What is the likelihood that Thoroughbred foals treated for septic arthritis will race?

REASONS FOR PERFORMING STUDY

Septic arthritis is a serious problem in the neonate, with a poor prognosis being reported for recovery. The impact of neonatal septic arthritis on the likelihood that Thoroughbred (TB) foals will start on a racecourse is not known.

HYPOTHESIS

The development of septic arthritis in a TB foal significantly reduces the likelihood that it will race when compared to foals from the same dam.

METHODS

Medical records of 69 foals treated for septic arthritis were reviewed. The dam's foaling records were reviewed and lifetime racing records were then retrieved for both the affected foals and at least one of their siblings (controls). Outcomes that were statistically evaluated included discharge from the hospital and whether the foal eventually raced. Univariate analyses of categorical variables were conducted for each outcome. The number of affected and unaffected foals that raced at least once were compared using regression analysis. Survival analysis was used to compare age at first race between the study and comparison groups.

RESULTS

Foals with septic arthritis were less likely to start on a racecourse compared to controls (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.12-0.62, P = 0.001), while those foals that were discharged from the hospital were also less likely to start on a racecourse compared to controls (OR 036; CI 0.15-0.83, P = 0.008). The presence of multisystem disease was associated with a decreased likelihood of surviving to be discharged (OR 0.13; 95% CI 0.02-0.90; P = 0.005), but did not affect the likelihood that they would start in at least one race if discharged successfully (OR 0.45; 95% CI 0.04-2.81; P = 0.34) compared to the other foals with septic arthritis. Log-rank comparison of survival curves confirmed that foals discharged following treatment for septic arthritis took significantly longer to start in their first race compared to the sibling population (mean age of study group 1757 days, CI 1604-1909; mean age of sibling group 1273 days, CI 1197-1349; P = 0.0006).

CONCLUSIONS

The development of septic arthritis in a TB foal significantly reduces the likelihood that it will start on a racecourse when compared to controls.

POTENTIAL RELEVANCE

Accurate figures allowing a realistic assessment of the athletic future of a foal following treatment for septic arthritis are of significance for both owner and treating veterinarian.

Influence of rider on lameness in trotting horses

REASONS FOR PERFORMING STUDY

Equine lameness is commonly evaluated when the horse is being ridden, but the influence of the rider on the lameness has not been documented.

OBJECTIVE

To document the effect of 2 riders of different training levels on the vertical movement of the head and croup.

METHODS

Twenty mature horses were ridden at trot by an experienced dressage rider and a novice rider, as well as trotted in hand. Kinematic measurements of markers placed on the horse's head and sacral bone were carried out. The asymmetries of the vertical head and sacral bone motion were calculated as lameness parameters and compared with paired t tests.

RESULTS

Trotting in hand, 17 horses showed forelimb lameness (1-4/10) and 13 hindlimb lameness (1-2/10). Intra-individually, 11 horses showed significant differences in forelimb lameness and 4 horses showed significant differences in hindlimb lameness when ridden. Over all horses, hindlimb lameness increased significantly under the dressage rider compared to unridden horses.

CONCLUSIONS

The presence of a rider can alter the degree of lameness; however, its influence cannot be predicted for an individual horse.

POTENTIAL RELEVANCE

In order to evaluate mild lameness, horses should be evaluated at trot both under saddle and in hand. If lameness is exacerbated, a second rider may be helpful; the level of training of the rider should be taken into consideration.

Effect of tracheal mucus and tracheal cytology on racing performance in Thoroughbred racehorses

REASON FOR PERFORMING STUDY

Accumulations of mucus within the trachea are often found during endoscopic examinations of the airways of poorly performing racehorses, but the clinical importance of this finding is unknown.

OBJECTIVES

To determine the effect of tracheal mucus, pharyngeal lymphoid hyperplasia (PLH) and cytological indices of tracheal aspirate on racing performance in Thoroughbred horses assessed by race place and whether the horse was raced.

