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Hart KA, Kimura S. Pharmacologic Interventions to Immunologic and Immune-Mediated Conditions in Horses. Vet Clin North Am Equine Pract 2024:S0749-0739(24)00033-6. [PMID: 38852015 DOI: 10.1016/j.cveq.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024] Open
Abstract
Immunomodulators can stimulate, suppress, or regulate one or many aspects of the immune response. Use of a variety of immunostimulants, immunosuppressors, and anti-inflammatory drugs are described in horses, but the evidence supporting their efficacy is variable. Corticosteroids and nonsteroidal anti-inflammatory drugs are the best characterized immunomodulators in horses, but further study is needed to fully define their ideal dosing protocols and indications and to characterize the efficacy of other immunomodulators in equine medicine.
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Affiliation(s)
- Kelsey A Hart
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, USA.
| | - Shune Kimura
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, USA
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Lykkjen S, Stenbakk LK, Holmøy IH. Prevalence and risk factors for laminitis within the Norwegian pony breed Nordlandshest/Lyngshest. Acta Vet Scand 2023; 65:22. [PMID: 37328910 DOI: 10.1186/s13028-023-00687-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/06/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Laminitis is a systemic condition resulting in debilitating pain and structural changes within the feet, and hence has major welfare implications. Causes include endocrine and systemic inflammatory conditions. Ponies are frequently affected, and observations in the field suggest that occurrence of laminitis is also common in Norwegian breeds. The aim of this study was to estimate the prevalence and risk factors for laminitis within the Norwegian pony breed Nordlandshest/Lyngshest. RESULTS The study was a cross-sectional study based on questionnaires sent to members of the Norwegian Nordlandshest/Lyngshest breed association. Questionnaires were received for 504 animals, of which 464 records were eligible and included in analyses. The population comprised 71 stallions, 156 geldings, and 237 mares, with an age between 1 and 40 years (median and interquartile ranges: 12 (6-18) years). The estimated 3-year period prevalence of laminitis was 8.4% (95% confidence interval (CI95): 6.0-11.3%), whereas lifetime prevalence was 12.5% (CI95: 9.6-15.9%). Mares had a significantly higher period- and lifetime prevalence of laminitis than male horses, and horses 10 years and older had a significantly higher prevalence than younger horses. The lifetime prevalence of laminitis was 3.2% in horses 9 years and younger, whereas from 17.3-20.5% in older horses. Multivariable logistic regression analysis identified age, sex, and regional adiposity as significantly (P < 0.05) associated with the 3-year period outcome of laminitis: Horses older than 9 years had a three-fold increase in the likelihood of having laminitis compared to the younger horses (Odds Ratio (OR)10-14 years = 3.37 (CI95 = 1.19-9.50), OR15-19 years = 3.06 (CI95 = 1.04-9.05), and OR>20 years = 2.70 (CI95 = 0.90-8.02). Mares were more than twice as likely (OR = 2.44 (CI95 = 1.17-5.12) to have laminitis compared to male horses, and horses with regional adiposity had increased odds (OR = 2.35 (CI95 = 1.15-4.82) of laminitis compared to horses without regional adiposity. CONCLUSIONS Laminitis appears to be a considerable welfare issue in the Norwegian pony breed Nordlandshest/Lyngshest. The identified risk factors age, sex, and regional adiposity highlight the need for improved owner education and awareness of strategies to reduce laminitis risk.
