical signs occurred in 31 horses, and 25 of those horses (80.6%) were considered either normal or mildly affected by the primary observer. When examining the results of all paired clinical examinations for 11 different categories, there was wide variability in the results. When examiners rated the presence or absence of any neurologic abnormalities, lameness, or ataxia, the agreement among observers was either good or excellent for 80% of horses. When assessing truncal sway, the agreement among observers was good or excellent for 60% of the horses. When examining the horses for asymmetry of deficits, agreement was either good or excellent for 40% of the horses. Agreement among observers was excellent or good for only 20% of the horses when assessing muscle atrophy, spasticity (hypermetria), and overall assessment of the severity of neurologic abnormalities.

CONCLUSIONS AND CLINICAL IMPORTANCE

This study underscores the subjectivity of the neurologic examination and demonstrates a reasonable level of agreement that may be achieved when different clinicians examine the same horse.

Effects of dietary glycaemic response after exercise on blood concentrations of substrates used indirectly for muscle glycogenesis

REASONS FOR PERFORMING STUDY

Exercise depletes muscle glycogen stores, which could subsequently impair performance. Muscle glycogen replenishment is determined by substrate availability.

OBJECTIVES

To study the effects of feeding meals of varying glycaemic responses on blood concentrations of substrates used for glycogenesis in horses with exercise-induced glycogen depletion.

METHODS

In a 3-way crossover study, 7 horses received each of 3 isocaloric diets for 72 h after undergoing glycogen-depleting exercise: 1) a high soluble-carbohydrate diet, which induced a high-glycaemic (HGI) response; 2 and 3) a low soluble-carbohydrate or a mixed soluble-carbohydrate diet (control group), which both induced a similar low-to-moderate glycaemic (LGI) response. Muscle biopsies and venous samples were collected before and up to 72 h after exercise.

RESULTS

Feeding HGI diet resulted in a higher (P<0.001) rate of muscle glycogenesis over 72 h compared to LGI diets. Plasma glycerol, triglyceride, lactate, serum NEFA and total protein concentrations, and haematocrit were significantly (P<0.001) higher after compared to before exercise. Whereas no significant overall dietary effect was observed on these metabolites over 72 h, there was a tendency for glycerol, NEFA and triglyceride concentrations to be lower for LGI compared to HGI diets over 6 h after exercise (P<0.05; 1, 6 and 4-6 h after exercise, respectively).

CONCLUSIONS

These data suggest that horses fed LGI meals after exercise had limited lipid utilisation without any significant shift of substrate utilisation toward gluconeogenesis, which could have contributed to the slower rate of muscle glycogenesis compared to horses fed HGI diets.

Cloning, comparative sequence analysis and mRNA expression of calcium-transporting genes in horses

Epithelial calcium transport occurs by paracellular and transcellular mechanisms. Transcellular transport in intestinal and renal epithelia involves several transport proteins, including transient receptor potential vanilloid member 5 (TRPV5), member 6 (TRPV6), calbindin D9k (CB9), calbindin D28k (CB28), sodium calcium exchanger 1 (NCX1), plasma membrane calcium ATPase 1 (PMCA1), and the vitamin D receptor (VDR). We are interested in the horse because of its unique calcium physiology (high blood calcium, high intestinal calcium absorption, high renal excretion of calcium, low vitamin D concentrations), and because horses often have dysregulated calcium balance with various diseases. We cloned the mRNA for equine TRPV5, TRPV6, CB9, CB28, NCX1, PMCA1, and VDR, performed comparative mRNA and protein sequence analysis, and quantified their mRNA expression in the kidney and gastrointestinal tract. Sequence homology for the mRNAs and proteins was high among mammals (>75%), with fish having the lowest homology (<75%). TRPV5, TRPV6, and CB9 expression was higher in the duodenum and proximal jejunum and followed a similar expression pattern. CB28 expression was greatest in the kidney. PMCA1 and NCX1 expression was similar throughout the intestine, but in the kidney PMCA1 expression was higher. Based on our findings, the proximal small intestine is the main site for transcellular calcium transport, with TRPV6 and CB9 serving as the main transport proteins. In the kidney, TRPV6, CB28, and PMCA1 are likely more important. The low VDR expression in the equine small intestine and kidney relative to the large intestine, together with the reported high intestinal absorption and renal excretion of calcium, and low vitamin D concentrations suggests that epithelial calcium transport in horses is not as dependent on vitamin D as in other species.

Rapid calcitonin response to experimental hypercalcemia in healthy horses

Calcium has important physiological functions, and disorders of calcium homeostasis are frequent in horses. We have made important progress understanding equine calcium homeostasis; however, limited information on equine calcitonin (CT) is available, in part because of the lack of validated CT assays. To determine the CT response to high ionized calcium (Ca(2+)) concentrations in healthy horses, we induced hypercalcemia in 10 healthy horses using a calcium gluconate 23% solution (5mg/kg; 120 mL/500 kg horse) infused over 4 min. Four horses were infused with 120 mL of 0.9% NaCl and used as controls. We validated a human-specific CT radioimmunoassay for use in horses. Serum Ca(2+) concentrations increased from 6.2+/-0.3mg/dL to 9.9+/-0.5mg/dL (4 min; P<0.01). Serum CT increased from 16.7+/-8.0 pg/mL to 87.1+/-55.8 pg/mL at 2 min, and 102.5+/-51.1 pg/mL at 4 min (P<0.01). Serum CT returned to baseline by 20 min, whereas serum Ca(2+) returned to baseline by 40 min. Of interest, CT concentrations returned to baseline despite hypercalcemia, suggesting thyroid gland C-cell CT depletion. Resting CT values higher than 40 pg/mL were considered abnormally elevated. No significant changes in serum Ca(2+) or CT concentrations were found in control horses. The coefficients of variation for the CT radioimmunoassay were lower than 11.9%. We conclude that the equine thyroid gland C-cell responds quickly to changes in extracellular Ca(2+) concentrations by secreting large quantities of CT into the systemic circulation, indicating that CT is important in equine calcium homeostasis. The human CT radioimmunoassay can be used to measure changes in equine CT.

Blood arginine vasopressin, adrenocorticotropin hormone, and cortisol concentrations at admission in septic and critically ill foals and their association with survival

BACKGROUND

Sepsis is an important cause for neonatal foal mortality. The hypothalamic-pituitary-adrenal axis (HPAA) responses to sepsis are well documented in critically ill humans, but limited data exist in foals. The purpose of this study was to evaluate the HPAA response to sepsis in foals, and to associate these endocrine changes with survival.

HYPOTHESIS

Blood concentrations of arginine vasopressin (AVP), adrenocorticotropin hormone (ACTH), and cortisol will be higher in septic foals as compared with sick nonseptic and healthy foals. The magnitude of increase in hormone concentration will be negatively associated with survival.

ANIMALS

Fifty-one septic, 29 sick nonseptic, and 31 healthy foals of < or =7 days of age were included.

METHODS

Blood was collected at admission for analysis. Foals with positive blood culture or sepsis score > or =14 were considered septic. Foals admitted with disease other than sepsis and healthy foals were used as controls. AVP, ACTH, and cortisol concentrations were measured using validated immunoassays.

RESULTS

AVP, ACTH, and cortisol concentrations were increased in septic foals. Septic nonsurvivor foals (n = 26/51) had higher plasma ACTH and AVP concentrations than did survivors (n = 25/51). Some septic foals had normal or low cortisol concentrations despite increased ACTH, suggesting relative adrenal insufficiency. AVP, ACTH, and cortisol concentrations were higher in sick nonseptic foals compared with healthy foals.

CONCLUSIONS AND CLINICAL IMPORTANCE

Increased plasma AVP and ACTH concentrations in septic foals were associated with mortality. Several septic foals had increased AVP : ACTH and ACTH : cortisol ratios, which indicates relative adenohypophyseal and adrenal insufficiency.

Report of the equine herpesvirus-1 Havermeyer Workshop, San Gimignano, Tuscany, June 2004

Amongst the infectious diseases that threaten equine health, herpesviral infections remain a world wide cause of serious morbidity and mortality. Equine herpesvirus-1 infection is the most important pathogen, causing an array of disorders including epidemic respiratory disease abortion, neonatal foal death, myeloencephalopathy and chorioretinopathy. Despite intense scientific investigation, extensive use of vaccination, and established codes of practice for control of disease outbreaks, infection and disease remain common. While equine herpesvirus-1 infection remains a daunting challenge for immunoprophylaxis, many critical advances in equine immunology have resulted in studies of this virus, particularly related to MHC-restricted cytotoxicity in the horse. A workshop was convened in San Gimignano, Tuscany, Italy in June 2004, to bring together clinical and basic researchers in the field of equine herpesvirus-1 study to discuss the latest advances and future prospects for improving our understanding of these diseases, and equine immunity to herpesviral infection. This report highlights the new information that was the focus of this workshop, and is intended to summarize this material and identify the critical questions in the field.