METHODS

Endoscopic examination of the nasopharynx, larynx and trachea was performed, and a tracheal aspirate obtained monthly at Thistledown racetrack from April to December, 2002 and 2003. Horses received a score of 0-4 for the degree of PLH and 0-4 for the amount of mucus visible in the trachea. The tracheal aspirate was assessed for turbidity, and total and differential cell counts. Generalised estimating equations models were used as repeated measures models for each risk factor and the level of association assessed through the risk factor's P value in the model.

RESULTS

Moderate to severe tracheal mucus (2-4) was a risk factor for poor racing performance. There was no association between degree of PLH, cell counts or turbidity of tracheal wash fluid and racing performance. However, horses that raced had higher total neutrophil counts in tracheal wash aspirates than horses that did not race.

CONCLUSIONS

Grades 2-4 tracheal mucus should be considered a potential cause of poor racing performance in Thoroughbred horses.

CLINICAL RELEVANCE

Because moderate to severe tracheal mucus accumulation, and not increased tracheal neutrophils, was a risk factor for poor racing performance, functionally significant airway inflammation may best be confirmed by the presence of mucus rather than increased number of neutrophils in the trachea.

Effects of stylopharyngeus muscle dysfunction on the nasopharynx in exercising horses

REASONS FOR PERFORMING STUDY

Nasopharyngeal collapse has been observed in horses as a potential cause of exercise intolerance and upper respiratory noise. No treatment is currently available and affected horses are often retired from performance.

OBJECTIVE

To determine the effect of bilateral glossopharyngeal nerve block and stylopharyngeus muscle dysfunction on nasopharyngeal function and airway pressures in exercising horses.

METHODS

Endoscopic examinations were performed on horses at rest and while running on a treadmill at speeds corresponding to HRmax50, HRmax75 and HRmax, with upper airway pressures measured with and without bilateral glossopharyngeal nerve block.

RESULTS

Bilateral glossopharyngeal nerve block caused stylopharyngeus muscle dysfunction and dorsal nasopharyngeal collapse in all horses. Peak inspiratory upper airway pressure was significantly (P = 0.0069) more negative at all speeds and respiratory frequency was lower (P = 0.017) in horses with bilateral glossopharyngeal nerve block and stylopharyngeus muscle dysfunction compared to control values.

CONCLUSIONS

Bilateral glossopharyngeal nerve anaesthesia produced stylopharyngeus muscle dysfunction, dorsal pharyngeal collapse and airway obstruction in all horses.

POTENTIAL RELEVANCE

The stylopharyngeus muscle is probably an important nasopharyngeal dilating muscle in horses and dysfunction of this muscle may be implicated in clinical cases of dorsal nasopharyngeal collapse. Before this information can be clinically useful, further research on the possible aetiology of stylopharyngeus dysfunction and dysfunction of other muscles that dilate the dorsal and lateral walls of the nasopharynx in horses is needed.

In vitro measurement of internal hoof strain

REASONS FOR PERFORMING STUDY

Strains during stance on the hoof wall surface have been measured by a number of authors in vitro and in vivo. Histological structure and mechanical properties vary through the wall thickness (radially); radial strain measurements may therefore aid the understanding of mechanical function of the capsule and adjacent tissues.

OBJECTIVES

To develop instrumentation capable of measuring internal hoof strain, and to carry out a preliminary comparison of normal and laminitic hooves.

METHODS

Six forelimbs from 4 horses, including 2 with laminitis from the same horse, were tested using an Instron test rig designed to simulate the walk at impact, midstance and breakover. Internal strains were measured at a dorsal site using strain gauges moulded into a plug made of 007 fast-set structural adhesive. In addition, kinetic and kinematic data were collected from each specimen.

RESULTS

When simulating the walk, a significant (P<0.0001) increase in gradient of radial tensile strain was found in a normal hoof wall, from 5.6 +/- 73.9 microepsilon at the outer gauge to 418.5 +/- 170.6 microepsilon at the inner gauge. However, radial strains measured at the inner gauge site in limbs with laminitis were found to be significantly (P<0.0001) compressive, with values of -406.7 +/- 156.3 and -109.9 +/- 72.4 microepsilon for Specimens 1 and 2, respectively.

