Response of cows with osteomalacia grazing sub-tropical native pastures to phosphorus supplementation with loose mineral mix or feed blocks

Osteomalacia outbreaks often occur in cattle grazing native pastures in regions with endemic phosphorous (P) deficiency. This study evaluated the responses of two groups of cows, initially with clinical signs of chronic P deficiency, to P supplements (100 g P/kg) offered ad libitum for 13 weeks as a loose mineral mix (LMM group) or the same mineral mix offered as blocks (BMM group). Half of the cows in each group were categorized as 'with' or 'without' severe osteopenia according to a test that depended on the resistance to penetration of a needle through the left lateral process of the L4-L5 lumbar vertebra. The groups grazed two paddocks that were switched each 3 weeks. The liveweight, supplement intakes, and the P-concentrations in soil, forage, blood, and external cortical bone (ECB) of the ribs were measured. The bicarbonate-extractable P in soil was 3.5 mg/kg. The mean of total P in forage (0.95 g/kg/DM), inorganic P in serum (iP, 0.96 mmol/L), and total P in the ECB of the ribs (85 mg/mL) at the beginning of the experiment were all low and consistent with severe chronic P deficiency. The P supplementation allowed clinical recovery in 18/20 cows with their serum and ECB P and calcium approaching normal values and in the two remaining cows the only sign was abnormal gait. Cows consumed more of the LMM than BMM supplement (means 8.3 and 6.6 g P/day, respectively). After 13 weeks cows initially classified as 'with severe osteopenia' and supplemented with LMM had higher (P < 0.05) final liveweight (difference = 21.6 kg), iP (difference = 0.74 mmol/L), bone Ca (difference = 65.7 mg/mL) and bone P (difference = 26.5 mg/mL) concentrations and lower (P < 0.01) final serum Ca/iP ratio (difference = -0.65) than cows with severe osteopenia but supplemented with BMM. The treatment of severe P deficiency cows grazing P deficient sub-tropical grasslands by P supplementation for 13 weeks was more effective with LMM than BMM.

Diet quality, liveweight change and responses to N supplements by cattle grazing

Experiments during 4 years examined the diets selected, growth, and responses to N supplements by Bos indicus-cross steers grazing summer-rainfall semi-arid C4 Astrebla spp. (Mitchell grass) rangelands at a site in north-western Queensland, Australia. Paddock groups of steers were not supplemented (T-NIL), or were fed a non-protein N (T-NPN) or a cottonseed meal (T-CSM) supplement. In Experiment 1, young and older steers were measured during the late dry season (LDS) and the rainy season (RS), while steers in Experiments 2–4 were measured through the annual cycle. Because of severe drought the measurements during Experiment 3 annual cycle were limited to T-NIL steers. Pasture availability and species composition were measured twice annually. Diet was measured at 1–2 week intervals using near infrared spectroscopy of faeces (F.NIRS). Annual rainfalls (1 July–30 June) were 42–68% of the long-term average (471 mm), and the seasonal break ranged from 17 December to 3 March. There was wide variation in pasture, diet (crude protein (CP), DM digestibility (DMD), the CP to metabolisable energy (CP/ME) ratio) and steer liveweight change (LWC) within and between annual cycles. High diet quality and steer liveweight (LW) gain during the RS declined progressively through the transition season (TS) and early dry season (EDS), and often the first part of the LDS. Steers commenced losing LW as the LDS progressed. In Experiments 1 and 2 where forbs comprised ≤15 g/kg of the pasture sward, steers selected strongly for forbs so that they comprised 117–236 g/kg of the diet. However, in Experiments 3 and 4 where forbs comprised substantial proportions of the pasture (173–397 g/kg), there were comparable proportions in the diet (300–396 g/kg). With appropriate stocking rates the annual steer LW gains were acceptable (121–220 kg) despite the low rainfall. The N supplements had no effect on steer LW during the TS and the EDS, but usually reduced steer LW loss by 20–30 kg during the LDS. Thus during low rainfall years in Mitchell grass pastures there were substantial LW responses by steers to N supplements towards the end of the dry season when the diet contained c. <58 g CP/kg or c. <7.0 g CP/MJ ME.

The economics of phosphorus supplementation of beef cattle grazing northern Australian rangelands

Context Phosphorus (P) deficiency occurs in beef cattle grazing many rangeland regions with low-P soils, including in northern Australia, and may severely reduce cattle productivity in terms of growth, reproductive efficiency and mortality. However, adoption of effective P supplementation by cattle producers in northern Australia is low. This is likely to be due to lack of information and understanding of the profitability of P supplementation where cattle are P-deficient. Aims The profitability of P supplementation was evaluated for two dissimilar regions of northern Australia, namely (1) the Katherine region of the Northern Territory, and (2) the Fitzroy Natural Resource Management (NRM) region of central Queensland. Methods Property-level, regionally relevant herd models were used to determine whole-of-business productivity and profitability over 30 years. The estimated costs and benefits of P supplementation were obtained from collation of experimental data and expert opinion of persons with extensive experience of the industry. The economic consequences of P supplementation at the property level were assessed by comparison of base production without P supplementation with the expected production of P-supplemented herds, and included the implementation phase and changes over time in herd structure. In the Katherine region, it was assumed that the entire cattle herd (breeders and growing cattle) grazed acutely P-deficient land types and the consequences of (1) no P supplementation, or P supplementation during (2) the dry season, or (3) both the wet and dry seasons (i.e. 3 scenarios) were evaluated. In the Fitzroy NRM region, it was assumed that only the breeders grazed P-deficient land types with three categories of P deficiency (marginal, deficient and acutely deficient), each with either (1) no P supplementation, or P supplementation during (2) the wet season, (3) the dry season, or (4) both the wet and dry seasons (i.e. 12 scenarios). Key results In the Katherine region, year-round P supplementation of the entire cattle herd (7400 adult equivalents) grazing acutely P-deficient pasture resulted in a large increase in annual business profit (+AU$500000). Supplementing with P (and N) only in the dry season increased annual business profit by +AU$200000. In the Fitzroy NRM region, P supplementation during any season of the breeder herd grazing deficient or acutely P-deficient pastures increased profit by +AU$2400–AU$45000/annum (total cattle herd 1500 adult equivalents). Importantly, P supplementation during the wet season-only resulted in the greatest increases in profit within each category of P deficiency, comprising +AU$5600, AU$6300 and AU$45000 additional profit per annum for marginal, deficient and acutely P-deficient herds respectively. Conclusions The large economic benefits of P supplementation for northern beef enterprises estimated in the present study substantiate the current industry recommendation that effective P supplementation is highly profitable when cattle are grazing P-deficient land types. Implications The contradiction of large economic benefits of P supplementation and the generally low adoption rates by the cattle industry in northern Australia suggests a need for targeted research and extension to identify the specific constraints to adoption, including potential high initial capital costs.

Diets selected and growth of steers grazing buffel grass (Cenchrus ciliaris cv. Gayndah)–Centro (Centrosema brasilianum cv. Oolloo) pastures in a seasonally dry tropical environment

Context Liveweight (LW) gain of grazing cattle in the seasonally dry tropics is usually moderate during the wet season (WS) and declines to slow growth or LW loss during the dry season (DS). Cattle growth can often be improved by inclusion of herbaceous legumes into pastures to improve their nutritional quality. Aims A study examined the quality of the diet selected and the growth of young cattle grazing a buffel grass (Cenchrus ciliaris)–Centro (Centrosema brasilianum) pasture in a high-rainfall, seasonally dry, tropical environment in northern Australia to relate the diet selected to cattle growth. Methods During three annual cycles, young steers grazed a grass–Centro legume pasture at moderate stocking rate. LW was measured monthly, and diet attributes (legume content, DM digestibility (DMD) and crude protein concentration) were measured fortnightly by near-infrared reflectance spectroscopy analyses of faeces. Pasture available and species were measured twice annually. Key results The annual LW gain and diet attributes followed a consistent profile through the annual cycles. Following the seasonal break, the diet DMD and crude protein concentration increased abruptly to maxima (means 732 and 184 g/kg respectively), and then declined approximately linearly during the remainder of the WS and the wet–dry transition season (TS); DMD decreased by 0.49, 0.74 and 0.88 g/kg units per day. DMD and crude protein averaged 561 and 61 g/kg respectively during the DS. Centro comprised 86–291 g/kg of the pasture on offer, and averaged 283 and 205 g/kg of the diet during the TS and DS, respectively, but only 58 g/kg during the WS. Cattle selected for Centro during the TS and the DS, but not during the WS. Cattle LW gain reflected diet quality averaging 0.86, 0.59 and 0.12 kg/day during the WS, TS and DS respectively. Conclusions The Centro legume contributed substantially to the diet of growing cattle during the TS and DS, but not during the WS. The LW gains of cattle were moderate during the WS and TS, and low during the DS. Implications Centro in a buffel grass pasture contributed substantially to the diet, but nevertheless annual LW gain was only modest (mean 179, range 159–209 kg/annum).