Parathyroid hormone (PTH) secretion, PTH mRNA and calcium-sensing receptor mRNA expression in equine parathyroid cells, and effects of interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha on equine parathyroid cell function

Parathyroid hormone (PTH) is secreted by the chief cells of the parathyroid gland in response to changes in ionized calcium (Ca(2+)) concentrations. In this study, we measured PTH secretion, and PTH mRNA and calcium-sensing receptor (CaR) mRNA expression by equine parathyroid chief cells in vitro. We also evaluated the effects of interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha on PTH secretion, and PTH and CaR mRNA expression. The relationship between PTH and Ca(2+) was inversely related. PTH secretion decreased from 100% (day 0) to 13% (day 30). PTH mRNA expression declined from 100% (day 0) to 25% (day 30). CaR mRNA decreased from 100% (day 0) to 16% (day 30). Chief cells exposed to high (2.0 mM) Ca(2+) concentrations had a lower PTH mRNA expression compared with low Ca(2+) concentrations. Ca(2+) concentrations had no effect on CaR mRNA expression. The inhibitory effect of high Ca(2+) concentrations on PTH secretion also declined over time. After day 10, there was no significant difference in PTH secretion between low and high Ca(2+ )concentrations. IL-1beta decreased both PTH secretion (75%) and PTH mRNA expression (73%), and resulted in a significant overexpression of CaR mRNA (up to 142%). The effects of IL-1beta were blocked by an IL-1 receptor antagonist. IL-1beta decreased the Ca(2+) set-point from 1.4 mM to 1.2 mM. IL-6 decreased PTH secretion (74%), but had no effect on PTH and CaR mRNA expression. TNF-alpha had no effect on PTH secretion, and PTH and CaR mRNA expression. In summary, the decreased responsiveness of parathyroid cells to Ca(2+) from 0 to 30 days can be explained, in part, by the reduced CaR expression. IL-1beta and IL-6 but not TNF-alpha affected parathyroid function in vitro and may be important in influencing PTH secretion in the septic horse.

Chronic pulmonary disease with radiographic interstitial opacity (interstitial pneumonia) in foals

Twelve foals, age 3-9 months, examined at The Ohio State University Veterinary Teaching Hospital between 1995 and 2000 were diagnosed with chronic pulmonary disease associated with marked interstitial opacity on radiographic examination. The most characteristic features were a history of respiratory disease of 1-3 months duration, marked clinical signs of respiratory disease, failure to yield a consistent pathogen from tracheobronchial aspirates and a predominantly interstitial pattern on thoracic radiographs. We attributed these signs to chronic interstitial pneumonia. Foals were treated with broad spectrum antimicrobial and corticosteroid drugs. All 12 foals were discharged alive from hospital and, of the 10 available for follow-up, all were disease-free and performing to expectation 5 months to 5 years after discharge. We conclude that chronic interstitial pneumonia, occuring in foals, is associated with a good prognosis and that corticosteroid therapy may be useful in its treatment.

Intradermal testing in healthy horses and horses with chronic obstructive pulmonary disease, recurrent urticaria, or allergic dermatitis

OBJECTIVE

To compare responses to a variety of intradermally injected allergens among healthy horses and horses with chronic obstructive pulmonary disease (COPD), recurrent urticaria (RU), and atopic dermatitis-insect hypersensitivity (allergic dermatitis [AD]).

DESIGN

Case-control study.

ANIMALS

86 horses.

PROCEDURE

Results of intradermal testing for horses with COPD, RU, or AD were compared with results for healthy horses.

RESULTS

Compared with healthy horses, horses with COPD, RU, and AD were significantly more likely to have positive (> or = 3+) reactions to intradermal allergens (molds, weeds, trees, grasses-crops, and insects) 30 minutes (immediate reaction), 4 hours (late-phase reactions), and 24 hours (delayed-phase reactions) after exposure. In addition, diseased horses reacted to a significantly higher number of allergens in each allergen group than did healthy horses.

CONCLUSIONS AND CLINICAL RELEVANCE

Reactions to individual allergens should not be used to determine that horses have hypersensitivity. Overall patterns of reactivity to intradermal allergens may be helpful in management when used in conjunction with a compatible history and evidence of potential exposure to allergens in horses with conditions associated with hypersensitivity to environmental allergens.

Diagnostic validity of electroencephalography in equine intracranial disorders

Electroencephalography (EEG) is a valuable diagnostic test to identify functional disturbances in brain activity. The purpose of this study was to assess the validity of EEG as a diagnostic indicator of intracranial diseases in horses. The validity of EEG was estimated by comparing clinical, clinicopathologic, and histopathologic findings to EEG findings in 20 horses examined for seizures. collapse, or abnormal behavior between 1984 and 1997. A bipolar left-to-right, back-to-front montage and a bipolar circular montage were recorded from sedated (4) and anesthetized (16) horses. Visual and semiquantitative masked analysis of EEG recording Ist was validated on 10 horses presented for problems other than intracranial diseases. EEG pattern was normal in 7 of the 20 clinically affected horses. Abnormal EEG patterns included high-voltage slow waves and discrete paroxysmal activity with or without generalized activity in 13 horses. Histopathologic diagnoses in 10 horses included meningoencephalitis, neuronal necrosis, congenital anomalies. cerebral edema. and abscess. All of these horses had abnormal EEG patterns (sensitivity, 100%) with a positive neuroanatomic correlation in 7 animals. Localization of histopathologic and EEG abnormalities did not correlate in 15% of the horses (3/20). The cause of neurologic signs could not be explained at postmortem examination in 10 animals and the EEG pattern was normal in 7 of these horses (specificity, 70%). In conclusion, equine EEG was a sensitive tool in the diagnosis of intracranial disorders.

Comparison of serum parathyroid hormone and ionized calcium and magnesium concentrations and fractional urinary clearance of calcium and phosphorus in healthy horses and horses with enterocolitis

OBJECTIVE

To evaluate calcium balance and parathyroid gland function in healthy horses and horses with enterocolitis and compare results of an immunochemiluminometric assay (ICMA) with those of an immunoradiometric assay (IRMA) for determination of serum intact parathyroid hormone (PTH) concentrations in horses.

ANIMALS

64 horses with enterocolitis and 62 healthy horses.

PROCEDURES

Blood and urine samples were collected for determination of serum total calcium, ionized calcium (Ca2+) and magnesium (Mg2+), phosphorus, BUN, total protein, creatinine, albumin, and PTH concentrations, venous blood gases, and fractional urinary clearance of calcium (FCa) and phosphorus (FP). Serum concentrations of PTH were measured in 40 horses by use of both the IRMA and ICMA.

RESULTS

Most (48/64; 75%) horses with enterocolitis had decreased serum total calcium, Ca2+, and Mg2+ concentrations and increased phosphorus concentrations, compared with healthy horses. Serum PTH concentration was increased in most (36/51; 70.6%) horses with hypocalcemia. In addition, FCa was significantly decreased and FP significantly increased in horses with enterocolitis, compared with healthy horses. Results of ICMA were in agreement with results of IRMA.

CONCLUSIONS AND CLINICAL RELEVANCE

Enterocolitis in horses is often associated with hypocalcemia; 79.7% of affected horses had ionized hypocalcemia. Because FCa was low, it is unlikely that renal calcium loss was the cause of hypocalcemia. Serum PTH concentrations varied in horses with enterocolitis and concomitant hypocalcemia. However, we believe low PTH concentration in some hypocalcemic horses may be the result of impaired parathyroid gland function.

Comparison of immediate intradermal test reactivity with serum IgE quantitation by use of a radioallergosorbent test and two ELISA in horses with and without atopy

OBJECTIVE

To compare a radioallergosorbent test and 2 ELISA with intradermal testing for the determination of environmental allergen hypersensitivity in horses with and without atopic diseases.

DESIGN

Prospective clinical study.

ANIMALS

10 horses with recurrent urticaria, 7 with atopic dermatitis, 16 with chronic obstructive pulmonary disease, and 22 without atopy.