CONCLUSIONS AND POTENTIAL RELEVANCE

These preliminary data indicate that a marked redistribution may well occur in the wall of laminitic hooves. With a larger sample size, the results should have relevance to the treatment and management of laminitis.

Effects of a Streptococcus equi infection-mediated nutritional insult during mid-gestation in primiparous Thoroughbred fillies. Part 1: Placental and fetal development

REASONS FOR PERFORMING STUDY

There is a paucity of information on factors that influence placental development in the horse.

HYPOTHESIS

Changes in nutrition, particularly around the time of proliferative placental growth, can affect development of the placenta and fetal growth.

OBJECTIVE

To investigate the effects of 2 planes of nutrition and an unforeseen infection-mediated nutritional insult on placental and fetal development in the mare.

METHODS

Twenty maiden Thoroughbred fillies, age 3 or 4 years, mated to one Thoroughbred stallion, were maintained on either High or Moderate food intake throughout pregnancy. In mid-gestation all the mares unexpectedly became infected with Streptococcus equi and suffered varying degrees of weight loss as a consequence. Gross and stereological measurements of the placenta and measurements of foal birthweight, crown-rump length, ponderal index and plasma IGF-1 concentration were made at term.

RESULTS

Gains in bodyweight during gestation were significantly higher in the High vs. the Moderate nutrition groups. Placental and fetal growth parameters were not influenced by the plane of nutrition. However, transient weight loss in mid-gestation from acutely reduced food intake resulted in morphological changes to the allantochorion and decreased foal birthweight.

CONCLUSIONS

Excessive weight gain during gestation in maiden Thoroughbred fillies does not result in nutrient partitioning to the dam at the expense of the fetus. However, sudden weight loss in mid-gestation has detrimental effects on placental development which results in reduced fetal growth.

POTENTIAL RELEVANCE

Clinicians should appreciate the likely effects of maternal infection and resulting weight loss on pregnancy outcome.

Pulmonary intravascular macrophages and endotoxin-induced pulmonary pathophysiology in horses

Endotoxemia causes significant mortality and morbidity in horses. The mechanisms underlying this complex pathophysiology remain unclear. Therefore, effective tools to treat endotoxemia in horses are lacking. Furthermore, the multifactorial and multiorgan pathophysiology of equine endotoxemia has not been fully addressed, especially the lung injury associated with endotoxemia. Within the context of the broader picture of endotoxemia and lung injury, we offer a perspective on the roles of pulmonary intravascular macrophages in endotoxin-induced lung inflammation in horses.

EFFECT OF ACUTE AIRWAY INFLAMMATION ON THE PULMONARY ANTIOXIDANT STATUS

Effects of acute airway inflammation induced by organic dust inhalation on pulmonary antioxidant status were investigated in healthy horses and horses affected by recurrent airway obstruction. Exposure to organic dust induced acute airway neutrophilia, which was associated with increases in elastase and decreases in ascorbic acid concentrations in bronchoalveolar lavage fluid. However, markers of oxidative stress were unaffected, as was hydrogen peroxide in breath condensate. Decreases in ascorbic acid correlated with increased respiratory resistance (P = .001) when both groups were combined. In conclusion, acute neutrophilic airway inflammation does not result in significant evidence of oxidative stress in horses affected by recurrent airway obstruction.

Caudal compression of the infraorbital nerve: a novel surgical technique for treatment of idiopathic headshaking and assessment of its efficacy in 24 horses

REASONS FOR DESIGNING AND REPORTING TECHNIQUE: Idiopathic headshaking has remarkable similarities to human neuropathic facial pain syndromes associated with post herpetic and trigeminal neuralgia. These derive from abnormal sensory function within the peripheral or central pathways of the trigeminal nerve (TgN). Limiting input from the TgN can be helpful in controlling the perception of pain. Rhizotomy of the infraorbital branch of the TgN as it emerges from the infraorbital canal has been reported but has a poor efficacy. A novel technique involves compression of the nerve at a more caudal location within the infraorbital canal and the technique requires validation.