Estimating the voluntary intake by sheep of tropical grasses from digestibility, regrowth-age and leaf content: a meta-analysis

Context The voluntary intake (VI) of forages by ruminants is usually estimated from diet DM digestibility (DMD), but may be related also to the age of regrowth and the leaf blade content (Leaf) of the forage. Aim To examine the reliability of the prediction of the VI of tropical grasses by sheep from the DMD, Leaf and Regrowth-age characteristics of the forage. Methods Data from eight experiments with mature sheep fed tropical grass hay diets (n = 229) were used to explore prediction of VI of DM (VIDM), digestible DM (DDM) (VIDDM) and estimated metabolisable energy from the DMD, Leaf and Regrowth-age of the forage. Key results The variables were generally correlated. In data pooled across experiments the VI (g/kg W0.75.day) of DM was poorly correlated with DMD, Leaf or Regrowth-age (r = 0.30–0.52). The regressions between VI and each of the variables differed among experiments in elevation (P &lt; 0.001) but generally not in slope. When ‘experiment’ was included as a factor the VIDM (g/kg W0.75.day) = K + 0.0912 × DMD (R2 0.80; r.s.d. 6.8; K range –26.0 to +7.8; P &lt; 0.001). Also VIDM = K + 0.069 × DMD + 0.020 × Leaf (R2 0.88; r.s.d. 5.4; DMD and Leaf, P &lt; 0.001); thus inclusion of Leaf reduced the r.s.d. while K ranged widely (–20.5 to +12.0). The voluntary intake of digestible DM (VIDDM) = K + 0.081 × DMD + 0.011 × Leaf (R2 0.89; r.s.d. 3.2; DMD and Leaf P &lt; 0.001; K range –35.0 to –16.3). Regrowth-age was correlated with both Leaf and DMD, and VIDM was predicted by Regrowth-age or Leaf with comparable error. Because numerous factors alter the composition of grasses at a specific Regrowth-age the DMD should be a more generally suitable variable to predict intakes of forage DM and DDM. Conclusions The estimation of the VI of ruminants ingesting tropical grass forages can be improved if the diet Leaf is included with diet DMD as a predictor. However, the general prediction of VI of sheep may involve large errors. Implications Knowledge of the leaf content as well as the digestibility should improve estimation of VI of tropical grasses by ruminants.

Management of phosphorus nutrition of beef cattle grazing seasonally dry rangelands: a review

This review examines the effects of phosphorus (P) deficiency as a major constraint to productivity of cattle grazing rangelands with low-P soils. Nutritional deficiency of P may severely reduce liveweight (LW) gain of growing cattle (e.g. by 20–60 kg/annum) and the productivity of breeder cow herds as weaning rate, mortality and calf growth. In seasonally dry tropical environments, the production responses to supplementary P occur primarily during the rainy season when the nutritional quality of pasture as metabolisable energy (ME) and protein is high and pasture P concentration is limiting, even though the P concentrations are higher than during dry season. When ME and nitrogen of rainy-season pasture are adequate, then P-deficient cattle typically continue to gain LW slowly, but with reduced bone mineralisation (i.e. osteomalacia). In beef breeder herds when diet P is insufficient, cows with high bone P reserves can mobilise bone P reserves during late pregnancy and early lactation. Mobilisation may contribute up to the equivalent of ~7 g diet P/day (one-third of the P requirements) in early lactation, and, thus, allow acutely P-deficient breeders to maintain calf growth for at least several months until depletion of cow body P reserves. However, severe P deficiency in cattle is usually associated with reduced voluntary intake (e.g. by 20–30% per kg LW), severe LW loss and poor reconception rates. When P intake is greater than immediate requirements, breeders can replenish bone P. Replenishment in mature cows occurs slowly when ME intake is sufficient only for slow LW gain, but rapidly at ME intakes sufficient for rapid LW gain. Bone P replenishment also occurs in late-pregnant heifers even when losing maternal LW. Intervals of mobilisation and replenishment of body P reserves will often be important for P nutrition of beef breeder cows through annual cycles. Diagnosis of P deficiency in grazing cattle is difficult and must encompass estimation of both diet P intake and availability of P from body reserves. Cattle behaviour (e.g. pica, osteophagea), low soil P concentrations and low herd productivity provide valuable indicators. Some constituents of blood (plasma inorganic P, calcium, plasma inorganic P:calcium ratios and endocrine markers) are valuable indicators, but the threshold values indicative of P deficiency at various ME intakes are not well established. It is evident that knowledge of both the nutritional physiology and requirements for P provide opportunities to better manage P nutrition to alleviate production losses in low-input systems with beef cattle grazing rangelands.

Learned behaviours lead to bone ingestion by phosphorus-deficient cattle

Grazing cattle deficient in phosphorus (P) often seek out and chew bones, apparently to obtain dietary P. To investigate this phenomenon heifers naïve to P deficiency were either fed a P-deficient diet (LowP) or grazed P-adequate pasture (AdeqP), and preference tests examined their attraction to weathered bones or a control of wood. During Phase 1 (Days 1–145), the LowP heifers developed severe P deficiency and pica, but demonstrated little attraction to weathered bones. During Phase 2 (Days 146–155), heifers were allowed to interact with and to chew a variety of weathered bones. After this experience LowP heifers were more attracted to bones during Phase 3 (Days 156–166) than during Phase 1 (P &lt; 0.05), and more attracted than AdeqP heifers during either phase. Subsequently, in Phase 4 (Days 167–171), LowP heifers were more attracted than AdeqP heifers (P &lt; 0.01) to weathered bones than to a control of wood, and in Phase 5 (Days 172–176) to bones with more extended weathering. During Phase 6 (Days 177–182), attraction was reduced when bones were placed inside a cloth bag. The olfactory constituents from weathered bones were dominated by aliphatic aldehydes and ketones, consistent with long-chain fatty acid breakdown. It was concluded that attraction of P-deficient cattle to seek and ingest bones is primarily a learned response. Smell, taste and visual appearance all appear to be important cues for attraction. Pica is likely important in causing P-deficient cattle to investigate unusual materials, including bones, resulting in cattle learning by making an association between bone chewing and P ingestion.

Nitrogen recycling and feed efficiency of cattle fed protein-restricted diets

The ability of cattle to grow and reproduce when ingesting low-protein diets is a crucial attribute for productive beef cattle systems in the seasonally dry tropics and subtropics. Nitrogen (N) recycling to the rumen is an important and known physiological mechanism allowing ruminants to efficiently grow in low-protein diets, but is usually disregarded in the nutritional models. This review discusses the role and magnitude of N recycling to provide additional N as microbial substrate in the rumen and in determining the efficiency of ruminants ingesting low-protein diets, to better understand the major factors regulating N recycling to the rumen. In addition to a review of the literature, study-adjusted regressions were used to evaluate various aspects of crude protein (CP) intake and availability, N recycling and excretion. There is large variation in N excretion and N-use efficiency among diets and among individuals, illustrating the opportunity for improvement in overall efficiency of cattle production. These data indicated that N recycling to the entire gastrointestinal tract supplies from half to twice as much N available for microbial growth as does the diet. Addition of rumen-degradable protein can increase rumen efficiency in using the available energy, as, conversely, the addition of fermentable energy can increase rumen efficiency in using the available CP. The present review has demonstrated that both are possible because of greater N recycling. Also, the importance of preserving the available N for determining individual variation in feed efficiency and the implications for selection are discussed. Nitrogen recycling can be controlled at both the epithelial wall of compartments of the gastrointestinal tract and at the liver, where ureagenesis occurs. Addition of fermentable energy can increase N recycling to the rumen and to post-ruminal tract by acting at both sites, and the mechanisms for this are discussed in the text. Although the effect of altering CP concentration in the diet has been substantially investigated, other factors potentially modulating N recycling, such as total fermentable energy, sources of protein and energy, hormonal modulation, and genetic variance, remain poorly understood. The selection of more efficient animals and development of diets with a lower environmental impact inescapably means further elucidation of the N-recycling mechanism.

Bone mineral density in the tail-bones of cattle: effect of dietary phosphorus status, liveweight, age and physiological status

In three grazing experiments in the seasonally dry tropics of Australia, growing steers (Experiment 1), first-calf cows (Experiment 2) and mature breeder cows (Experiment 3), ingested diets for 12–17 months, which were either adequate or severely deficient in phosphorus (P) (Padeq and Pdefic, respectively). Bone mineral density (BMD) at the proximal end of the ninth coccygeal vertebra (Cy9) was measured at intervals using single photon absorptiometry (SPA). Liveweight (LW) and plasma inorganic phosphorus (PIP) concentrations were monitored at intervals and rib-bone cortical bone thickness (CBT) of biopsy samples was measured at the end of Experiments 1 and 3. Measurements of LW change, PIP concentrations and CBT confirmed that diet P intakes of cattle in the Padeq treatments were adequate whereas there was severe and chronic P deficiency in the Pdefic treatments. In Experiment 1 BMD in Padeq steers increased with LW and age from ~0.25–0.27 g/cc (8 months, 200 kg LW) to ~0.34 g/cc (32 months, 490 kg LW), whereas in Pdefic steers BMD decreased progressively to ~0.23–0.24 g/cc. Although BMD decreased in the Pdefic steers bone volume of Cy9 (calculated from tail-bone thickness) increased, and some net bone deposition in the Cy9 continued. Rib-bone CBT and tail-bone BMD at the end of Experiment 1 were closely correlated (r = 0.93). In Experiment 2 BMD was initially 0.33 g/cc (~25 months, 400 kg LW) and did not change through pregnancy and lactation in Padeq cows. However, in the Pdefic cows there was a gradual decline in BMD to ~0.25 g/cc. There was no change in dimensions of the Cy9 so the decreases in BMD involved net demineralisation of bone. In Experiment 3 BMD was less responsive to P deficiency than in Experiments 1 and 2. Only after ~11 months was BMD reduced (P < 0.05) in the Pdefic cows, and then only by 15%. In contrast, rib-bone CBT decreased by 30% due to P deficiency, and BMD was poorly correlated with CBT (r = 0.4). The effects of animal weight, age and maturity on tailbone BMD of P-adequate animals, and the different responses to P deficiency observed in young growing steers, first-calf cows and mature breeders are discussed in relation to the use of SPA measured tail-bone BMD to diagnose P deficiency in grazing cattle.