PROCEDURE

History, physical examination, hemogram, serum biochemical analyses, bronchoalveolar lavage, and an intradermal test (used as the criterion standard) with a regional panel of 73 allergens were performed in all horses. Serum was analyzed by use of the 3 in vitro assays of allergen-specific IgE.

RESULTS

An ELISA based on the alpha chain of the high-affinity IgE receptor, the Fcepsilon receptor immunoglobin epsilon chain (FcepsilonRIalpha) for IgE, had the overall highest kappa statistic (0.238), positive predictive value (49%), and negative predictive value (78%). Overall agreement between the FcepsilonRIalpha-based ELISA and the intradermal test was fair. The highest kappa statistic was obtained by the FcepsilonRIalpha-based ELISA in horses with atopic dermatitis (0.330). Kappa statistics for the radioallergosorbent test and a polyclonal antibody-based ELISA agreed slightly with that of the intradermal test at best.

CONCLUSIONS AND CLINICAL RELEVANCE

None of the 3 serum allergy tests reliably detected allergen hypersensitivity, compared with the intradermal test. The FcepsilonRIalpha-based ELISA performed significantly better overall than the other 2 tests. Low sensitivity of all 3 assays indicates the need for continued study to elucidate a more sensitive test for the determination of potentially pathogenic allergens in horses.

Results of intradermal tests in horses without atopy and horses with chronic obstructive pulmonary disease

OBJECTIVE

To compare results of intradermal tests (IDT), conducted using environmental allergens, in horses without atopy and horses with chronic obstructive pulmonary disease (COPD).

ANIMALS

38 horses (22 horses without atopy and 16 horses with COPD).

PROCEDURE

All horses were examined (physical examination, hematologic examination, serum biochemical analyses, examination of bronchoalveolar lavage fluid). An IDT was conducted, using a full panel of 73 allergens consisting of grasses, weeds, trees, molds, and insects. Results of the IDT were evaluated 30 minutes and 4, 6, and 24 hours after injection of allergens. Horses without atopy were euthanatized, and gross and histologic changes of lung parenchyma were assessed.

RESULTS

Horses without atopy had a greater number of positive immediate and late-phase reactions than did horses with COPD. Horses with COPD did not have a significantly greater number of positive reactions than horses without atopy at any time period for any allergen group (grasses, weeds, trees, molds, and insects).

CONCLUSIONS AND CLINICAL RELEVANCE

Positive results of IDT document allergen-specific hypersensitivity but do not necessarily distinguish clinically relevant reactions from subclinical reactivity in horses with COPD. Interpreting the clinical relevance of results of IDT requires a thorough knowledge of the medical history, physical examination findings, and environment of each animal.

Analysis of risk factors for the development of equine protozoal myeloencephalitis in horses

OBJECTIVE

To investigate risk factors for development of equine protozoal myeloencephalitis (EPM) in horses.

DESIGN

Case-control study.

ANIMALS

251 horses admitted to The Ohio State University Veterinary Teaching Hospital from 1992 to 1995.

PROCEDURE

On the basis of clinical signs of neurologic disease and detection of antibody to Sarcocystis neurona or S neurona DNA in cerebrospinal fluid, a diagnosis of EPM was made for 251 horses. Two contemporaneous series of control horses were selected from horses admitted to the hospital. One control series (n = 225) consisted of horses with diseases of the neurologic system other than EPM (neurologic control horses), and the other consisted of 251 horses admitted for reasons other than nervous system diseases (nonneurologic control horses). Data were obtained from hospital records and telephone conversations. Risk factors associated with disease status were analyzed, using multivariable logistic regression.

RESULTS

Horses ranged from 1 day to 30 years old (mean +/- SD, 5.7 +/- 5.2 years). Risk factors associated with an increased risk of developing EPM included age, season of admission, prior diagnosis of EPM on the premises, opossums on premises, health events prior to admission, and racing or showing as a primary use. Factors associated with a reduced risk of developing EPM included protection of feed from wildlife and proximity of a creek or river to the premises where the horse resided.

CONCLUSIONS AND CLINICAL RELEVANCE

Development of EPM was associated with a number of management-related factors that can be altered to decrease the risk for the disease.

Evaluation of risk factors associated with clinical improvement and survival of horses with equine protozoal myeloencephalitis

OBJECTIVE

To investigate risk factors for use in predicting clinical improvement and survival of horses with equine protozoal myeloencephalitis (EPM).

DESIGN

Longitudinal epidemiologic study.

ANIMALS

251 horses with EPM.

PROCEDURE

Between 1992 and 1995, 251 horses with EPM were admitted to our facility. A diagnosis of EPM was made on the basis of neurologic abnormalities and detection of antibody to Sarcocystis neurona or S neurona DNA in CSF. Data were obtained from hospital records and through telephone follow-up interviews. Factors associated with clinical improvement and survival were analyzed, using multivariable logistic regression.

RESULTS

The likelihood of clinical improvement after diagnosis of EPM was lower in horses used for breeding and pleasure activities. Treatment for EPM increased the probability that a horse would have clinical improvement. The likelihood of survival among horses with EPM was lower among horses with more severe clinical signs and higher among horses that improved after EPM was diagnosed.

CONCLUSIONS AND CLINICAL RELEVANCE

Treatment of horses with EPM is indicated in most situations; however, severity of clinical signs should be taken into consideration when making treatment decisions. Response to treatment is an important indicator of survival.

Determinants of oxygen delivery and hemoglobin saturation during incremental exercise in horses

OBJECTIVE

To determine components of the increase in oxygen consumption (VO2) and evaluate determinants of hemoglobin saturation (SO2) during incremental treadmill exercise in unfit horses.

ANIMALS

7 unfit adult mares.

PROCEDURES

Horses performed 1 preliminary exercise test (EXT) and 2 experimental EXT. Arterial and mixed venous blood samples and hemodynamic measurements were taken during the last 30 seconds of each step of the GXT to measure PO2, hemoglobin concentration ([Hb]), SO2, and determinants of acid-base state (protein, electrolytes, and PCO2).

RESULTS

Increased VO2 during exercise was facilitated by significant increases in cardiac output (CO), [Hb], and widening of the arteriovenous difference in O2. Arterial and venous pH, PaO2, and PvO2 decreased during exercise. Arterial PCO2, bicarbonate ([HCO3-])a, and [HCO3-] decreased significantly, whereas PVCO2 and increased. Arterial and venous sodium concentration, potassium concentration, strong ion difference, and venous lactate concentration all increased significantly during exercise.

CONCLUSIONS AND CLINICAL RELEVANCE

Increases in CO, [Hb], and O2 extraction contributed equally to increased VO2 during exercise. Higher PCO2 did not provide an independent contribution to shift in the oxyhemoglobin dissociation curve (OCD) in venous blood. However, lower PaCO2 shifted the curve leftward, facilitating O2 loading. The shift of ODC resulted in minimal effect on O2 extraction because of convergence of the ODC at lower values of PO2. Decreased pH appeared responsible for the rightward shift of the ODC, which may be necessary to allow maximal O2 extraction at high blood flows achieved during exercise.

Contributions of equine exercise physiology research to the success of the 1996 Equestrian Olympic Games: a review

Following public concern about the weather conditions for the 1996 Olympic Games in Atlanta an international research programme was initiated. The primary objective of this effort was to identify strategies for ensuring welfare of horses competing in the heat. Field observations of horses during the endurance test of 3-day events in Europe, Canada, and the USA characterised the work effort of this form of competition; laboratory treadmill studies assessed limitations to performance of heat and humidity, explored the relationships of thermoregulatory demands to the phases of the competition and documented fluid and electrolyte losses. Estimates of energy expenditure and heat production during the endurance test were made. Strategies for facilitating heat dissipation were also studied in depth. Assessment of the effect of environmental conditions was based upon intensive climate monitoring using a modification of the Wet Bulb Globe Temperature index. Studies of heat acclimation provided a basis for recommendation of acclimatization times for horses before the Games. The results of all these studies guided the management of equine athletes at the 1996 Olympic Games and significantly advanced knowledge of thermoregulation in competitive horses.