HYPOTHESIS

Caudal compression of the infraorbital nerve with platinum coils, performed in horses diagnosed with idiopathic headshaking, results in a decrease in clinical signs.

METHODS

Caudal compression of the infraorbital nerve, using platinum embolisation coils, was performed under fluoroscopic guidance. Clinical records of 24 idiopathic headshakers that had undergone this procedure were reviewed. Follow-up information was obtained by telephone questionnaire with the owner or referring veterinary surgeon.

RESULTS

All 24 horses had at least one surgical procedure. Median follow-up time was 6 months. There were 2 horses which had surgery 2 weeks before follow-up and these were excluded from the analysis of outcome. Following one surgery, 13/22 horses (59.0%) had a successful outcome. Of the 9 horses that did not improve, surgery was repeated in 6 cases. Two of these horses had a successful outcome. Overall, a successful outcome was obtained in 16/19 horses (84.2%).

CONCLUSIONS

This surgical technique is likely to prevent input from the TgN at a more caudal location then the previously described infraorbital neurectomy. The technique requires refinement.

Foaling rates and risk factors for abortion in pregnant mares presented for medical or surgical treatment of colic: 153 cases (1993-2005)

The purpose of this study was to determine foaling rates in mares presented for medical or surgical treatment of colic, and to examine risk factors associated with abortion following colic. A retrospective analysis of 153 medical records found that mares treated surgically for colic (P = 0.0007) were 3.5 times more likely to have a negative pregnancy outcome than were mares treated medically for colic. Anesthetic time (P = 0.01) and intra-operative hypotension (P = 0.03) were significantly associated with negative pregnancy outcome. Mares with an anesthetic time > or = 3 h were 6 times more likely to abort. Signs of endotoxemia (P = 0.30), hypoxia (P = 0.89), flunixin meglumine administration (P = 0.13), mucous membrane color at the time of presentation (P = 0.82) and capillary refill time (P = 0.76) were not associated with pregnancy outcome. There was no difference in the foaling rate for mares that had received progestin supplementation versus those that had not (P = 0.42). In this study, the significant risk factors for abortion were surgically treated colic, long anesthetic time, and intraoperative hypotension.

[Comparison of different methods to quantify the volume of horse limbs]

Measuring the leg volume of horses is useful for diagnostic and treatment of different diseases in relation to swollen legs. In the present study different methods to quantify the limb volume are compared, the water displacement method, an optoelectronic 2-dimensional body scanner, the so-called perometer and calculation of volume by applying the disc model. As reference method the golden standard of human medicine - the water displacement method was used. We took volume measurements from different tall horses in a defined section of the forelegs between the coronary band and the carpal joint. All applied methods are easily reproducible. The optoelectronic method has a higher intra-class correlation coefficient (ICC) of 0.90 than the water displacement method (ICC = 0.84). Pairwise comparison delivers strong linear relationship with coefficients of correlation > or = 0.972 and comparing the absolute values delivers coefficients of concordance > or = 0.962. In comparison to the water displacement method, the volumes taken by the disc model using a measuring tape tend to underestimate the volume by approximately 8%. The volume taken by the perometer agrees well in the range of measuring accuracy (-0.6 +/- 4.4%), but tends to slightly overestimate the volume (0.6%). Due to the linear relationship, the different methods are easily interchangeable using a conversion factor. The only methods applicable in clinical practice are the disc model and the perometer. The water displacement method is strongly limited due to its lacke of acceptance by horses. In comparison with all the above-mentioned methods the results taken by the disc model are the least accurate. However, when viewed in comparison their reliability is in many applications satisfying. The best method to quantify the limb volume of a horse is the contactless optoelectronic measurement by the perometer. This is quite expensive, but it is found to be acceptable to horses and established results that are nearly one to one when compared to the golden standard. The examiner gets much more information (volume-time diagrams) due to different options and not only the pure result of volume.

Implications of different degrees of arytenoid cartilage abduction on equine upper airway characteristics

REASON FOR PERFORMING STUDY

The necessary degree of arytenoid cartilage abduction (ACA) to restore airway patency at maximal exercise has not been determined.