Inclusion of cottonseed meal into loose mineral mix supplements increases the voluntary intake of the supplement by grazing heifers

Loose mineral mix (LMM) supplements based on ingredients such as salt, urea and minerals offered ad libitum are widely used to provide additional nutrients to grazing cattle, but it is often difficult to achieve target intakes. An experiment with heifers grazing mature tropical pasture examined the effects of substituting 80, 160 or 320 g/kg of the salt in a LMM supplement with cottonseed meal on the voluntary intake of the LMM supplements by paddock groups of heifers over 10 weeks. Average voluntary intake of a LMM containing (g/kg) 640 salt, 300 urea and 60 ammonium sulfate (40.2 g DM and 6.14 g total nitrogen/day) was increased linearly (P < 0.001) to 50.8 g DM and 8.88 g total nitrogen/day when up to 320 g/kg cottonseed meal was substituted for salt in the LMM. This increase in intake of nitrogen in LMM was due to the increase in voluntary intake of the supplement rather than the increased nitrogen concentration of supplement. The distribution of daily intake of supplement within paddock groups of heifers was estimated during Weeks 5 and 10 using supplements labelled with lithium sulfate. Neither the coefficient of variation within paddock groups of heifers in supplement intake (mean 96%), nor the proportion of non-consumers of supplement (mean 17%), was changed (P > 0.05) by substitution of salt with cottonseed meal. In conclusion, the inclusion of a palatable protein meal into LMM increased the voluntary intake of this type of supplement.

New candidate markers of phosphorus status in beef breeder cows

Determining the phosphorus (P) status of cattle grazing P-deficient rangelands in northern Australia is important for improving animal production in these areas. Plasma inorganic P concentration is currently the best diagnostic marker of dietary P deficiency in growing cattle but is not suitable for assessing the P status of breeder cows, which often mobilise substantial bone and soft tissue reserves in late pregnancy and lactation. Markers of bone turnover offer potential as markers of P status in cattle, as they reflect bone mobilisation or bone formation. Recent experiments investigating the physiology of beef breeder cows during diet P deficiency have indicated that the ratio of plasma total calcium concentration to plasma inorganic P concentration might be suitable as a simple index of P deficiency. However, a more specific measure of increased bone mobilisation in P-deficient breeders is plasma concentration of C-terminal telopeptide of Type 1 collagen. Also, plasma concentration of bone alkaline phosphatase is a marker of defective bone mineralisation in dietary P deficiency. These candidate markers warrant further investigation to determine their predictive value for P deficiency in cattle.

Utilising mobilisation of body reserves to improve the management of phosphorus nutrition of breeder cows

Phosphorus (P) deficiency is a major constraint to the productivity of breeder herds grazing low-P rangelands due to adverse effects on growth and fertility. However, P supplementation during the wet season, when additional dietary P is most needed, is often difficult due to practical constraints. Body P reserves in breeders can be mobilised and alleviate dietary P deficiency within an annual cycle. Approaches to estimate bone P reserves and net mobilisation or replenishment of P from the analysis of rib and hip (tuber coxae) biopsies are discussed. In at least some circumstances, breeder cows grazing P-deficient pastures mobilise bone P to alleviate the effects of diet P deficiency. Recent experiments with breeders have investigated mobilisation of body P to alleviate the adverse effects of dietary P deficiency during pregnancy and early lactation, and subsequent replenishment of body P reserves. Both mature cows and first-calf cows (FCC) calving in a high P status and fed severely P-deficient diets during lactation were able to mobilise sufficient body P reserves to provide milk for moderate calf growth (viz. 0.6–0.8 kg liveweight (LW)/day for 3 months), but this was associated with rapid cow-LW loss and markedly decreased bone P content. First-calf cows appear to have lesser capacity than mature cows to mobilise body P. FCC fed P-adequate diets during late pregnancy maintained high voluntary intakes and had higher LW and bone P reserves at calving. When fed a P-deficient diet during early lactation, these greater bone P reserves were utilised. Bone P reserves can be replenished by P-adequate diets fed post-weaning. Breeder management that relies more on mobilising body P reserves when P demands are high and on replacing these body P reserves when P demands are lower offers an opportunity to alleviate the effects of dietary P deficiencies during the early wet season in situations where P supplementation is not possible.

The Shindig project: some lessons in implementing the GEHR architecture

In recent years there have been a number of projects and initiatives at local and national level to develop clinical information systems either for small-scale research or for wide-scale collation of information. The SHINDIG project undertook to provide a solution to the exchange of diabetes information between a general practice (GP) clinic and two hospitals. The consortium elected to base the development of the system on the information model developed for the EU-funded Good European Health Record (GEHR) project for which the development of a proof-of-concept prototype information system (known as PRISM) was already well underway. This paper looks at the aims, achievements and problems encountered during the SHINDIG project and draws a number of lessons from the development of one of the first systems to attempt to implement the GEHR architecture. Recommendations for consideration are also given to those embarking on similar projects and to inform the continued work in the healthcare record standards arena.

Black Sea tele-diab: development and implementation of an electronic patient record for patients with diabetes

Black Sea tele-diab (BSTD) is a three-year European Union (EU)-funded International Collaboration (INCO) Telematics Application Project to develop a standardized software package (in the national languages of the partners) for the storage and transfer of medical information collected from patients with diabetes. The software utilizes an electronic medical record architecture based on the Good European Health Record, developed within the Advanced Informatics in Medicine programme. Software development is being carried out by the partners in Eastern Europe, which will help promote the development of medical informatics and communication technologies among countries of Central Europe (CCE) and newly independent states (NIS) countries. The diabetes data set is based on the WHO Europe DiabCare Basic Information Sheet; the project therefore supports the World Health Organisation (WHO) Quality Care Programme for monitoring the prevalence and incidence of diabetic complications across Europe. Diabetes is used as a model, as standards for data collection and clinical care are well developed and the concepts applied and learnt in diabetes will be generally applicable to other chronic diseases and medical disciplines.

Validation of single photon absorptiometry for on-farm measurement of density and mineral content of tail bone in cattle

A validation study examined the accuracy of a purpose-built single photon absorptiometry (SPA) instrument for making on-farm in vivo measurements of bone mineral density (BMD) in tail bones of cattle. In vivo measurements were made at the proximal end of the ninth coccygeal vertebra (Cy9) in steers of two age groups (each n = 10) in adequate or low phosphorus status. The tails of the steers were then resected and the BMD of the Cy9 bone was measured in the laboratory with SPA on the resected tails and then with established laboratory procedures on defleshed bone. Specific gravity and ash density were measured on the isolated Cy9 vertebrae and on 5-mm2 dorso-ventral cores of bone cut from each defleshed Cy9. Calculated BMD determined by SPA required a measure of tail bone thickness and this was estimated as a fraction of total tail thickness. Actual tail bone thickness was also measured on the isolated Cy9 vertebrae. The accuracy of measurement of BMD by SPA was evaluated by comparison with the ash density of the bone cores measured in the laboratory. In vivo SPA measurements of BMD were closely correlated with laboratory measurements of core ash density (r = 0.92). Ash density and specific gravity of cores, and all SPA measures of BMD, were affected by phosphorus status of the steers, but the effect of steer age was only significant (P < 0.05) for steers in adequate phosphorus status. The accuracy of SPA to determine BMD of tail bone may be improved by reducing error associated with in vivo estimation of tail bone thickness, and also by adjusting for displacement of soft tissue by bone mineral. In conclusion a purpose-built SPA instrument could be used to make on-farm sequential non-invasive in vivo measurements of the BMD of tailbone in cattle with accuracy acceptable for many animal studies.

Controlling voluntary intake of molasses-based supplements in grazing cattle

Molasses-based liquid supplements fed ad libitum are widely used to provide additional metabolisable energy, non-protein N (NPN) and other nutrients to grazing cattle, but it is often difficult to achieve target intakes of supplementary nutrients. Experiments examined the effects of increasing concentrations of phosphoric acid, urea and ammonium sulfate on the voluntary intake (VI) of molasses-based supplements offered ad libitum to heifers grazing tropical pastures. In Experiment 1, the VI of a supplement containing 78 g urea/kg and 26 g phosphoric acid/kg as-fed (M80U+PA) was 3.61 g DM/kg liveweight (LW) per day, and provided 181 mg NPN and 32.4 mg phosphorus (P)/kg LW per day. Increasing the urea content of the supplement to 137 g/kg (M140U+PA) or 195 g/kg (M200U+PA) reduced VI of supplement DM, NPN and P by up to 76%, 44% and 80%, respectively. VI of supplement containing ammonium sulfate (M140+AS+PA) was lower (P < 0.05) than that of M140U+PA supplement, and tended (P > 0.05) to be lower than that of M200U+PA supplement. In experiment 2, the VI by heifers of a supplement containing 200 g urea/kg (M200U) was 1.53 g supplement DM/kg LW per day, which provided 186 mg NPN/kg LW per day. Inclusion of 49 g phosphoric acid/kg as-fed in this supplement (M190U+50PA) reduced (P < 0.05) VI of supplement DM and NPN by 33% and 36%, respectively, while inclusion of 97 g phosphoric acid/kg (M180U+100PA) reduced (P < 0.05) VI of supplement DM and NPN by 43% and 48%, respectively. The M190U+50PA and M180U+100PA supplements provided 16 and 26 mg P/kg LW per day, respectively. Heifers not fed supplements gained 0.07 kg/day, and the M200U supplement increased (P < 0.05) LW gain to 0.18 kg/day. LW gain was further increased (P < 0.05) by the M190U+50PA to 0.28 kg/day, indicating a growth response to supplementary P. No adverse effects of the supplements on animal health were observed in any of the experiments. In conclusion, addition of urea and/or phosphoric acid to molasses supplements effectively reduced VI of supplementary DM, NPN and P, and in the circumstances of Experiment 2, both molasses-urea and P supplements increased heifer LW.

Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies

Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

Nutrition of beef breeder cows in the dry tropics. 1. Effects of nitrogen supplementation and weaning on breeder performance

The effects of two dry season management strategies consisting of timing of weaning and/or nitrogen (N) supplementation on the body reserves, nutritional status and reproductive performance were, commencing in the early dry season, examined in Bos indicus × Bos taurus breeder cows (n = 122) grazing native pasture in the seasonally dry tropics. Cows were early-weaned in April in the early dry season or late-weaned in September in the late dry season. The supplement consisted of loose mineral mix which provided on average 14 g N/day, principally as non-protein N. In the early dry season in April 1997 all of the cows had been lactating for 3–5 months, averaged 363 kg (s.d. = 28) conceptus-free liveweight (CF.LW) and 4.7 (s.d. = 0.6) body condition score (9-point scale), and 53% were pregnant. In addition, from April to June 1997 10/26 non-pregnant lactating cows, and 24/31 non-pregnant non-lactating (i.e. early-weaned) cows became pregnant so that 81% of cows were pregnant by June. Predictions of diet from near-infrared spectroscopy of faeces indicated that the forage diet selected during the dry season (April–November) by the cows contained on average 9% (s.d. = 2) non-grass dicotyledonous plants and 4.4% (s.d. = 0.38) crude protein (CP), while DM digestibility was 51.1% (s.d. = 1.3). The diet CP concentration, the ratio of CP to metabolisable energy (ME) in the diet (mean 5.7, s.d. = 0.53, g CP/MJ ME) and faecal N concentration (mean 1.05, s.d. = 0.097, % N) all indicated that unsupplemented cows were deficient in dietary N during the dry season. Microbial CP synthesis in unsupplemented non-lactating cows decreased from 360 to 107 g microbial CP/day, or from 6.5 to 2.4 g microbial CP/MJ ME intake, as the dry season progressed from May to September 1997. Net endogenous N transfer to the rumen of up to 2 g CP/MJ ME apparently occurred from May to August. Microbial CP synthesis was 25% higher (P < 0.001) in lactating than in non-lactating cows. From April to September cow CF.LW was improved by 0.35 kg/day (P < 0.001) by early weaning, and by 0.11 kg/day (P < 0.10) by N supplementation, but there was no interaction (P > 0.10) between these treatments. From April to June 1997 calf LW gain averaged 0.79 kg/day, but from June to September was only 0.10 kg/day in unsupplemented paddocks and 0.13 kg/day in N-supplemented paddocks. Pregnant cows calved from November 1997 to March 1998. During subsequent mating 96% of non-lactating cows, but only 17% of lactating cows became pregnant. During the 1997–98 wet season there was compensatory LW gain of lower CF.LW non-lactating cows but not of lactating cows. In conclusion, weaning early in the dry season had a much greater effect than a non-protein N-based supplement to conserve breeder cow body reserves, and the effects of the two management strategies were additive.

Nutrition of beef breeder cows in the dry tropics. 2. Effects of time of weaning and diet quality on breeder performance

In the seasonally dry tropics the effects of three times of weaning and three nutritional regimes on the changes in liveweight (LW) and body condition score (BCS) of grazing Bos indicus × Bos taurus breeder cows (n = 210) and their calves were examined through an annual cycle, commencing in the early dry season in April 1998. Most of the cows (n = 180) were lactating initially, and were weaned in April (W1), July (W2) or September (W3) to represent the expected early, mid and late dry season. In addition, cows that had not lactated for 11 months before the experiment commenced (NOCALF treatment; n = 30) were examined. The seasonal break occurred in late August, 3.5 months earlier than average for the site. The nutritional regimes consisted of a native pasture (LOW), another native pasture augmented with Stylosanthes spp. legumes (MEDIUM), or this latter pasture supplemented during the dry season with molasses-urea (HIGH). These nutritional regimes were imposed from the commencement of the experiment in April 1998 until February 1999, except that for the HIGH treatment the supplement was fed only during the dry season. Near-infrared reflectance spectroscopy of faeces (F.NIRS) was used to estimate the contents of non-grass, crude protein (CP) and DM digestibility of the diet selected, and also DM intake and metabolisable energy (ME) intake. Diet quality was in accord with the expected seasonal cycle, and was consistently lower (P < 0.05) for the LOW than for the MEDIUM treatment. Concentrations of CP and CP/MJ ME in the diet, and of N in faeces, indicated that the cows grazing the LOW treatment were deficient in rumen degradable protein during the dry season. There was no interaction (P > 0.05) between the nutritional regime and the time of weaning on changes in conceptus-free liveweight (CF.LW) or BCS during the dry season. Weaning increased breeder CF.LW, relative to lactating breeders, by 0.42 kg/day in the early dry season (April–July; the difference between the W1 and W2 treatments), and 0.18 kg/day in the usual mid dry season (July–September; the difference between the W2 and W3 treatments). The NOCALF treatment cows were initially 79 kg heavier than lactating cows, and lost more LW during the dry season. Microbial CP synthesis was 21 and 29% greater (P < 0.05) in lactating than in non-lactating cows in the late dry season and shortly after the seasonal break (August and September), respectively. Calf growth was not affected (P > 0.05) by nutritional regime during the early dry season (April–July), but was lower for the LOW nutritional regime during the usual mid dry season (July–September); this indicated that the LOW nutritional regime cows mobilised sufficient additional body reserves to maintain milk production during the former, but not the latter, interval. All cows that were lactating at the commencement of the experiment gained CF.LW rapidly from September 1998 following the seasonal break. In conclusion, although nutrition affected LW change of both cows and calves, there was a much larger effect of weaning than of the nutrition treatments examined on conservation of body reserves in breeder cows during the dry season. The observation that the effects of weaning on conservation of cow body reserves were similar across a wide range of nutrition is important for management to achieve appropriate targets for breeder cow body reserves.

A double-blind, randomized, placebo-controlled, single-dose study of the cyclooxygenase-2 inhibitor, GW406381, as a treatment for acute migraine

The objective of the present study was to explore the clinical efficacy and tolerability of GW406381, a cyclooxygenase-2 (COX-2) inhibitor with relatively high CNS penetration, in acute migraine. This was a double-blind, single-dose study of GW406381 compared with placebo and naproxen sodium compared with placebo (protocol number CXA20008). Three hundred and thirty-seven subjects were randomized 1:1:1 to GW406381 (70 mg), naproxen sodium (825 mg), or placebo for the treatment of one migraine headache of moderate or severe intensity in a potential 8-week period. The primary end-point was the proportion of subjects with headache relief [reduction in headache severity score from pre-dose 2 (moderate) or 3 (severe) to 0 (no pain) or 1 (mild)] at 2 h post-dose for GW406381 compared with placebo. Significantly higher proportions of subjects treated with GW406381 (50%, P = 0.032) or naproxen sodium (56%, P = 0.005) than with placebo (35%) reported headache relief at 2 h post-dose. Additional significant benefits were observed on many secondary outcomes, including proportions of subjects pain-free, for both GW406381 and naproxen sodium treatment compared with placebo. Both active treatments were well tolerated. Single-dose GW406381 (70 mg) and naproxen sodium (825 mg) were effective and well tolerated in the treatment of acute migraine.

Diet quality and liveweight gain of steers grazing Leucaena - grass pasture estimated with faecal near infrared reflectance spectroscopy (F.NIRS)

Three drafts of Bos indicus cross steers (initially 178–216 kg) grazed Leucaena–grass pasture [Leucaena leucocephala subspecies glabrata cv. Cunningham with green panic (Panicum maximum cv. trichoglume)] from late winter through to autumn during three consecutive years in the Burnett region of south-east Queensland. Measured daily weight gain (DWGActual) of the steers was generally 0.7–1.1 kg/day during the summer months. Estimated intakes of metabolisable energy and dry matter (DM) were calculated from feeding standards as the intakes required by the steers to grow at the DWGActual. Diet attributes were predicted from near infrared reflectance spectroscopy spectra of faeces (F.NIRS) using established calibration equations appropriate for northern Australian forages. Inclusion of some additional reference samples from cattle consuming Leucaena diets into F.NIRS calibrations based on grass and herbaceous legume–grass pastures improved prediction of the proportion of Leucaena in the diet. Mahalanobis distance values supported the hypothesis that the F.NIRS predictions of diet crude protein concentration and DM digestibility (DMD) were acceptable. F.NIRS indicated that the percentage of Leucaena in the diet varied widely (10–99%). Diet crude protein concentration and DMD were usually high, averaging 12.4 and 62%, respectively, and were related asymptotically to the percentage of Leucaena in the diet (R2 = 0.48 and 0.33, respectively). F.NIRS calibrations for DWG were not satisfactory to predict this variable from an individual faecal sample since the s.e. of prediction were 0.33–0.40 kg/day. Cumulative steer liveweight (LW) predicted from F.NIRS DWG calibrations, which had been previously developed with tropical grass and grass–herbaceous legume pastures, greatly overestimated the measured steer LW; therefore, these calibrations were not useful. Cumulative steer LW predicted from a modified F.NIRS DWG calibration, which included data from the present study, was strongly correlated (R2 = 0.95) with steer LW but overestimated LW by 19–31 kg after 8 months. Additional reference data are needed to develop robust F.NIRS calibrations to encompass the diversity of Leucaena pastures of northern Australia. In conclusion, the experiment demonstrated that F.NIRS could improve understanding of diet quality and nutrient intake of cattle grazing Leucaena–grass pasture, and the relationships between nutrient supply and cattle growth.