Effect of ambient temperature and humidity on pulmonary artery temperature of exercising horses

Six healthy Thoroughbred mares were trained to run on a high-speed treadmill and were conditioned for approximately 5 weeks. Each horse performed 6 identical standardised exercise tests (SET) 5 to 7 days apart. Each SET was performed under different ambient laboratory conditions: low temperature/low humidity (LL) 20.2 degrees +/- 0.6 degree C, 53.6 +/- 4.1%; low temperature/high humidity (LH) 19.7 +/- 0.6 degrees C, 86.7 +/- 4.2%; medium temperature/low humidity (ML) 24.6 +/- 0.2 degrees C, 58.7 +/- 3.7%; medium temperature/high humidity (MH) 24.7 +/- 0.3 degrees C, 87.5 +/- 1.4%; high temperature/low humidity (HL) 31.1 +/- 0.6 degrees C, 41.6 +/- 3.5%; and high temperature/high humidity (HH) 30.6 +/- 0.2 degrees C, 84.4 +/- 3.6%. Horses completed the 46 min SET, became fatigued or exercise was terminated when a pulmonary artery temperature (PAT) of 41.5 degrees C was reached. During a 30 min recovery period, horses stood quietly on the treadmill. Only one trial was terminated due to fatigue; in all other trials horses completed the 46 min SET or the trial was terminated when PAT = 41.5 degrees C. The relationships among run time (min) or PAT (degree C), ambient temperature and % relative humidity were defined by multiple linear regression analysis. Run time (min) = 90.9 - (1.39 x ambient temperature degree C) - (0.236 x relative humidity %). Approximately 54% of the variation in run times was explained by variation in environmental conditions, indicating that ambient temperature and humidity contribute substantially to the rate of rise in PAT. Run times to a PAT of 41.5 degrees C were significantly shorter (P < 0.000001) in HH than in other groups during the SET. Approximately 63% of the variation in PAT at the end of exercise was due to ambient temperature and humidity. In general, the longer the exercise time, the better the correlation among PAT, ambient temperature and relative humidity. Rectal temperature increased significantly (P < 0.0001) during the recovery period only in horses in the HH group, indicating that heat dissipation during recovery may have been impaired by environmental conditions. This study demonstrates that hot humid conditions result in more rapid rate of rise in PAT for horses undertaking identical exercise tests.

Thoracic and abdominal blastomycosis in a horse

A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy.

In vitro dose-dependent effects of enrofloxacin on equine articular cartilage

OBJECTIVE

To determine whether enrofloxacin has detrimental, dose-dependent effects on equine articular cartilage in vitro.

ANIMALS

Cartilage explants were developed from 6 healthy horses between 0 and 96 months old.

PROCEDURE

Patellar cartilage explants were incubated in 5 concentrations of enrofloxacin (2 microg/ml, 10 microg/ml, 1,000 microg/ml, 10,000 microg/ml, and 50,000 microg/ml) for 72 hours. Proteoglycan synthesis (Na35SO4 incorporation for 24 hours), proteoglycan degradation (Na35SO4 release for 72 hours), endogenous proteoglycan content (dimethylmethlene blue assay), and total protein content were determined. Cartilage explants were evaluated by use of histomorphologic and histomorphometric techniques (toluidine blue stain) for cytologic and matrix characteristics. Quantitative data were analyzed with a one-way ANOVA to compare results among various enrofloxacin concentration groups and the control group. A general linear model was used to determine whether age had an effect.

RESULT

Proteoglycan synthesis was excellent in control specimens and in specimens incubated in low concentrations of enrofloxacin (2 microg/ml and 10 microg/ml). High concentrations of enrofloxacin (> 1,000 microg/ml) effectively eliminated proteoglycan synthesis regardless of horse age. Proteoglycan degradation at low concentrations (2 microg/ml and 10 microg/ml) was not different than control. High concentrations of enrofloxacin (> 1,000 microg/ml) caused significant degradation. Different concentrations of enrofloxacin did not affect endogenous proteoglycan. High concentrations of enrofloxacin were associated with a significant increase in number of pyknotic nuclei.

CONCLUSION

Concentrations of enrofloxacin that might be achieved following systemic administration did not suppress chondrocyte metabolism in vitro. High concentrations of enrofloxacin (> 1,000 microg/ml) were toxic to chondrocytes.

Evaluation of washing with cold water to facilitate heat dissipation in horses exercised in hot, humid conditions

OBJECTIVE

To determine whether body temperature of horses exercised in hot, humid conditions and then repetitively washed with cold water will decrease more rapidly than that of horses that are not washed, and to determine whether washing with cold water has deleterious effects on horses.

ANIMALS

5 physically fit Thoroughbred mares, 3 to 10 years old.

PROCEDURES

Horses were exercised on a high-speed treadmill in hot (31.1+/-0.3 C), humid (relative humidity, 77.7+/-2%) conditions. Exercise was terminated when pulmonary artery temperature reached 41.5 C. Values for pulmonary artery, rectal, and left gluteal muscle temperatures were compared throughout a 30-minute recovery period after exercise during which horses stood quietly (passive cooling) or were cooled (active cooling) by repeated applications of cold (1 5.6+/-0.6 C) water.

RESULTS

Pulmonary artery temperature was significantly less for actively cooled horses, compared with passively cooled horses 4 minutes into the recovery period. Left gluteal muscle temperature decreased significantly in actively cooled, but not passively cooled, horses during the recovery period. Heart rate and rectal temperature were significantly less for actively cooled horses by 15 minutes of the recovery period. Cooling technique did not effect hydration status, muscle health, or serum electrolyte concentrations. Active cooling did not cause obvious adverse effects.

CONCLUSION AND CLINICAL RELEVANCE

Active cooling by washing with cold water is a safe, effective means for facilitating heat dissipation of horses after exercise in a hot, humid environment.

Results of quantitative cultures of urine by free catch and catheterization from healthy adult horses

Quantitative urine cultures were performed on 11 male and 11 female healthy adult horses. Urine was collected by free catch and catheterization using standard methods. Results showed that all samples collected by free catch contained less than 20,000 colony-forming units (CFU)/mL. All samples collected by catheterization contained 500 CFU/mL or less. A significant difference was found between collection methods (P < .005), with catheterization having less contamination. In samples collected by free catch, females had significantly greater contamination than did males (P < .03). Predominant bacterial species isolated included Streptococcus spp., Escherichia coli, Enterobacter sp., Bacillus sp., Staphylococcus spp., Diptheroids sp., Proteus spp., and Enterococcus sp. Many samples contained multiple bacterial species. Bacterial isolates were representative of the normal bacterial flora of the equine urogenital tract. This paper establishes reference values for quantitative urine culture results in healthy adult horses to aid in the diagnosis of urinary tract infections.

Effect of sodium bicarbonate administration on blood constituents of horses

OBJECTIVE

To describe changes in blood constituents of horses after oral and i.v. administration of sodium bicarbonate (NaHCO3), and to determine whether the changes are dose dependent.

ANIMALS

6 adult Standardbred mares.

PROCEDURE

3 oral doses (1,500, 1,000, and 250 mg/kg of body weight) or 1 intravenous dose (250 mg/kg, 5% solution) of NaHCO3 in 3 L of water, or water (3 L orally), were given to the mares; then changes in blood constituents were measured. Access to food and water was denied during the experiment. Blood samples were collected immediately before treatment and at hourly intervals for 12 hours after treatment, and were analyzed for blood gas tensions; serum osmolality; serum sodium, potassium, chloride, and creatinine concentrations; PCV; and total solids concentration in plasma.

RESULTS

All NaHCO3 treatments induced significant (P < 0.05) metabolic alkalosis, hypernatremia, hypokalemia, and hyperosmolality for at least 8 hours. In mares given the 1,500- and 1,000-mg doses of NaHCO3 orally, hypercapnia persisted for at least 12 hours, whereas hypercapnia lasted 2 hours in mares given the 250-mg dose orally or i.v. (P < 0.05). A tendency for reduction in PCV, proteins in plasma concentration, and serum concentration of chloride was observed 1 hour after i.v. administered doses of NaHCO3.

CONCLUSIONS

Oral or i.v. administration of NaHCO3 (> or = 250 mg/kg) to resting horses without ad libitum access to water induces significant and persistent acid-base and electrolyte changes.

Effect of sodium bicarbonate administration on renal function of horses

OBJECTIVE

To describe changes in renal function of horses after oral and i.v. administration of sodium bicarbonate (NaHCO3) and to determine whether changes are dose dependent.

ANIMALS

6 Standardbred mares.

PROCEDURE

Blood and urine samples for determination of renal function were collected immediately before and at hourly intervals for 12 hours after administration of each of 3 oral doses (1,500, 1,000 and 250 mg/kg of body weight, in 3 L of water) and 1 i.v. dose (250 mg/kg, 5% solution) of NaHCO3, or water (3 L orally).