OBJECTIVES

Use computational fluid dynamics modelling to measure the effects of different degrees of ACA on upper airway characteristics of horses during exercise.

HYPOTHESIS

Maximal ACA by laryngoplasty is necessary to restore normal peak airflow and pressure in Thoroughbred racehorses with laryngeal hemiplegia.

METHODS

The upper airway was modeled with the left arytenoid in 3 different positions: maximal abduction; 88% cross-sectional area of the rima glottis; and 75% cross-sectional area of the rima glottis. The right arytenoid cartilage was maximally abducted. Two models were assumed: Model 1: no compensation of airway pressures; and Model 2: airway pressure compensation occurs to maintain peak airflow. The cross-sectional pressure and velocity distributions for turbulent flow were studied at peak flow and at different positions along the airway.

RESULTS

Model 1: In the absence of a change in driving pressure, 12 and 25% reductions in cross-sectional area of the larynx resulted in 4.11 and 5.65% reductions in peak airflow and 3.68 and 5.64% in tidal volume, respectively, with mild changes in wall pressure. Model 2: To maintain peak flow, a 6.27% increase in driving tracheal pressure was required to compensate for a cross-sectional reduction of 12% and a 13.63% increase in driving tracheal pressure was needed for a cross-sectional area reduction of 25%. This increase in negative driving pressure resulted in regions with low intraluminal and wall pressures, depending on the degree of airway diameter reduction.

CONCLUSION

Assuming no increase in driving pressure, the decrease in left ACA reduced airflow and tidal volume. With increasing driving pressure, a decrease in left ACA changed the wall pressure profile, subjecting the submaximally abducted arytenoid cartilage and adjacent areas to airway collapse.

CLINICAL RELEVANCE

The surgical target of ACA resulting in 88 % of maximal cross-sectional area seems to be appropriate.

Days lost from training by two- and three-year-old Thoroughbred horses: a survey of seven UK training yards

REASONS FOR PERFORMING STUDY

The first major epidemiological study of injury incidence in the UK flat racing Thoroughbred (TB), published in 1985, found lameness to be the single largest reason for days when horses failed to train. It was considered advisable to ascertain if progress has been made in reducing the problem of musculoskeletal injuries in the intervening period.

OBJECTIVE

To quantify injury incidence and days lost from training by 2- and 3-year-old TBs in UK training yards during 2002 and 2003.

METHODS

One-hundred-and-eighty-two yearling TBs were recruited at the end of 2001 and daily training and injury records maintained over the following 2 training and racing seasons. Days were defined as lost from training when a horse failed to train at a slow canter speed or faster, and could be assigned to one of 4 categories: lameness, medical, traumatic and unknown. The incidence and number of days lost due to specific injuries and medical conditions was determined by further subdividing the lameness and medical categories.

RESULTS

The study period provided a total of 52,601 2-year-old and 29,369 3-year-old days available for training, with 2-year-olds failing to train on a significantly greater proportion of days available than 3-year-olds. Lameness was the most important condition causing horses to miss training, with stress fractures being the most important cause of lameness. Medical conditions were a relatively minor cause of days lost from training, accounting for approximately 5% of untrained days in the 2 age groups.

CONCLUSIONS

In UK flat racehorses there has been little change in the proportion of days lost from training due to lameness over the last 20 years.

POTENTIAL RELEVANCE

This study highlights the need for further efforts to reduce the problem of lameness in the racing TB.

Neurokinin receptors in recurrent airway obstruction: a comparative study of affected and unaffected horses