Faecal near infrared reflectance spectroscopy estimates of diet quality and responses to nitrogen supplements by cattle grazing Bothriochloa pertusa pastures

A grazing experiment in the seasonally dry tropics of north Queensland examined the diet selected and the growth responses of Bos indicus steers to urea supplement over two dry seasons and one wet season, from August 2001 to January 2003. There were two groups of 10 steers (control and urea-supplemented) and each group comprised two age cohorts, A and B, of five steers each with an age difference of ~1 year. In June 2002, cohort A steers were replaced with steers 2 years younger (cohort C). The steers grazed Bothriochloa pertusa pastures on a low fertility Red Chromosol soil. The groups were switched between two adjoining paddocks at fortnightly intervals when they were weighed and faecal samples were collected for faecal near infrared reflectance spectroscopy (F.NIRS) estimates of diet quality and growth rate. Rainfall and diet quality followed the expected seasonal pattern, but the 2001–02 wet season was very short (November–January) with only 65% of the long-term average rainfall. There was no rain during the 2001 dry season (DS-1) from August to mid November, and no effective rain (17 mm) between February and December 2002. Non-grass (i.e. herbaceous dicot plants) made only a small contribution to the diet, averaging 13%. In DS-1 and in the dry season of 2002 (DS-2) diet crude protein (CP) averaged 2.5% and 2.9%, and DMD/CP (ratio of dry matter digestibility to CP) averaged 18.6 and 17.1, respectively. Liveweight (LW) loss in control steers during DS-1 averaged 32 kg. Urea supplement reduced LW loss by 18 kg (P < 0.001), but most of the benefit was lost during the following growing season. During the extended dry period in 2002, average LW losses of control steers were 85 and 47 kg in the older and younger cohorts, respectively, and supplementation with urea reduced weight losses by 53 and 31 kg, respectively (P < 0.001). F.NIRS predicted the cumulative LW of the unsupplemented steers in cohorts A and B with acceptable accuracy, the difference between the observed and predicted final LW being 6 kg for cohort A after 10 months, 12 kg for cohort B after 17 months, and 27 kg for cohort C after 7 months. The results demonstrated that F.NIRS can be effectively used to monitor dietary CP and DMD levels in grazing cattle, to help develop an understanding of cattle responses to urea supplement relative to the quality of the basal forage diet, and to provide useful decision support information for the nutritional management of grazing cattle.

Thyroid hormone abnormalities and outcome in dogs with non-thyroidal illness

OBJECTIVES

To document thyroid hormone abnormalities in dogs with non-thyroidal illness and identify markers of prognostic value.

METHODS

Circulating total and free thyroxine, total triiodothyronine and thyrotropin concentrations were measured in 196 dogs with non-thyroidal illness. Clinical signs, previous medications and outcome were recorded in each case. Data were analysed to determine endocrine prognostic factors, and to document the prevalence of thyroid hormone abnormalities.

RESULTS

Total triiodothyronine, and total and free thyroxine concentrations were decreased in 75.9, 34.7 and 4.5 per cent of cases, respectively. Dogs which were euthanased had significantly decreased total triiodothyronine, and total and free thyroxine concentrations compared with those which made a full recovery. Total triiodothyronine concentrations were significantly lower in dogs that were euthanased compared with those which made a partial recovery.

CLINICAL SIGNIFICANCE

Thyroid hormone concentrations may be used as prognostic indicators in dogs with non-thyroidal illness. Low triiodothyronine syndrome may be more common in dogs than previously recognised.

Faecal near infrared reflectance spectroscopy (F.NIRS) measurements of non-grass proportions in the diet of cattle grazing tropical rangelands

Frequent faecal near infrared reflectance spectroscopy (F.NIRS) analyses of faeces from cattle grazing a range of tropical pastures were used to measure the non-grass component, and other aspects, of their diets. Seasonal profiles of non-grass and crude protein in the diet are presented for nine sites from the speargrass, Aristida–Bothriochloa, and Mitchell grass dominated pasture regions, and for three shrubland sites where browse was plentiful. In grass-dominated native pastures of the speargrass and Aristida–Bothriochloa pasture regions of Queensland where little browse was available, non-grass was usually only 5–15% of the diet. Diet non-grass was even lower for a buffel grass pasture. In uncleared eucalypt woodland in the speargrass region, browse may have contributed up to 20% of the diet in the late dry season when grasses were senesced. In regions with abundant browse (e.g. mulga lands and desert upland systems) cattle preferentially selected actively growing grasses and forbs when they were available. With diminishing availability or declining quality of the forbs and grass due to grazing selection and dry conditions, browse increasingly contributed to intake. In Mitchell grass dominated pastures forbs often comprised more than 50% of the diet, and there appeared to be strong selection for forbs during the dry season. Where browse was available in association with Mitchell grass dominated pastures, it appeared to contribute to intake only in the late dry season. Dry season sampling in monsoonal tallgrass and Mitchell grass dominated pastures indicated dietary crude protein to be linearly correlated with diet non-grass, demonstrating the importance of non-grass in the prevention or alleviation of dry season protein deficiency in cattle. Changes in diet selected by cattle in relation to season and rainfall were generally in accord with the previous limited information, largely with sheep, in comparable vegetation systems. The results demonstrate the value of F.NIRS technology to assist understanding of diet selection by grazing cattle in northern Australia.

Association of canine hypothyroidism with a common major histocompatibility complex DLA class II allele

Dogs exhibit a range of immune-mediated conditions including a lymphocytic thyroiditis which has many similarities to Hashimoto's thyroiditis in man. We have recently reported an association in Doberman Pinschers between canine hypothyroidism and a rare DLA class II haplotype that contains the DLA-DQA1*00101 allele. We now report a further series of 173 hypothyroid dogs in a range of breeds where a significant association with DLA-DQA1*00101 is shown.

Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 1: Maintenance of surgical arytenoid abduction and complications of surgery

REASONS FOR PERFORMING STUDY

Laryngoplasty (LP) is currently the most common surgical treatment for equine laryngeal paralysis, however, there have been no reports quantifying the degree of retention of arytenoid abduction following LP. Additionally, the complications of LP have been poorly documented.

OBJECTIVES

To record the degree of arytenoid abduction retention following LP and to accurately document all complications of surgery.

METHODS

A study (1986-1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP (using 2 stainless steel wires) and combined ventriculocordectomy was undertaken; 198 owners completed questionnaires, a median of 19 months following surgery. The degree of arytenoid abduction achieved was endoscopically, semi-quantitatively evaluated using a 5-grade system, at 1 day, 7 days, and 6 weeks after surgery.

RESULTS

On the day following LP, 62% of horses had good (median grade 2) arytenoid abduction, 10% had excessive (grade 1), and 5% had minimal (grade 4) abduction (overall-median grade 2). Due to progressive loss of abduction, moderate (median grade 3, range 1-5) abduction was present overall at 1 and 6 weeks after LP. Further surgery was required to re-tighten prostheses in 10% of cases with excessive loss of abduction, or to loosen prostheses in 7% of horses which had continuing high levels of LP abduction and significant post operative dysphagia. LP wound problems (mainly seromas and suture abscesses) were reported to last < 2 weeks in 9% of cases, < 4 weeks in 4% and > 4 weeks in 4%. The (partially sutured) laryngotomy wounds discharged post operatively for < 2 weeks in 22% of cases, < 4 weeks in 7% and for > 4 weeks in 2%. Coughing occurred at some stage post operatively in 43% of cases and its presence correlated significantly with the degree of surgical arytenoid abduction. This coughing occurred during eating in 24% of cases and was not associated with eating (or dysphagia) in the other 19% of cases. Chronic (> 6 months duration) coughing occurred in 14% of cases, but appeared to be due to intercurrent pulmonary disease in half of these horses.

CONCLUSIONS

Suturing the cricotracheal membrane allows most laryngotomy wounds to heal quickly. Laryngoplasty wound problems were of little long-term consequence when stainless steel wire prostheses were used.

POTENTIAL RELEVANCE

A significant loss of LP abduction occurs in most horses in the 6 weeks following surgery and efforts should be made to find ways to prevent such loss. However, excessive LP abduction is associated with post operative dysphagia and coughing.