RESULTS

NaHCO3 induced increases in urine flow; electrolyte-free water reabsorption; urine concentrations of sodium and bicarbonate; fractional excretion of sodium, potassium, chloride, and bicarbonate; urinary excretion and clearance of sodium and bicarbonate; urine pH and anion gap; and mean plasma concentration of antidiuretic hormone. NaHCO3 induced attenuation in reduction with time of urine excretion and clearance of potassium, chloride, and osmoles, and induced reduction in urine osmolality. Plasma aldosterone and atrial natriuretic peptide concentrations and glomerular filtration rate were not modified.

CONCLUSIONS

Renal responses to NaHCO3 load emphasize conservation of plasma volume and reestablishment of acid-base balance over control of hyperosmolality by diuresis, natriuresis, and increased bicarbonaturia. These responses imply a large fluid shift from the extravascular space to the vascular compartment, which was eliminated via diuresis, thus preventing hypervolemia.

Seroprevalence of antibodies to Sarcocystis neurona in horses residing in Ohio

OBJECTIVE

To determine the seroprevalence of serum antibodies to Sarcocystis neurona in horses residing in Ohio.

DESIGN

Prevalence survey.

SAMPLE POPULATION

Serum from samples from 1,056 horses. Serum was collected on every 36th sample submitted to the Ohio State Diagnostic Laboratory for testing for equine infectious anemia.

PROCEDURE

Serum was frozen at -80 C and analyzed for antibodies to S neurona, using a western blot. Information regarding blood sample collection, age, breed, sex, and geographic location was recorded for each horse. Data were analyzed, using multivariable logistic regression.

RESULTS

Horses of 37 breeds from 81 of Ohio's 88 counties were included in the study population. There were 481 females, 133 males, and 442 geldings ranging in age from 3 months to 27 years; > 48% were < 5.6 years old. More than 53% of samples were seropositive for antibodies to S neurona. A gender or breed effect on seroprevalence was not identified. There was a significant effect of age (P < or = 0.0001; with older horses more likely to be affected), and of location (statistical and extension districts; P = 0.02 and P = 0.03, respectively) on seroprevalence. Location effects appeared to be correlated to the number of days with temperatures below freezing (P < 0.05).

CLINICAL IMPLICATIONS

The high seroprevalence of antibodies to S neurona found in the sample population emphasizes the importance of examining CSF for S neurona-specific antibodies when establishing a diagnosis of equn protozoal myeloencephalitis.

Necrotizing enterocolitis in horses: a retrospective study

The clinical and clinicopathologic characteristics of fatal necrotizing enterocolitis were examined in 16 horses (age 4 months to 12 years). At initial presentation, 8 of 16 horses were pyrexic (median temperature, 38.4 degrees C; range, 33.8 to 40.6 degrees C); all 16 were tachycardic (median heart rate, 93 bpm, range, 66 to 138 bpm); 13 of 16 were tachypneic (median heart rate, 36 bpm, range, 16 to 80 bpm), dehydrated, and had discolored mucous membranes. All horses that were pyrexic were also tachycardic and tachypneic. PCV was high (> 45%) in 14 horses. Six horses were leukopenic (< 5,000 cells/microL); 12 were neutropenic (< 2,300 cells/microL), and 14 had > 100 band neutrophils/microL. Twelve horses were acidemic (pH < 7.37; range, 6.88 to 7.33) and the venous bicarbonate concentration was low (< 23 mEq/L) in 14 horses. Median anion gap in 16 horses was 31.5 mEq/L (> 15 mEq/L in 15 horses). Eleven of 16 horses were hyponatremic (< 137 mEq/L), 1 horse was hypernatremic (> 143 mEq/L), 3 were hypokalemic (< 3.2 mEq/L), 6 were hyperkalemic (> 4.5 mEq/L), and 14 were hypochloremic (< 98 mEq/L). Serum creatinine concentrations were high (> 1.4 mg/dL) in 15 horses. Abdominal fluid was examined in 12 horses 4 had total protein concentrations > 2.5 g/dL and 6 had nucleated cell counts > 5,000/ microL and < 10,000/microL; none had > 10,000/microL. Eight of 12 samples revealed a nondegenerate neutrophilia (> 50%). Abdominal fluid collected from 4 horses immediately before death was normal in 2 horses and indicative of suppurative inflammation in 2. All 8 horses tested had low or nonexistent serum immunofluorescent antibody titers to Ehrlichia risticii. Four of 16 horses had Salmonella spp isolated from feces or tissues. All 16 horses either died (5 of 16; 31%) or were euthanized because of a grave prognosis. Median time to death was 45.5 hours (range, 7 to 113 hours) from the time of admission. Death was preceded by severe abdominal pain in 14 horses. Fatal necrotizing enterocolitis of horses is characterized by a brief course, profound dehydration, electrolyte derangements, acid-base abnormalities, and terminally, severe abdominal pain. Abdominal fluid analysis was frequently not indicative of the severity of disease.

Physiological responses of horses competing at a modified 1 star 3-day-event

The impending 1996 summer Olympic 3-day-event in Atlanta has focused attention on the need to determine what modifications to the demanding Endurance Test will be required to ensure safety of the horses competing. Three groups of horses participated in a Field Trial held in August of 1994 in northern Georgia to determine the safety and feasibility of conducting a modified 3-day-event in hot, humid weather. One group (TD) completed a modified 1 Star 3-day-event test, a control group (HT) completed a Horse Trial identical to the modified 1 Star test except for the omission of Phases B and C and the third group (E), comprised of European horses, completed the modified 1 Star test with a longer, faster Phase C than was used for TD. During the Endurance Test, the ambient temperature and relative humidity ranged from 24.3 degrees C and 98.9% in the morning to 30.2 degrees C and 51.6% in the afternoon. No horse failed to complete the Trial because of heat stress or fatigue. There were no significant (P < 0.05) differences detected in heart rate, rectal temperature, respiratory rate or net weight loss between HT and TD horses at any observation time. The highest rectal temperature recorded at the end of Phase C was 39.6 degrees C. These findings suggest that the modified 1 Star Endurance Test was as well tolerated by American horses as the control Horse Trial test. Rectal temperature was significantly higher for E than for TD or HT at the finish of Phase C. European horses had significantly greater decreases in weight than HT and TD at the end of Phases C and D and the next day. These findings probably reflect the faster and longer work effort of E horses during Phase C. Modification of Phase C and the rest-pause to ensure that recovery and heat dissipation occurred before the start of Phase D resulted in a 3-day-event that was safe for horses. The Field Trial provides a model for designing a modified Olympic Endurance Test. If the 1996 Olympic 3-day-event is held in hotter and more humid weather than the Field Trial, additional modifications to the Endurance Test (decreased distances, speeds and numbers of jumping efforts) will probably be required to ensure safety of competing horses.

Physiological responses to the endurance test of a 3-day-event during hot and cool weather

Physiological data were collected during two 3-day-event competitions: one (H) held in hot and the other (CL) in cool conditions. During H, ambient temperature and relative humidity were 2.5 degrees C-35 degrees C and 74-36% respectively, while during CL, ambient temperature and relative humidity were 7.8 degrees C-8.3 degrees C and 46%-41%, respectively. Rectal temperature, heart and respiratory rates were recorded on arrival at the event, at the end of Phase C and 6 min later, at the end of Phase D and for 30 min at 10 min intervals after each horse finished Phase D (Recovery Period). Because of the heat, the rest-pause during the Endurance Test was extended from 10 to 15 min for horses competing in H, and horses at H were aggressively cooled by repetitive bathing with ice water during the rest-pause and the 30 min Recovery Period. Heart rate was significantly higher (P < 0.05) at the end of Phase C in horses participating at H, as compared to those participating at CL. Heart rates were significantly decreased in both groups after 6 min in the rest-pause and by 10 min after the finish of Phase D. Rectal temperature were significantly higher in horses competing at H than in those competing at CL at the end of Phase C and 6 min later, and at 10 and 20 min after the finish of Phase D. In both groups, rectal temperatures decreased significantly during the first 6 min in the rest-pause and at 10 and 20 min after the finish of Phase D. Fifty-five of 79 (69.6%) horses starting Phase A at H completed Phase D, as compared to 23 of 28 (82.1%) of starters at CL (P > 0.05). Of 10 horses eliminated during the rest-pause at H, 3 were lame, 1 had exertional rhabdomyolysis, 4 were exhausted and 2 were lame and exhausted. Two horses were eliminated during the rest-pause at CL:1 was lame and the other had exertional rhabdomyolysis. There was marked individual variation in horses' responses to heat at H. Heat may have limited the effectiveness of evaporative cooling in horses at H, and resultant thermal stress probably contributed to exhaustion in horses unable to complete the Endurance Test. Aggressive cooling during the rest-pause and the Recovery Period was important to facilitate heat dissipation in horses at H. These measures were not necessary at CL.