The purpose of the study was to compare in vitro airway responses to neurokinin A & B (NKA and NKB) and expression of NK-2 receptors in airways of horses affected and unaffected with recurrent airway obstruction (RAO). Neurokinin-A, an inflammatory mediator belonging to the tachykinin family of neuropeptides, causes bronchoconstriction by binding to NK-2 receptors. Neurokinin-B is a lesser-known neuropeptide that acts on NK-3 receptors. Horses were placed into RAO-affected and RAO-unaffected groups based on their history, clinical scoring, and pulmonary function testing. Lung tissue from each lobe was collected for immunohistochemical staining for NK-2 receptors. Cumulative concentration-response relationships were determined on bronchial rings (4-mm wide) collected and prepared from the right diaphragmatic lung lobe to graded concentrations (half log molar concentrations 10(-7)M to 10(-4)M) of NKA and NKB. The results showed that NKA caused significantly greater contraction than NKB in both groups. In RAO-affected horses, both agents produced significantly greater bronchial contractions than those in the RAO-unaffected horses. Immunohistochemical staining showed that the overall NK-2 receptor distribution was significantly increased in bronchial epithelium and smooth muscles of bronchi and pulmonary vessels of RAO-affected than RAO-unaffected horses. The findings indicate that NK-2 receptors are up-regulated in RAO, suggesting that NK-2 receptor antagonists may have some therapeutic value in controlling the progression of airway hyperreactivity in horses affected with RAO.

Medical implications of obesity in horses--lessons for human obesity

There is growing recognition that obesity is common and represents a significant detriment to the health of companion animals in a manner similar to that by which it is affecting the human population. As is the case for other species, obesity appears to promote insulin resistance in horses and it is through this pathophysiological process that many of the adverse medical consequences of obesity are being characterized. Equine medical conditions that have been described in the context of obesity and insulin resistance differ from those in humans. Chronic human conditions that have been attributed to obesity and insulin resistance, such as atherosclerosis and diabetes mellitus, are rarely described in obese horses. Significant current interest is centered on the recognition that insulin resistance plays a role in the pathogenesis of laminitis, a potentially severe and debilitating cause of lameness in the equine species. Other equine medical conditions that are more likely in obese, insulin-resistant individuals include hyperlipemia (hepatic lipidosis) and developmental orthopedic disease (osteochondrosis). Pituitary pars intermedia dysfunction (equine Cushing's syndrome) represents another common endocrinopathic condition of older horses associated with insulin resistance. This review presents an introductory overview of the present understanding of obesity and insulin resistance and how these conditions may be associated with disease conditions in horses.

Development of equine upper airway fluid mechanics model for Thoroughbred racehorses

REASON FOR PERFORMING STUDY

Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments.

HYPOTHESIS

The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated.

METHODS

Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse.

RESULTS

The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx.

CONCLUSIONS AND CLINICAL RELEVANCE

In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis.

Halicephalobus gingivalis-associated meningoencephalitis in a Thoroughbred foal

A 13-week-old Thoroughbred colt from central Kentucky was euthanized after an acute onset of ataxia, blindness, head tremors, leaning to the right, recumbency, and seizures. Microscopically, there was a verminous meningoencephalitis characterized by an eosinophilic and granulomatous inflammatory reaction primarily affecting the cerebellum. Dispersed within regions of inflammation were numerous cross and longitudinal sections of intact and degenerative small nematodes. The nematodes had dorsoflexed ovaries and ventroflexed vulvas, which are distinguishing features of Halicephalobus gingivalis. Intact nematodes, compatible with H. gingivalis, also were recovered and identified from portions of the brain that had been frozen for 5-week post-necropsy examination via tissue maceration and additional laboratory techniques.

Lower respiratory tract disease in Thoroughbred racehorses: analysis of endoscopic data from a UK training yard

REASON FOR PERFORMING STUDY

There has been much research directed at potential causative agents and the epidemiology of lower respiratory tract disease (LRTD), but few reports of the clinical progression and outcome.

OBJECTIVES

To define clinical features of LRTD in racehorses, including association with age and average duration of disease, through the analysis of endoscopic data.

METHODS

A retrospective analysis of records from a single training yard of endoscopic examinations undertaken over a 2-year period was performed. Horses were subjected to regular endoscopic examination for a variety of reasons, and all horses placed on antibiotic therapy for lower respiratory tract disease were rescoped following treatment. Data analysed included a 0-8 tracheal mucus score based on visible endoscopic mucus and gross tracheal lavage turbidity, as well as age and treatment duration and type.