Effects of supplement type and previous experience on variability in intake of supplements by heifers

Intakes, and variability in intakes, of a range of supplements were examined in groups (n = 10–20) of cattle grazing tropical native pasture in 24-ha paddocks. Intakes of supplement by individual animals were measured using lithium sulfate as a marker. In Expt 1, heifers (n = 160) were offered 1 of 4 supplements consisting of (i) a restricted amount of cottonseed meal (CSM); or ad libitum amounts of (ii) molasses containing 74 g urea/kg (M8U), (iii) a loose mineral mix (LMM) containing (g/kg) salt 390, urea 300, CSM 150, calcium phosphate 150, and sulfur 10, and (iv) feed block supplements containing (g/kg) molasses 494, urea 99, calcium phosphate 62, salt 62, bran 62, calcium oxide 148, and magnesium oxide 74. After 5 and 10 weeks the variation in supplement intake among heifers within a group was lower (P < 0.05) for CSM and M8U (coefficient of variation (CV) 24–37%) than for the LMM or block supplements (CV 55–118%). All heifers offered CSM or M8U consumed at least some supplement, but up to 5% and 20% of heifers were non-eaters of LMM or block supplement, respectively. Both the per�cent non-eaters of supplement and the variability in intake of these latter supplements tended (P < 0.10) to decline as the experiment progressed. In Expt 2 the same heifers were re-allocated to paddock groups and were offered ad libitum supplements of (i) M8U, (ii) molasses containing 107 g urea/kg (M12U), (iii) M8U mixed with monensin (M8U-M), or (iv) M8U mixed with meatmeal (M8U-MM). The CV of supplement intake ranged from 37 to 58%, and except in one paddock group offered M8U-MM, all heifers consumed at least some supplement. In Expt�3, paddock groups of heifers (n = 120) without, or with experience of LMM supplements during the previous dry season were offered LMM supplements containing either nil or 300�g CSM/kg. Voluntary intake of LMM supplement DM was increased (P < 0.001) by 93% by inclusion of CSM and decreased (P < 0.05) by 24% by previous experience of a similar LMM supplement. Neither variability in supplement intake (CV 66–150%) nor the per�cent non-eaters was significantly (P > 0.05) affected by previous experience of the heifers with LMM supplements or inclusion of CSM in the supplement. However, the per cent non-eaters of LMM supplement was inversely related to the mean voluntary intake of the supplement by the paddock group; when the average voluntary intake of the supplement by the paddock group exceeded 0.2 g DM/kg LW.day, then ≤10% of heifers were non-eaters of supplement. In conclusion, within groups of heifers offered LMM and block supplements the variability in intake and per cent non-eaters of supplement were higher than for cottonseed meal or molasses-urea supplements, and variability appeared to be associated with voluntary intake of the supplements.

Lithium salts as a marker of intake of supplements by cattle

In a series of experiments the appearance of lithium cation in plasma following ingestion or intravenous administration of lithium salts was measured in order to examine the suitability of lithium as a marker of supplement intake by cattle. In experiment 1, cattle were offered low quality hay ad libitum and 0.15, 0.4, 1.0 and 3.0 kg cottonseed meal (CSM) supplement per day. Following ingestion of lithium-labelled CSM, the lithium concentration in plasma reached a maximum after about 24 h and the subsequent decrease in concentration appeared to follow a single exponential relationship. The rate constant of this disappearance of lithium from plasma was greater (P<0.05) when 3.0 kg than when lesser amounts of lithium-labelled CSM were consumed. Plasma lithium concentrations 24 and 32 h after ingestion of lithium-labelled CSM were both linearly related to the amount of supplement consumed (r = 0.86 and 0.87, respectively, n = 32, P<0.001), indicating that the plasma lithium concentrations could be used to measure intakes of supplement by individual animals. In experiment 2, following intravenous administration of lithium chloride the disappearance of lithium from plasma over 96 h appeared to be best described by 3 exponential compartments. In experiment 3, cattle were offered molasses-based or loose mineral mix (LMM) supplement, or water, labelled with lithium and the rate constant of disappearance of lithium from plasma between 32 and 96 h was determined. The pattern of the decrease in plasma lithium concentration was similar to that observed in experiment 1. In experiment 4, the variation about the estimates of supplement intake was measured in heifers (n = 24) offered hay and water ad libitum and in addition a meal of 60 g of lithium-labelled molasses–urea supplement; between 20 and 28 h after ingestion of the lithium-labelled supplement the coefficient of variation (CV) among animals in plasma lithium concentration was about 15%. The likely errors associated with the use of lithium salts to measure intake of supplement are discussed. These experiments confirm that lithium salts can be used as a marker to estimate intake of supplement by individual animals.

Treatment and therapeutic monitoring of canine hypothyroidism

Thirty-one dogs with spontaneous hypothyroidism were treated with thyroid hormone replacement therapy (THRT) and monitored for approximately three months. Good clinical and laboratory control was ultimately achieved in all cases with a mean L-thyroxine (T4) dose of 0.026 mg/kg administered once daily. There was a significant increase and decrease in circulating total T4 and canine thyroid stimulating hormone (cTSH) concentrations, respectively, after starting THRT. After commencing treatment, 11 cases subsequently required an increase and three cases required a decrease in dose to achieve optimal clinical control. Median (semi interquartile range [SIR]) circulating six-hour post-pill total T4 (53.6 [27.91 nmol/litre) and cTSH (0.03 [0] microg/litre) concentrations were significantly increased and decreased, respectively, in treated dogs that did not require a dose change; corresponding values in treated dogs in which an increase in dose was required were 29.3 (12.7) nmol/litre and 0.15 (0.62) microg/litre, respectively. However, circulating cTSH measurement was of limited value in assessing therapeutic control because, although increased values were associated with inadequate therapy, reference range cTSH values were common in inadequately treated dogs. Lethargy and mental demeanour were typically the first clinical signs to improve, with significant bodyweight reduction occurring within two weeks of commencing THRT. Routine clinicopathological monitoring was of value in confirming a general metabolic response to THRT, but was of limited value in accurately monitoring cases or tailoring therapy in individual cases.

Urinary cortisol:creatinine ratios in healthy horses and horses with hyperadrenocorticism and non-adrenal disease

Urinary cortisol and creatinine concentrations, and the cortisol:creatinine ratio were compared between 12 healthy horses (group 1), 13 horses with Cushing's disease (group 2), and eight horses with dysautonomia syndrome (equine grass sickness) (group 3). The mean (sd) urinary cortisol concentrations were 112 (55.7), 250 (357) and 864 (526) nmol/litre in groups 1, 2 and 3, respectively; the mean (sd) urinary creatinine concentrations were 18.9 (7.3), 12.0 (6.7) and 45.2 (26.4) nmol/litre in groups 1, 2 and 3, respectively, and the mean (sd) ratios were 6.1 (2.6), 19.8 (23.8) and 21.3 (14.5) (x 10(-6)) in groups 1, 2 and 3, respectively. The urinary cortisol and creatinine concentrations were significantly greater in group 3 than in groups 1 and 2, but the ratios were not significantly different, although there was a trend (P=0.076) towards higher values in groups 2 and 3. A diagnostic cut-off in the cortisol:creatinine ratio for the confirmation of Cushing's disease of more than 6.9 x 10(-6) was associated with a diagnostic sensitivity and specificity of 92.3 and 75.0 per cent, respectively, when compared with healthy horses. However, when group 3 horses were included, a cut-off of more than 7.4 x 10(-6) was associated with a diagnostic sensitivity and specificity of 84.6 and 54.5 per cent, respectively.

Tolerability and immune responses in humans to a PowderJect DNA vaccine for hepatitis B

We are developing a DNA vaccine toward hepatitis-B virus (HBV) using PowderJect's proprietary needle-free technology to deliver DNA-coated gold particles directly into cells of the skin. Preclinical studies in animals showed that (i) microgram doses of the DNA vaccine were sufficient to immunize pigs and non-human primates to antibody levels comparable to those obtained with a commercial recombinant subunit vaccine; (ii) the DNA vaccine was effective in mouse strains that respond poorly to protein subunit vaccines; (iii) the vaccine induces robust cytotoxic T-cell responses, and (iv) the vaccine is non-toxic and well tolerated. Based on these findings, this DNA vaccine was evaluated for safety, tolerability, and the induction of immune responses in phase 1 clinical studies in healthy, hepatitis-naïve human volunteers. Preliminary results indicate that the vaccine is safe and well tolerated, and elicits both humoral and cellular immune responses in man.

Daytime liver glycogen accumulation, measured by 13C magnetic resonance spectroscopy, in young children with Type 1 diabetes mellitus

AIM

To examine daytime liver glycogen accumulation in prepubertal children with Type 1 diabetes mellitus (Type 1 DM) compared with non-diabetic controls.

METHODS

Liver glycogen content was ascertained in the fasting (morning) and fed (afternoon) state using 13C magnetic resonance (MR) spectroscopy. Data were analysed from six children with Type 1 DM (median (range) age 8.7 (6.3-12.2) years), who were all on conventional insulin regimens, and six healthy controls (age 8.9 (7-10.2) years).

RESULTS

Children with diabetes tended to have lower fasting glycogen values than controls but this did not reach statistical significance (median (range) 154 (70-177) vs. 178 (120-203) mM glycosyl units, Type 1 DM vs. controls respectively; P = 0.06). Glycogen increased in all children with diabetes during the day and concentrations were similar to those in controls by the afternoon (175 (157-299) vs. 172 (136-238) mM glycosyl units; P = 0.7).