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Affiliation(s)
- Sigrid Lykkjen
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Equine Section, Norwegian University of Life Sciences, 5003, NO-1432, Ås, Norway.
| | | | - Ingrid Hunter Holmøy
- Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, 5003, NO-1432, Ås, Norway
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Tokawa PKA, Baccarin RYA, Zanotto G. Systematic review of the association between intrasynovial corticosteroid use and laminitis—What is the evidence? EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Paula Keiko Anadão Tokawa
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science University of São Paulo São Paulo Brazil
| | - Raquel Yvonne Arantes Baccarin
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science University of São Paulo São Paulo Brazil
| | - Gustavo Zanotto
- Large Animal Clinical Sciences Department, College of Veterinary Medicine and Biomedical Sciences Texas A&M University College Station Texas USA
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Van Olmen J, Van Nooten J, Philips H, Sollie A, Daelemans W. Predicting COVID symptoms from free text in medical records using Artificial Intelligence: a feasibility study (Preprint). JMIR Med Inform 2022; 10:e37771. [PMID: 35442903 PMCID: PMC9049643 DOI: 10.2196/37771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Josefien Van Olmen
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Jens Van Nooten
- Computational Linguistics, Psycholinguistics and Sociolinguistics Research Centre, University of Antwerp, Antwerp, Belgium
| | - Hilde Philips
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Annet Sollie
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Walter Daelemans
- Computational Linguistics, Psycholinguistics and Sociolinguistics Research Centre, University of Antwerp, Antwerp, Belgium
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Menzies-Gow NJ, Wakeel F, Little H, Buil J, Rickards K. Cross-sectional study to identify the prevalence of and factors associated with laminitis in UK donkeys. Equine Vet J 2021; 54:757-765. [PMID: 34478179 DOI: 10.1111/evj.13505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 07/21/2021] [Accepted: 08/19/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Laminitis causes lameness in donkeys, but its prevalence and factors associated with disease remain uncertain. OBJECTIVES To determine the prevalence of and identify factors associated with laminitis in donkeys. STUDY DESIGN Retrospective cross-sectional study. METHODS All donkeys at the Donkey Sanctuary, UK, October 2015 to March 2019 were included. For animals that had laminitis during this period, age, sex, weight, body condition score, and the onset date and type of each episode (first or recurrent, acute or chronic) were recorded. Additionally, management data, foot lesion score, endocrine data, other medical conditions, occurrence of foot trimming, surgical procedures, diagnostic imaging, behavioural modification therapy or movement between farms within the month prior were noted. Controls were animals that did not experience laminitis during this period and similar data were recorded. Multivariable logistic regression modelling assessed the differences between the control group and laminitis outcome groups (first, all laminitis, acute and chronic episodes). RESULTS Altogether, 707 animals were included; 364 were control animals; 343 had a first episode of laminitis during the study period, of which 200/343 had no further episodes and 143/343 had recurrent episodes resulting in a total of 512 laminitis episodes and the period prevalence was 48.5% over 42 months. Overall, 180/512 (35%) laminitis episodes were acute and 332/512 (65%) were chronic. Compared with control animals, the laminitic outcome groups were significantly (P < .05) more likely to be younger (first episode), less likely to get extra feed (all four groups) or have an additional medical problem (first episode), and less likely to have undergone dental work, movement, imaging (all four groups) or surgery (first; all laminitis, chronic episodes) in the month preceding the episode. MAIN LIMITATIONS These results may not be applicable to the wider donkey population. CONCLUSIONS Laminitis commonly affects donkeys, but factors associated with donkey laminitis differ from those reported in horses.