Acid:base and serum biochemistry changes in horses competing at a modified 1 Star 3-day-event

We examined the effects of participation in each of 3 modifications of Day 2 of a 3-day-event on blood and serum variables indicative of hydration, acid:base status and electrolyte homeostasis of horses. Three groups of horses - 8 European (E) horses and 2 groups each of 9 North American horses performed identical Days 1 (dressage) and 3 (stadium jumping) of a 3-day-event. E horses and one group of the North American horses (TD) performed modifications of Day 2 of a 1 Star 3-day-event and the other group of North American horses (HT) performed a Horse Trial on Day 2. Jugular venous blood was collected from each horse on the morning of Day 2 before any warm-up activity, between 4 min 55 s and 5 min 15 s after Phase D and the following morning. Eight E horses, 5 TD horses and 8 HT horses completed the trials. There were few significant differences in acid:base or serum biochemistry variables detected among horses performing either 2 variations of the Speed and Endurance day of a 1 Star 3-day-event, or a conventional Horse Trial. Failure to detect differences among groups may have been related to the low statistical power associated with the small number of horses, especially in the TD group, variation in quality of horses among groups and the different times of the day at which the E horses competed. Differences detected among time points were usually common to all groups and demonstrated metabolic acidosis with a compensatory respiratory alkalosis, a reduction in total body water and cation content, and hypocalcaemia. Importantly, horses of all groups did not replenish cation, chloride, and calcium deficits after 14-18 h of recovery.

Myeloid and megakaryocytic hypoplasia in related standardbreds

Myeloid and megakaryocytic bone marrow hypoplasia in association with moderate to profound neutropenia was observed in 8 young Standardbred horses sired by the same stallion; 7 horses were intermittently thrombocytopenic. Evaluation of serial neutrophil counts in 2 horses suggested that a cyclic variation in neutrophil numbers was present, that lymphocyte numbers increased when neutrophil counts decreased, and that platelet counts decreased when neutrophil counts decreased. Preliminary bone marrow cultures indicated that myeloid progenitor cells were present and that these cells were able to respond to exogenous growth factors by differentiating. A bone marrow microenvironment or growth factor defect is suspected. Seven of 8 horses died or were euthanized. One horse with moderate neutropenia and a normal platelet count has been racing for 3 years. Necropsies in 4 horses did not reveal a cause for the myeloid hypoplasia. A familial basis for the disease is suspected.

Effect of exercise intensity on plasma prostaglandin concentrations in horses

Exertion has an effect on plasma, serum, and/or urine prostanoid concentrations in many species. We investigated the effect of exercise intensity on plasma prostaglandin concentrations during and after exercise in horses. Six Thoroughbreds completed 4 trials: 3 exercise trials (low-, medium-, and high-speed) and 1 nonexercise (control) trial on a high-speed treadmill. Blood samples were collected from a jugular catheter before, during, and after exercise. The PCV and blood lactate, plasma protein, plasma prostacyclin (6-keto-PGF1 alpha), thromboxane B2 (TXB2), and prostaglandin E2 (PGE2) concentrations were measured before, during, and after exercise. Exercise significantly (P = 0.001) increased plasma TXB2 concentration during and after exercise in the low-, medium-, and high-speed trials, although effect of exercise intensity was not detected. Exercise was associated with an increase in PCV and blood lactate and plasma protein concentrations. There was no effect of exercise on plasma 6-keto-PGF1 alpha concentrations; PGE2 was not detected in plasma from any horse in any trial.

Early insulin response to an intravenous glucose tolerance test in horses

Plasma insulin concentration of many species has a characteristic early or acute-phase response in the minutes after IV administration of glucose. However, the plasma insulin response of horses soon after the IV administration of glucose has not been examined, whereas the more prolonged response has been evaluated. We examined the plasma insulin and glucose concentration responses of adult mares during the 30 minutes after rapid IV administration of glucose (0.33 g/kg of body weight). Plasma glucose concentration peaked at 664 +/- 54 mg/dl within 1 minute of cessation of glucose administration, whereas insulin concentration peaked at 326 +/- 24 pmol/L at 2 minutes after the end of glucose administration. Thus, these mares had an acute insulin response, consistent with that observed in other species, including dogs, human beings, and cattle.

Assessment of vertebral canal diameter and bony malformations of the cervical part of the spine in horses with cervical stenotic myelopathy

Magnification of cervical radiographs prevents accurate interpretation of vertebral canal absolute minimum sagittal diameter (MSD) values and application of the established MSD values for diagnosis of cervical stenotic myelopathy (CSM). Variability in MSD determination in human beings, owing to radiographic magnification, is minimized by assessing a ratio of the vertebral canal diameter to the sagittal width of the vertebral body. This relative measurement technique improves the accuracy of diagnosis of cervical spinal stenosis in human beings. The MSD of the vertebral canal was determined in 50 horses with CSM and 50 control horses, using a radiopaque marker method for correction of magnification. In addition, a ratio of the absolute MSD to the sagittal width of the vertebral body and a ratio of the absolute MSD to the length of the vertebral body were determined in 100 CSM-affected and 100 control horses. Response operating characteristic curve analysis of each method determined that the sagittal ratio method of canal diameter assessment provided the most accurate interpretation of cervical radiographs for diagnosis of CSM, with sensitivity and specificity of > or = 89% at each vertebral site. The accuracy of the ratio method, without consideration of bony malformation, supports the importance, and perhaps prerequisite, of generalized vertebral canal stenosis in the pathogenesis of CSM. Subjective evaluation of bony malformations from cervical radiographs of 100 CSM-affected horses and 100 control horses indicated that CSM-affected horses have more severe bony malformation than do control horses. However, moderate to marked degenerative joint disease of the articular processes was frequently observed in control horses.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacokinetics of single intravenous and single and multiple dose oral administration of rifampin in mares

The disposition of rifampin in six healthy mares after single intravenous (i.v.) and oral (p.o.) doses and after seven oral doses of 10 mg/kg administered twice a day was investigated using a high performance liquid chromatographic (HPLC) method. Pharmacokinetic variables for rifampin determined using the HPLC method were comparable to variables reported from earlier studies utilizing a microbiological assay. Desascetylrifampin, a major metabolite of the parent compound, could not be detected in the serum but was detected at low concentrations in urine. Mean trough concentrations of rifampin increased from the first to the second dose of the multiple dose oral study and then remained unchanged through 72 h. At 84 h after the first dose (i.e. 12 h after the final dose) the rifampin concentration was significantly decreased (P = 0.001). The harmonic mean of the half-life of rifampin decreased significantly from 13.3 h after a single oral dose of 7.99 h after the seventh oral dose. The mean serum protein binding of rifampin over the concentration range of 2-20 micrograms/ml was 78%. Mean trough serum concentrations of unbound rifampin after multiple oral doses ranged from 0.67 micrograms/ml at 24 h to 0.40 micrograms/ml at 72 h. The mean unbound serum rifampin concentration at 84 h (i.e., 12 h after the final dose) was 0.30 micrograms/ml. Trough concentrations and the 84-h sample concentration of unbound rifampin exceeded the minimum inhibitory concentration for most gram positive bacterial isolates from horses reported in this study. All organisms with minimum inhibitory concentrations less than 0.125 micrograms/ml were considered susceptible. Based on the pharmacokinetics of rifampin after p.o. administration, we concur with the current dosage recommendation of 10 mg/kg twice a day by mouth. At this dose, most streptococci, Rhodococcus equi, and coagulase-positive staphylococci would be considered susceptible to rifampin.

Serological titers of equine monocytic ehrlichiosis associated with gastro-intestinal disorders and serological follow-up on two endemic farms

The purpose of this work was to study the association of positive serological titers to Ehrlichia risticii, the causative agent of equine monocytic ehrlichiosis (EME) with gastro-intestinal disorders in hospitalized horses referred to The Ohio State University College of Veterinary Medicine Teaching Hospital (OSU VMTH). In addition, serological titers for E. risticii were monitored in two horse populations with endemic EME for one season to monitor temporal changes in titers. A statistically significant difference was found between the proportion of the total hospitalized horse population presented with a gastro-intestinal disorder during the study period, and study horses with IFA titers > or = 1:80 with these signs (P < 0.05). No such difference was found between the proportion of the total hospital horse population presented with signs of gastro-intestinal disorder, and the study horses with IFA titers of 1:20-1:40 with these signs, suggesting that these titers may not have any clinical significance for EME (P > 0.05). Thirty-eight horses on two farms endemic for EME were tested approximately every 3 weeks, 33 of which were tested serially at least two times. Five of the 38 horses (13.2%) had IFA titers > or = 1:80--two that were positive initially and three that seroconverted during the study; 15 horses' titers fluctuated between negative (IFA titers < 1:20) and exposed titers (1:20 through 1:40); and 18 horses remained negative throughout the study.