CONCLUSIONS

The ability of young children with Type 1 DM to replace liver glycogen depleted after an overnight fast was at least as good as that in control subjects, suggesting that impaired glycogen storage is not a contributory factor in nocturnal hypoglycaemia.

Hypo-osmotic swelling-activated release of organic osmolytes in brain slices: implications for brain oedema in vivo

A decrease in the intracellular levels of osmotically active species has invariably been seen after swelling of mammalian brain tissue preparations. The exact identity of the species, and the manner of their decrease, remain to be described. We investigated the swelling-activated decrease of organic osmolytes in rat cortical brain slices using (1)H- and (31)P-magnetic resonance spectroscopy. We found that acute hypo-osmotic shock causes decreases in the levels of a range of intracellular amino acids and amino acid derivatives, N-acetyl-aspartate, creatine, GABA, glutamate, hypotaurine, and also in the levels of the methylamines glycerol-phosphorylcholine, phosphorylcholine and choline. Incubation of cortical slices with the anion channel blockers niflumic acid and tamoxifen caused inhibition of organic osmolyte efflux, suggesting that such osmolyte efflux occurs through anion channels. Intracellular phosphocreatine was also seen to decrease during acute hypo-osmotic superfusion, although intracellular ATP remained constant. In addition, the acidification of an intracellular compartment was observed during hypo-osmotic superfusion. Our results suggest a link between brain energy reserve and brain osmoregulation.

The Black Sea Tele-Diab System: development-implementation-clinical evaluation

This paper describes the application of the GEHR (Good European Health Record) architecture to develop a system to enable the storage and exchange of EHCRs (Electronic Health Care Record) of patients with diabetes, in the Black Sea area. The objectives of the Black Sea Tele Diab System (BSTD) were to develop and evaluate the use of a fully-computerised healthcare record system in a clinical setting, to promote the use of electronic data exchange of healthcare information and to provide a framework for the epidemiological study and monitoring of diabetes care.

Effect of biofeedback-assisted relaxation training on foot ulcer healing

A prospective, randomized study was conducted to determine the effect of biofeedback-assisted relaxation training on foot ulcer healing. For patients with chronic nonhealing foot ulcers, medical care was combined with a standardized biofeedback-assisted relaxation training program in the experimental group. The intervention was designed to increase peripheral perfusion, thereby promoting healing. A total of 32 patients with chronic nonhealing ulcers participated in the study. In the experimental group, 14 out of 16 ulcers (87.5%) healed, as compared with 7 out of 16 ulcers (43.8%) in the control group.

Effects of experience on voluntary intake of supplements by cattle

Experiments examined the effects of prior experience of young cattle on their voluntary intake of supplements, and variability among animals in intake of supplements. Variability was measured using supplement labelled with lithium salts. Experiment 1 examined the effects of offering a concentrate supplement to calves before and/or after weaning on their subsequent intake of the same supplement and of a loose mineral mix supplement. Experience of the concentrate supplement increased acceptance and reduced variability in intake of the loose mineral mix supplement. However, neither voluntary intake (mean is 105 g DM/head.day) nor variability in intake of loose mineral mix supplement was affected by prior experience. Experiments 2 and 3 examined variability in intake of loose mineral mix supplement by weaners in larger groups or offered molasses–urea supplement, respectively. Experiment 4 examined the effects of provision of supplements and/or exposure to human activity and handling on subsequent intake of loose mineral mix supplement. Supplementing grazing weaners with concentrates had a transient effect by increasing voluntary intake of loose mineral mix supplement, but increased exposure to supplements, and human activity and handling while held in yards after weaning had no effects. Variability among animals in intake of loose mineral mix supplement (CV is 52–103%) tended to be greater than with the concentrate or molasses-based supplements (CV is 23–43%), irrespective of previous experience. There were fewer than 1% non-eaters of concentrate supplement and 0–7% non-eaters of loose mineral mix supplement. In experiment 5, prior experience of loose mineral mix supplements increased intake of such supplements by weaners during weeks 1 and 2 but not from weeks 3 to 9. In experiment 6, intake of loose mineral mix supplement by adult cattle was not affected by their experience as weaners of a similar supplement. In conclusion, although prior experience of supplements by young cattle sometimes increased their initial acceptance and voluntary intake of supplements, longer-term intake of supplements was not affected.

N-Acetylaspartate and DARPP-32 levels decrease in the corpus striatum of Huntington's disease mice

Huntington's disease (HD) is an autosomal dominant condition involving progressive neurodegeneration, primarily the corpus striatum and cerebral cortex. We have used in vivo magnetic resonance spectroscopy (MRS) to assess specific neuronal markers in transgenic mice (R6/1 line) expressing exon I of the human huntingtin gene with an expanded CAG repeat. Levels of N-acetylaspartate (NAA), an indicator of healthy neuronal function, were significantly reduced (26%) in the corpus striatum of HD mice relative to wild-type littermates at 5 months of age. However, levels of cholines and creatine-phosphocreatine were not altered in the HD mice. Expression of dopamine- and cAMP-regulated phosphoprotein, 32 kDa (DARPP-32), was assessed by immunohistochemistry in the striatum of HD mice and found to be downregulated by 5 months and, even more dramatically, at 11 months of age. In contrast, expression of calbindin was not significantly decreased in HD mice. Our results suggest that the observed decreases in DARPP-32 and NAA may contribute to aberrant receptor signalling and neuronal dysfunction in HD.

Induction of antigen-specific CD8+ T cells, T helper cells, and protective levels of antibody in humans by particle-mediated administration of a hepatitis B virus DNA vaccine

A DNA vaccine against the hepatitis B virus (HBV) was evaluated for safety and induction of immune responses in 12 healthy, hepatitis-naïve human volunteers using the needle-free PowderJect system to deliver gold particles coated with DNA directly into cells of the skin. Three groups of four volunteers received three administrations of DNA encoding the surface antigen of HBV at one of the three dose levels (1, 2, or 4 microg). The vaccine was safe and well tolerated, causing only transient and mild to moderate responses at the site of administration. HBV-specific antibody and both CD4+ and CD8+ T cell responses were measured before and after each immunization. All the volunteers developed protective antibody responses of at least 10 mIU/ml. In volunteers who were positive for the HLA class I A2 allele, the vaccine also induced antigen-specific CD8+ T cells that bound HLA-A2/HBsAg(335-343) tetramers, secreted IFN-gamma, and lysed target cells presenting a hepatitis B surface antigen (HBsAg) CTL epitope. Enumeration of HBsAg-specific T cells producing cytokine indicated preferential induction of a Type 1 T helper cell response. These results provide the first demonstration of a DNA vaccine inducing protective antibody titers and both humoral and cell-mediated immune responses in humans.

Phase II study of the oxygen saturation curve left shifting agent BW12C in combination with the hypoxia activated drug mitomycin C in advanced colorectal cancer

BW12C (5-[2-formyl-3-hydroxypenoxyl] pentanoic acid) stabilizes oxyhaemoglobin, causing a reversible left-shift of the oxygen saturation curve (OSC) and tissue hypoxia. The activity of mitomycin C (MMC) is enhanced by hypoxia. In this phase II study, 17 patients with metastatic colorectal cancer resistant to 5-fluorouracil (5-FU) received BW12C and MMC. BW12C was given as a bolus loading dose of 45 mg kg(-1) over 1 h, followed by a maintenance infusion of 4 mg kg(-1) h(-1) for 5 h. MMC 6 mg m(-2) was administered over 15 min immediately after the BW12C bolus. The 15 evaluable patients had progressive disease after a median of 2 (range 1-4) cycles of chemotherapy. Haemoglobin electrophoresis 3 and 5 h after the BW12C bolus dose showed a fast moving band consistent with the BW12C-oxyhaemoglobin complex, accounting for approximately 50% of total haemoglobin. The predominant toxicities--nausea/vomiting and vein pain--were mild and did not exceed CTC grade 2. Liver 31P magnetic resonance spectroscopy of patients with hepatic metastases showed no changes consistent with tissue hypoxia. The principle of combining a hypoxically activated drug with an agent that increases tissue hypoxia is clinically feasible, producing an effect equivalent to reducing tumour oxygen delivery by at least 50%. However, BW12C in combination with MMC for 5-FU-resistant colorectal cancer is not an effective regimen. This could be related to drug resistance rather than a failure to enhance cytotoxicity.

Intravenous administration of levothyroxine for treatment of suspected myxedema coma complicated by severe hypothermia in a dog

A 7-year-old male English Coonhound with suspected myxedema coma complicated by severe hypothermia and metabolic abnormalities was treated with a combination of active external and core rewarming techniques, i.v. and oral administration of levothyroxine, supplemental oxygen, and administration of fluids (0.9% NaCl solution). Myxedema coma develops as a consequence of severe hypothyroidism and is characterized by a hypometabolic, stuporous state. Myxedema coma is associated with a high mortality rate, and most reported cases have involved Doberman Pinschers. Intravenous administration of levothyroxine can be used successfully in combination with oral administration to restore normal metabolic function and assist in warming and thermoregulation, although dosages should be conservative to avoid adverse cardiovascular effects.