RESULTS

A total of 522 endoscopic examinations undertaken on 123 horses and tracking 169 episodes of lower respiratory tract disease were recorded. Mean duration of disease episode was 15.5 days (median = 11 days, range = 4-61 days). Horses age 2 years were significantly more likely than those age > or=3 years to have at least one episode of respiratory disease (P<0.001). There was a direct association between initial tracheal mucus score and rescope score after treatment.

CONCLUSIONS

Lower respiratory tract disease was more common in 2-year-olds than in older horses. Affected horses had endoscopic evidence of increased tracheal mucus accumulation for an average of 15.5 days per episode, a considerably shorter period than that suggested by previous studies.

POTENTIAL RELEVANCE

Endoscopic examinations permit longitudinal tracking of lower respiratory tract disease in Thoroughbred racehorses. A prolonged duration of disease, sometimes extending for months, can be expected in a small proportion of cases, some of which appear to be refractory to treatment. There is a clear need for evidence-based analysis of treatment regimes to assist clinicians in decision making when managing disease in both individual and group situations.

[Influence of subclinical pulmonary findings on cardiac parameters in Icelandic horses]

In the present study we examined, if in Icelandic horses an increase in heart and/ or breathing rate is physiological and breed dependend or a sign of a pulmonary or cardiac disease. Therefore we examined 37 Icelandic horses with the prereport of being healthy. During clinical lung examination four horses showed symptoms of a pulmonary disease like increased breathing rate and enforced breathing at rest. These horses were excluded from the study. The other 33 horses were clinically normal. 17 of these horses were unridden (untrained) and 16 horses were regularly worked (trained). After clinical examination in all horses analysis of arterial blood gas, endoscopy with tracheo- bronchial secret analysis and radiographic examination of the lung were carried out. Additionally electro- and echocardiographic examinations and standardised exercise tests with determination of heart and breathing rate as well as plasma lactate values were performed in all horses. During electro- and echocardiographic examination no pathological findings were observed. In total 22 of the 33 horses showed abnormal lung findings. Seven horses had mild signs of RAO and 15 horses had mild signs of interstitial bronchitis. Three horses had additional pulmonary haemorrhage. Eleven out of the 33 horses showed no abnormal lung findings. The breathing rate at rest differed not significantly between horses with (21 +/- 1/min) or without (23 +/- 2/min) pulmonary findings. The heart rate also did not differ significantly between horses with (39 +/- 1/min) or without (42 +/- 1/min) pulmonary findings. In contrast to this the trained Icelandic horses with abnormal pulmonary findings had significantly higher heart rates (p = 0.01) and significantly lower breathing rates (p = 0.009) compared to those without abnormal pulmonary findings. During echocardiography Icelandic horses with abnormal pulmonary findings had significantly larger left atrial diameter (without abnormal pulmonary findings: 82 +/- 7 mm, with abnormal pulmonary findings: 90 +/- 8 mm, p = 0.02). Compared to the untrained Icelandic horses (5.4 +/- 2 mmol/l) the trained horses showed significantly lower plasma lactate values (3.1 +/- 2 mmol/l, p = 0.001) immediately after exercise. After exercise the icelandic horses with abnormal pulmonary findings had significantly higher breathing rates (p < 0.05) and longer recovery periods (30 minutes) than horses without abnormal respiratory findings (15 minutes). Recovery of heart rate after exercise showed no differences between groups.

Granulosa cell tumors of the equine ovary

The granulosa cell tumor is the most common ovarian tumor in mares. A clinical diagnosis can be made based on the presence ofa unilaterally enlarged ovary and a small inactive contralateral ovary. Endocrine testing may be beneficial to confirm a diagnosis. Surgical removal of the tumor eliminates the adverse effect on pituitary function and results in resumption of follicular development and ovulation in the opposite ovary over time.