A retrospective study of 192 horses affected with septic arthritis/tenosynovitis

The medical records of 192 horses with septic arthritis/tenosynovitis 1979-1989 were reviewed. Forty-three horses developed infection after an intra-articular injection, 46 following a penetrating wound, 25 following surgery, 66 were foals less than 6 months old, and 12 were adult horses without a known aetiology. Haematogenous infection of a joint occurs in adult horses and should be considered as a differential diagnosis in horses with an acute onset of severe lameness. The aetiology of the infection had a significant effect on the type of bacteria identified by culture. Staphylococcus was cultured from most of the horses that developed infection following a joint injection or surgery, 69% of the horses from which an organism was identified. Horses that developed infection secondary to a penetrating wound frequently provided cultures of more than one organism; Enterobacteriaceae and anaerobes were more frequently isolated in this group. The most common organisms isolated from foals were Enterobacteriaceae; E. coli was identified in more than 27% of the foals. The hock was the most frequently involved joint. Multiple treatments were used over the 10-year period of study. Survival rates were lowest in foals; only 45% survived to be released from the hospital. Survival was greater in adult horses; 85% of the horses that were treated were released from the hospital. Survival was significantly greater in horses with septic tenosynovitis; all 14 of the horses that were treated survived. Survival was not significantly affected by the joint involved or by the type of bacteria cultured from the synovial fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

Antimicrobial susceptibility of bacterial isolates from 233 horses with musculoskeletal infection during 1979-1989

Bacterial culture and susceptibility results were analysed from 233 horses with septic arthritis/tenosynovitis or osteomyelitis that developed after fracture repair. Antibiotics were deemed highly effective, effective or ineffective if > or = 85%, 70-84.9% or < 70% of the isolates were susceptible respectively. In total, 424 bacterial types were isolated; 386 were aerobic or facultative and 38 were anaerobic. Enterobacteriaceae (28.8%) were the most common bacterial group isolated, followed by non-beta-haemolytic streptococci (13.0%), coagulase-positive staphylococci (11.8%), beta-haemolytic streptococci (9.4%), and coagulase-negative staphylococci (7.3%). The remainder of the organisms were other Gram-negative (15.8%), other Gram-positive (2.3%) and miscellaneous (2.6%) bacteria. Penicillin and ampicillin were highly effective against beta-haemolytic streptococci, but were ineffective against other bacteria. Ampicillin was no more effective than penicillin against most bacteria. Amikacin was the most effective antibiotic against the wide range of bacteria isolated in this study. Amikacin was highly effective against coagulase-positive staphylococci, Enterobacteriaceae and Pseudomonas and was effective against coagulase-negative staphylococci and Actinobacillus. Gentamycin was not highly effective against any bacterial group; but was effective against coagulase-positive and negative staphylococci, Pseudomonas, Salmonella and Actinobacillus. Kanamycin was ineffective against all bacteria with the exception of Actinobacillus. Cephalothin was highly effective against beta-haemolytic streptococci, coagulase-positive staphylococci and Actinobacillus and was effective against coagulase-negative staphylococci.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of protein source in liquid formula diets on food intake, physiologic values, and growth of equine neonates

The effects of 2 liquid formula diets differing in protein source were evaluated in orphan foals. The response of 7 foals fed a diet containing casein as the protein source, and 6 foals fed a diet containing a combination of whey and casein, was compared with the response in a reference group of 8 mare-raised foals. Orphaned foals were fed 150 kcal/kg of body weight/d, divided into 6 equal feedings of 25 kcal/kg. Formula intake was comparable among the experimental groups, and foals fed the liquid formula diet grew as well as mare-raised foals. There was no difference among groups in mean daily body weight gain, wither height, heart girth, body temperature, pulse, respiration rate, capillary refill time, or skin tenting. Insulin and blood glucose concentrations increased in both groups of foals fed formula diets, returning to prefeeding values within 4 hours. Differences among groups were found for serum alkaline phosphatase, alanine transaminase, cholesterol, creatinine, and glucose values; all other serum chemical values were comparable among groups. Plasma amino acid determinations revealed that arginine and ornithine were significantly lower in foals in both experimental groups than in reference foals, suggesting that arginine may have been the limiting amino acid in these diets. Diarrhea developed in foals in all treatment groups, but in most cases was self-limiting. These results suggest that the protein source of liquid formula diets may be less important in foals than in infants.

Tracheal obstruction from tracheal collapse associated with pneumonia in a horse

A 20-month-old Quarter Horse stallion was admitted for evaluation of labored breathing, honking cough, and bilateral epistaxis that were caused by pneumonia and collapsed trachea. A transtracheal aspiration revealed highly cellular, serosanguineous fluid. Radiography revealed a patchy alveolar pattern and a narrowed tracheal lumen. Endoscopy confirmed narrowing of the tracheal lumen. Streptococcus zooepidemicus was isolated on culture of the transtracheal aspirate. The horse responded to penicillin treatment, and the tracheal collapse improved endoscopically after 4 days, with complete recovery within 1 year. Tracheal collapse has been reported to be a disease of older horses associated with degenerative cartilage. The findings in the horse of this report suggested that tracheal collapse may result from inflammation secondary to pneumonia and, therefore, may be reversible.

A preliminary study of the tolerance of healthy foals to a low residue enteral feeding solution

After a three day acclimatization period, six healthy, young (aged 4 to 20 days) orphan foals of mixed breeding were fed 100 per cent of their caloric needs (estimated at 523 kjoules/kg bodyweight [bwt] or 125 kcal/kg bwt/day) as a low residue isotonic feeding solution (LRF) for seven days. The solution provided 4.18 kjoules (1 kcal/ml) and was fortified with minerals and protein to meet estimated foal requirements. The solution was fed through an indwelling 12 French feeding tube. Five of the six foals completed the study; the loss of the sixth foal apparently was unrelated to the feeding protocol. The foals tolerated LRF well. Signs of intolerance were noted in two foals and were limited to flatulence, mild bloat and very mild abdominal pain associated with a decreased interval between two feedings during the first 48 h on 100 per cent LRF. Complete recovery without therapy occurred within 6 h and feedings were resumed. Growth in height and weight were comparable to published data for healthy foals raised with their dams. Feeding tubes were easily maintained with no apparent dysphagia, regurgitation or discomfort to foals. This low residue, calorically dense, isotonic feeding solution may be useful for enteral feeding of selected foals aged at least seven days.

Microcytosis, hypoferremia, hypoferritemia, and hypertransferrinemia in standardbred foals from birth to 4 months of age

At birth, 24 Standardbred foals were assigned at random to 1 of 2 groups and were given a placebo supplement (group 1) or an iron supplement (248 mg of iron/treatment; group 2). Foals were given iron supplement or placebo 4 times during the second and third weeks after birth. Hematologic variables and general health were monitored until foals were 4 months old. Mean PCV in foals of both groups decreased during the first 2 weeks after birth, but values remained within adult horse reference ranges. During the first 6 weeks after birth, foal erythrocytes were smaller than adult horse erythrocytes, but foal erythrocyte glucose-6-phosphate dehydrogenase activity was greater than that in adult horses. At every measurement, indices of anisocytosis were lower in foals, compared with adult horse reference values, suggesting that foals have a homogeneous population of microcytic erythrocytes during early foalhood. In 2-week-old foals of both groups and in 4-week-old placebo-treated foals, mean serum iron concentration was lower than that in adult horses. In foals at birth and during the first 4 months, total iron-binding capacity values were above the adult reference range. In newborn foals, transferrin saturation percentage values decreased to below the reference range in foals from 2 weeks to 4 months after birth. When foals were born, serum ferritin concentration values were above the adult horse reference range, but decreased to within the reference range by the time foals were 1 day old. From 2 through 6 weeks after birth, foal ferritin concentration values were below the adult reference range.(ABSTRACT TRUNCATED AT 250 WORDS)