Response of lambs fed low quality roughage to supplements based on urea, cereal grain, or protein meals

The intake and growth responses of lambs fed barley straw to a range of supplements provided on a 3- or 4-day cycle were examined. Supplements were urea and sulfur (N/S) added to the straw, or 3 increments of each of 3 approximately isonitrogenous supplements consisting of barley grain mixed with urea and sulfur (Bar/N), cottonseed meal (CSM), and a 0.4 : 0.6 mixture of fishmeal and lucerne hay (FM/L). Lambs fed straw alone consumed 38.3 g dry matter (DM)/kg W0.75 day of straw and an estimated 2.54 MJ metabolisable energy (ME)/day, and lost 20 g liveweight (LW)/day. Supplementation with N/S increased estimated ME intake by 32%. Substitution rates of Bar/N, FM/L, and CSM supplements for straw were 0.50, 0.36, and 0.25 g/g, respectively, but these rates did not differ (P > 0.05) between supplements. Digestibilities of organic matter (OM) and neutral detergent fibre (NDF) were affected differently depending on both the type and amount of supplement. Estimated ME intake was increased 7.1, 7.9, and 8.6 kJ/g supplement DM by Bar/N, FM/L, and CSM, respectively. LW gain and wool growth were increased (P < 0.01) by consecutive increments of each of the supplements, and were increased more (P < 0.01) by the FM/L and CSM than by the Bar/N supplement. The slopes of the linear relationships between LWgain and estimated ME intake were greater (P < 0.05) for CSM and FM/L than for Bar/N supplement, ingested ME being used with about twice the efficiency for LW gain when the protein meal supplements rather than the cereal grain–urea supplement was fed. However, across all supplement treatments, LW gain was correlated (r = 0 .9 1 ; P < 0.001) with the absorbed amino acid supply as estimated from feeding standards. In conclusion, although supplements based on either cereal grain or protein meals increased LW gain in these young lambs, there were much greater responses to the protein meals due principally to more efficient utilisation of ingested ME for LW gain.

Recombinant leptin for weight loss in obese and lean adults: a randomized, controlled, dose-escalation trial

CONTEXT

The protein hormone leptin is important to the homeostatic regulation of body weight. Treatment with exogenous leptin may affect weight loss.

OBJECTIVE

To determine the relationship between increasing doses of exogenous leptin administration and weight loss in both lean and obese adults.

DESIGN

A randomized, double-blind, placebo-controlled, multicenter, escalating dose cohort trial conducted from April 1997 to October 1998.

SETTING

Four university nutrition and obesity clinics and 2 contract clinical research clinics.

PARTICIPANTS

Fifty-four lean (body mass index, 20.0-27.5 kg/m2; mean [SD] body weight, 72.0 [9.7] kg) and 73 obese (body mass index, 27.6-36.0 kg/m2; mean [SD] body weight, 89.8 [11.4] kg) predominantly white (80%) men (n = 67) and women (n = 60) with mean (SD) age of 39 (10.3) years.

INTERVENTIONS

Recombinant methionyl human leptin self-administered by daily morning subcutaneous injection (0 [placebo], 0.01, 0.03, 0.10, or 0.30 mg/kg). In part A, lean and obese subjects were treated for 4 weeks; in part B, obese subjects were treated for an additional 20 weeks. Lean subjects consumed a eucaloric diet to maintain body weight at the current value, and obese subjects were prescribed a diet that reduced their daily energy intake by 2100 kJ/d (500-kcal/d) from the amount needed to maintain a stable weight.

MAIN OUTCOME MEASURES

Body weight, body fat, and incidence of adverse events.

RESULTS

Weight loss from baseline increased with increasing dose of leptin among all subjects at 4 weeks (P = .02) and among obese subjects at 24 weeks (P = .01) of treatment. Mean (SD) weight changes at 4 weeks ranged from -0.4 (2.0) kg for placebo (n = 36) to -1.9 kg (1.6) kg for the 0.1 mg/kg dose (n = 29). Mean (SD) weight changes at 24 weeks ranged from -0.7 (5.4) kg for the 0.01 mg/kg dose (n = 6) to -7.1 (8.5) kg for the 0.30 mg/kg dose (n = 8). Fat mass declined from baseline as dose increased among all subjects at 4 weeks (P = .002) and among obese subjects at 24 weeks of treatment (P = .004); more than 95% of weight loss was fat loss in the 2 highest dose cohorts at 24 weeks. Baseline serum leptin concentrations were not related to weight loss at week 4 (P = .88) or at week 24 (P = .76). No clinically significant adverse effects were observed on major organ systems. Mild-to-moderate reactions at the injection site were the most commonly reported adverse effects.

CONCLUSIONS

A dose-response relationship with weight and fat loss was observed with subcutaneous recombinant leptin injections in both lean and obese subjects. Based on this study, administration of exogenous leptin appears to induce weight loss in some obese subjects with elevated endogenous serum leptin concentrations. Additional research into the potential role for leptin and related hormones in the treatment of human obesity is warranted.

Epidemiological, clinical, haematological and biochemical characteristics of canine hypothyroidism

Hypothyroidism was diagnosed in 50 dogs and excluded in 86 dogs suspected of hypothyroidism, on the basis of the results of bovine thyrotropin response tests. Breed, pedigree, sex or neutering status did not significantly influence the likelihood of the dogs being hypothyroid. The hypothyroid dogs were significantly older than the non-hypothyroid dogs referred to the University of Glasgow during the same period. However, when dogs under two years of age were excluded from the statistical analyses there was no significant difference in age between the two groups. The most common clinical characteristics associated with hypothyroidism were metabolic signs (84 per cent of cases), particularly lethargy (76 per cent), obesity or weight gain (44 per cent), and exercise intolerance (24 per cent); and dermatological abnormalities (80 per cent), including alopecia (56 per cent), poor coat quality (30 per cent) and hyperpigmentation (20 per cent). When compared with the laboratory reference limits the most common biochemical and haematological abnormalities were increased concentrations of triglycerides (88 per cent), cholesterol (78 per cent), glucose (49 per cent), and fructosamine (43 per cent), and increased activities of creatine kinase (35 per cent), and decreased concentrations of inorganic phosphate (63 per cent), and a low red blood cell count (40 per cent). When compared with reference limits derived from the euthyroid dogs the most common abnormalities were increased concentrations of gamma-glutamyltransferase (21 per cent), cholesterol (18 per cent), and aspartate aminotransferase (15 per cent) and a decreased red blood cell count (29 per cent), and decreased neutrophils (18 per cent) and decreased activity of creatine kinase (15 per cent). Assessment of cholesterol, creatine kinase, aspartate aminotransferase, gamma-glutamyltransferase, and red blood cell and neutrophil counts may be particularly useful in distinguishing hypothyroid dogs from euthyroid animals with similar clinical signs.

Canine serum thyroglobulin autoantibodies in health, hypothyroidism and non-thyroidal illness

Thyroglobulin autoantibody (TGAA) was measured in serum from dogs with hypothyroidism (n = 42), non-thyroidal illness (NTI) (n = 77) and clinically healthy dogs (n = 70) using a commercially available enzyme immunoassay kit. Precision studies were consistent with good intra-assay and inter-assay repeatability. TGAA positive results occurred in 15 of the 42 (36 per cent) hypothyroid and four healthy dogs of the remaining 147 animals resulting in a lower incidence of false positive results than obtained with previous TGAA assays. The presence of TGAA was not influenced by age, sex, neutering or pedigree status. Of the four apparently healthy TGAA -positive dogs, two had additional clinicopathological evidence of hypothyroidism. TGAA was positive in 43 per cent of hypothyroid dogs with unexpectedly normal serum c TSH concentrations and was particularly useful in the classification of these cases.

31P magnetic resonance spectroscopy of the liver in HELLP syndrome

OBJECTIVES

Using magnetic resonance spectroscopy (MRS) to measure phosphorus-containing metabolites in the liver, this study aimed to investigate non-invasively whether or not women with haemolysis, elevated liver enzymes and low platelets (HELLP) have detectable abnormalities of hepatic energetics.

SETTING

John Radcliffe Hospital, Oxford.

DESIGN

Prospective study.

METHODS

After giving informed consent, patients with HELLP syndrome (n = 7) and controls with severe pre-eclampsia (n = 3), were studied by 31P MRS of the liver as soon as possible after delivery (range 2-4 days) and compared with normal nonpregnant controls (n = 6). Haematological and biochemical tests were performed serially and on the day of the MRS in all pregnant patients.

RESULTS

The severity of HELLP varied as follows: peak aspartate aminotransferase (range 129-2574), peak gamma glutamyl transferase (range 28-96), peak lactate dehydrogenase (range 305-2820), nadir platelets (range 25-114), peak international normalised ratio for prothrombin time (before fresh frozen plasma) (range 0.9-1.9). One pregnancy was terminated but all others resulted in live births and all mothers made uneventful, rapid recoveries. MRS-determined relative hepatic concentrations of phosphorus-containing metabolites and absolute concentrations of adenosine triphosphate did not differ significantly between groups. One patient with the most clinically severe HELLP syndrome (by laboratory criteria) exhibited magnetic resonance spectra which showed a relative increase in phosphomonoester and an absolute decrease in hepatic adenosine triphosphate (to 62% of control).

CONCLUSIONS

Enthusiasm for the conservative management of HELLP syndrome that develops remote from term has been tempered by the inability to identify patients at risk for progression to hepatic necrosis. We found that most patients with HELLP syndrome had normal liver metabolism as assessed by MRS. However, clinically severe HELLP syndrome can be associated with disturbed hepatic metabolism consistent with that seen in hepatic ischaemia and/or granulocytic infiltration of the liver.