Breeding-induced endometritis in mares

Endometritis is a common cause of infertility in broodmares. In the past, the condition was believed to be exclusively the result of bacterial contamination of the uterus. Treatment strategies were focused on preventing bacteria from entering the uterus and on treating mares with signs of endometritis with antibiotics. More recent research on uterine defense mechanisms has increased our understanding of the pathophysiology of equine endometritis. Additional causative agents have been identified, and we have learned to separate uterine infections and a physiologic breeding-induced endometritis resulting from uterine exposure to semen.vi

Adenosine receptor modulation: potential implications in veterinary medicine

Adenosine is a purine nucleoside whose concentration increases during inflammation and hypoxia and the many roles of this molecule are becoming better understood. Increased reactivity to adenosine of the airways of asthmatic but not of normal subjects underlines the role of adenosine in airway inflammation. The identification and pharmacological characterisation of different adenosine receptors have stimulated the search for subtype-specific ligands able to modulate the effects of this molecule in a directed way. Several compounds of different chemical classes have been identified as having potential drawbacks, including side effects resulting from the broad distribution of the receptors across the organism, have prevented clinical application. In this article, the effects of adenosine's different receptors and the intracellular signalling pathways are reviewed. The potential of adenosine receptor modulation as a therapeutic target for chronic airway inflammation is considered, taking equine recurrent airway disease and feline asthma as examples of naturally occurring airway obstructive diseases. Other potential applications for adenosine receptor modulation are also discussed. As the intrinsic molecular events of adenosine's mechanism of action become uncovered, new concrete therapeutic approaches will become available for the treatment of various conditions in veterinary medicine.

Physiology of equine performance and associated tests of function

This review addresses the physiology of performance horses in the context of functional tests aimed at assisting clinicians in the search for explanations of the individual's limitations, actual or perceived as below expectation. The intention is to assist clinicians who are faced frequently by owners or trainers seeking explanations for poor performance; and for research workers as a basis on which to proceed in their search for new methodologies, particularly those that can be applied in the field as for treadmill exercise. The review sets out fundamental physiological pathways, the entailment of which may represent a limiting factor to performance, while taking into account the individual's status, including anamnesis and the possibility of actual disease being present. Tests that assess the possible roles of several body systems, as causes of limited performance, are discussed. These systems include pulmonary, cardiovascular and neuromuscular systems. The evaluation of anaerobic and aerobic energy pathways is also discussed. Emphasis is given to the assessment of pulmonary ventilation by techniques such as spirometry and ergospirometry. These techniques are considered to be of particular potential for further development.

Morphologic changes associated with functional adaptation of the navicular bone of horses

Failure of functional adaptation to protect the skeleton from damage is common and is often associated with targeted remodeling of bone microdamage. Horses provide a suitable model for studying loading-related skeletal disease because horses are physically active, their exercise is usually regulated, and adaptive failure of various skeletal sites is common. We performed a histologic study of the navicular bone of three groups of horses: (1) young racing Thoroughbreds (n = 10); (2) young unshod ponies (n = 10); and (3) older horses with navicular syndrome (n = 6). Navicular syndrome is a painful condition that is a common cause of lameness and is associated with extensive remodeling of the navicular bone; a sesamoid bone located within the hoof which articulates with the second and third phalanges dorsally. The following variables were quantified: volumetric bone mineral density; cortical thickness (Ct.Th); bone volume fraction, microcrack surface density; density of osteocytes and empty lacunae; and resorption space density. Birefringence of bone collagen was also determined using circularly polarized light microscopy and disruption of the lacunocanalicular network was examined using confocal microscopy. Remodeling of the navicular bone resulted in formation of transverse secondary osteons orientated in a lateral to medial direction; bone collagen was similarly orientated. In horses with navicular syndrome, remodeling often led to the formation of intracortical cysts and development of multiple tidemarks at the articular surface. These changes were associated with high microcrack surface density, low bone volume fraction, low density of osteocytes, and poor osteocyte connectivity. Empty lacunae were increased in Thoroughbreds. Resorption space density was not increased in horses with navicular syndrome. Taken together, these data suggest that the navicular bone may experience habitual bending across the sagittal plane. Consequences of cumulative cyclic loading in horses with navicular syndrome include arthritic degeneration of adjacent joints and adaptive failure of the navicular bone, with accumulation of microdamage and associated low bone mass, poor osteocyte connectivity, and low osteocyte density, but not formation of greater numbers of resorption spaces.