Failure of pH to predict ionized calcium percentage in healthy horses

Blood, serum, and plasma total calcium concentrations and plasma and serum ionized calcium concentrations were anaerobically determined by use of a calcium-specific electrode for samples obtained from 39 healthy horses. Mean (+/- SD) serum ionized calcium concentration was 6.6 +/- 0.3 mg/dl (1.6 +/- 0.1 mmol/L) and the mean serum ionized calcium percentage was 58.2 +/- 3.4%. Serum ionized calcium percentage was not significantly correlated with serum pH. Plasma ionized calcium percentage was weakly correlated with plasma pH (r = -0.480; P less than or equal to 0.05). Ionized calcium concentration was determined in serum samples manipulated in vitro by additions of 1 to 80 microliters of 0.1N hydrochloric acid or sodium hydroxide to yield 6 to 10 pH values between 6.8 and 8.2. In all horses, the relationship between serum ionized calcium percentage and serum pH at these pH values was then examined by use of a repeated-measures multiple regression analysis. Correlations between serum ionized calcium percentage and adjusted serum pH value for each horse were highly significant (P less than or equal to 0.05); however, analysis of pooled data from all horses indicated that a statistically significant relationship between serum pH and ionized calcium percentage did not exist. Lack of a significant relationship between these variables was most likely attributable to heterogeneity of variance of ionized calcium percentage among horses, reflecting variation in undefined biochemical constituents of serum that affect the equilibrium of calcium binding. When it is essential to evaluate the calcium status of a horse, direct measurement of serum ionized calcium concentration is recommended.

Renal and systemic hemodynamic responses to sustained submaximal exertion in horses

We investigated the effects of 1 h of sustained submaximal exertion on the renal and systemic hemodynamics of six horses. The horses ran on a treadmill at a speed that produced heart rates of 55-60% of each horse's maximum heart rate. Exertion produced heart rates of 121 +/- 6.6 and 126 +/- 6.1 (SE) beats/min after 15 and 60 min, respectively. Cardiac output increased significantly (P less than 0.05) from 70.1 +/- 3.1 to 246.2 +/- 4.7 ml.min-1.kg body wt-1 after 15 min of exertion and thereafter did not change. There was no significant change from rest in p-aminohippuric acid and creatinine clearances, filtration fraction, or renal blood flow during exertion. Plasma total solid concentration and hematocrit increased by 3.8 and 8.6%, respectively, between 20 and 60 min of exertion. Pulmonary artery temperature increased significantly from 37.6 degrees C at rest to 38.6 degrees C at 60 min of exertion. This study demonstrates the ability of the horse to maintain renal hemodynamics similar to resting values and systemic hemodynamics at steady-state values despite hemoconcentration and increased body temperature during sustained submaximal exertion.

Colostral and serum IgG, IgA, and IgM concentrations in Standardbred mares and their foals at parturition

Immunoglobulin G, IgM, and IgA concentrations were measured in serum collected from 36 Standardbred mares within 12 hours of foaling, in colostrum collected within 6 hours of foaling, and in serum collected from foals 24 to 48 hours after birth. In serum collected from mares after parturition, mean concentrations of IgG, IgM, and IgA were 2,463.9 +/- 1,337.3 mg/dl, 136.4 +/- 218 mg/dl, and 305.2 +/- 237.5 mg/dl, respectively. In serum from foals, mean concentrations of IgG, IgM, and IgA were 1,953.3 +/- 1,635 mg/dl, 33.8 +/- 30.4 mg/dl, and 58.4 +/- 42.2 mg/dl, respectively. In colostrum, mean concentrations of IgG, IgM, and IgA were 8,911.9 +/- 6,282.2 mg/dl, 957 +/- 1088.1 mg/dl, and 122.9 +/- 77.3 mg/dl, respectively. The IgG concentrations in foal serum were poorly correlated with IgG concentrations in colostrum (r = 0.462, P less than 0.01). Correlations of IgM or IgA concentrations in serum from foals with IgM or IgA concentrations in colostrum and correlations of IgG concentrations in serum from mares with those in colostrum were not significant (P less than 0.01). Of 36 foals, 1 (2.8%) had a serum IgG concentration less than 400 mg/dl. Of 36 foals monitored for 4 months, 6 developed infectious respiratory tract disease requiring antimicrobial therapy at ages varying from 55 to 113 days; these infections were probably not related to failure or partial failure of passive transfer of antibody.

Ultrastructure of junctional epidermolysis bullosa in Belgian foals

Ultrastructural examination of a mechanobullous disease of probable hereditary nature in Belgian foals, confirmed light microscopic findings that separation of the dermo-epidermal junction occurred through the lamina lucida of the basement membrane, leaving the intact lamina densa adherent to the dermis and the plasmalemma of the basal epithelial cells intact. The location of the cleft and the presence of small hemidesmosomes in adjacent intact skin are additional characteristics which make this condition similar to junctional epidermolysis bullosa of man.

Selected aspects of the clinical pharmacology of visceral analgesics and gut motility modifying drugs in the horse

Comparison of the visceral analgesic effects of xylazine, morphine, butorphanol, pentazocine, meperidine, dipyrone, and flunixin in a cecal distention model of colic pain indicated that xylazine produces the most relief from abdominal discomfort. Repeated administration of xylazine may reduce visceral pain so effectively that the seriousness of abdominal disease is obscured. Xylazine decreased propulsive motility in the jejunum and pelvic flexure of healthy ponies. Morphine and butorphanol also gave relief from visceral pain in the cecal distention model. Morphine may inhibit colonic, and butophanol jejunal, motility. Whether xylazine or opiate mediated decreases in gut motility cause clinically important slowing of ingesta transit is controversial and requires further investigation. The development of behavioral changes (i.e., apprehension and pawing) in horses given opiate therapy may limit the use of these drugs. Combinations of xylazine and morphine or butorphanol produce excellent, safe, visceral analgesia and sedation without untoward behavioral effects. Although flunixin fails to demonstrate good visceral analgesic effects in the cecal distention model, this drug produces analgesia in some cases of colic by blocking prostaglandin mediated induction of pain. Improvement of propulsive gut motility in patients with ileus may follow administration of neostigmine (which is particularly effective when the large bowel is hypomotile), naloxone (which experimentally stimulates propulsive colonic motility), and metoclopramide (which stimulates stomach and proximal small intestinal motility).

Laboratory diagnosis and characterization of renal disease in horses

Laboratory evaluation of renal function in horses has advanced dramatically in the last 10 years largely as a result of the interest generated by the creative approach to diagnostic indices taken by Brobst, Traver, Coffman, and others. Some methods of assessing renal function discussed here are clearly outside the scope of a practice environment but are available in referral hospitals for use in difficult or unusual cases. Other methods described, such as calculation of fractional excretions and urine to serum creatinine ratios, are accessible and readily interpreted by the veterinary practitioner. These diagnostic methods should help in the early identification of renal disease in horses and therefore should allow veterinarians the option to treat renal disease before renal failure is advanced. In addition, practitioners may be able to offer more informed prognoses after a more complete evaluation of renal function.

Equine herpes myeloencephalopathy

The neurologic form of EHV-1 infection appears to be the result of central nervous system infarction caused by vasculitis, which is initiated in endothelial cells of small blood vessels. The etiologic agent is equine herpesvirus-1, subtype 1. There is some evidence to suggest that the neurologic form of the disease actually results from reactivation of a previous infection. Whether the vasculitis that causes the central nervous system injury is the direct result of the infection or an immune response to the infection has not been determined. The clinical signs are rapid in onset, nonprogressive, and many horses may improve. The diagnosis must often remain tentative, particularly in horses that recover, because there is no single reliable confirmatory test. The prognosis is generally good, although recovery may be slow and incomplete. Supportive therapy is essential, and administration of corticosteroids may be useful. There is no specific therapy for the virus or for the vasculitis. Currently no vaccine can be claimed to protect against the central nervous system form of the disease. Vaccination is recommended, however, to reduce the incidence of respiratory disease, abortion, and neonatal death on the farm. Repeated vaccination is necessary to maintain presumably protective antibody concentrations. Vaccination every 3 to 4 months may decrease the incidence of EHV-1 infection on the farm and therefore may indirectly prevent the occurrence of the neurologic form of the disease.

Bilateral renal hypoplasia in four young horses

Three horses less than or equal to 3 years old were evaluated because of stunted growth, weight loss, anorexia, depression, and lethargy of at least 1 month's duration. A neonatal foal was examined after its death. In each case, gross and microscopic renal lesions were compatible with bilateral renal hypoplasia (ie, cortical hypoplasia with severe medullary hypoplasia). In young horses with renal failure, bilateral renal hypoplasia should be considered in the differential diagnosis, and may represent a congenital lesion.