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Grzeskowiak RM, Alghazali KM, Hecht S, Donnell RL, Doherty TJ, Smith CK, Anderson DE, Biris AS, Adair HS. Influence of a novel scaffold composed of polyurethane, hydroxyapatite, and decellularized bone particles on the healing of fourth metacarpal defects in mares. Vet Surg 2021; 50:1117-1127. [PMID: 33948951 PMCID: PMC8360067 DOI: 10.1111/vsu.13608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 01/04/2021] [Accepted: 01/24/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the effect of a novel scaffold, designed for use in bone regeneration, on healing of splint bone segmental defects in mares. STUDY DESIGN In vivo experimental study. SAMPLE POPULATION Five adult mares (4-10 years old; mean weight, 437.7 kg ± 29 kg). METHODS Bilateral 2-cm full-thickness defects were created in the fourth metacarpal bones (MCIV) of each horse. Each defect was randomly assigned to either a novel scaffold treatment (n = 5) or an untreated control (n = 5). The scaffold was composed of polyurethane, hydroxyapatite, and decellularized bone particles. Bone healing was assessed for a period of 60 days by thermography, ultrasonography, radiography, and computed tomography (CT). Biopsies of each defect were performed 60 days after surgery for histological evaluation. RESULTS On the basis of radiographic analysis, scaffold-treated defects had greater filling (67.42% ± 26.7%) compared with untreated defects (35.88% ± 32.7%; P = .006). After 60 days, CT revealed that the density of the defects treated with the scaffolds (807.80 ± 129.6 Hounsfield units [HU]) was greater than density of the untreated defects (464.80 ± 81.3 HU; P = .004). Evaluation of histology slides provided evidence of bone formation within an average of 9.43% ± 3.7% of the cross-sectional area of scaffolds in contrast to unfilled defects in which connective tissue was predominant throughout the biopsy specimens. CONCLUSION The novel scaffold was biocompatible and supported bone formation within the MCIV segmental defects. CLINICAL SIGNIFICANCE This novel scaffold offers an effective option for filling bone voids in horses when support of bone healing is indicated.
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Affiliation(s)
- Remigiusz M. Grzeskowiak
- Department of Large Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - Karrer M. Alghazali
- Center for Integrative Nanotechnology SciencesUniversity of Arkansas at Little RockLittle RockArkansasUSA
| | - Silke Hecht
- Department of Small Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - Robert L. Donnell
- Department of Biomedical and Diagnostic SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - Thomas J. Doherty
- Department of Large Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - Christopher K. Smith
- Department of Small Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - David E. Anderson
- Department of Large Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - Alexandru S. Biris
- Center for Integrative Nanotechnology SciencesUniversity of Arkansas at Little RockLittle RockArkansasUSA
| | - Henry S. Adair
- Department of Large Animal Clinical SciencesThe University of Tennessee College of Veterinary MedicineKnoxvilleTennesseeUSA
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An equine veterinary surveillance network for the UK horse population. Vet Rec 2021; 188:466-468. [PMID: 34143479 DOI: 10.1002/vetr.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
April Lawson and Gina Pinchbeck of the University of Liverpool introduce a new initiative that will use electronic health records to create an evidence base for equine research and surveillance.
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Mainguy-Seers S, Lavoie JP. Glucocorticoid treatment in horses with asthma: A narrative review. J Vet Intern Med 2021; 35:2045-2057. [PMID: 34085342 PMCID: PMC8295667 DOI: 10.1111/jvim.16189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 12/15/2022] Open
Abstract
Despite substantial research efforts to improve the treatment and outcome of horses with asthma, glucocorticoids (GC) remain the cornerstone of drug treatment of this prevalent disease. The high efficacy of GC to relieve airway obstruction explains their extensive use despite potential deleterious effects. However, much is yet to be uncovered concerning GC use in horses with asthma, including the comparative efficacy of the different drugs, the determination of minimal effective doses and the mechanisms underlying their variable modulation of airway inflammation. The objectives of this structured review were to report and compare the plethora of effects of the various GC used in asthmatic horses with a focus on impact on lung function, airway inflammation, and bronchial remodeling. Adverse effects are also briefly described, with an emphasis on those that have been specifically reported in horses with asthma. Ultimately, we aimed to highlight gaps in the literature and to identify future research areas.
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Affiliation(s)
- Sophie Mainguy-Seers
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Jean-Pierre Lavoie
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Quebec, Canada
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Knych HK, McKemie DS, Kanarr KL, White SD. Pharmacokinetics of mycophenolate mofetil following single-dose intravenous and single- and multiple-dose oral administration and clinicopathologic effects of mycophenolate mofetil following long-term oral administration in healthy horses. Am J Vet Res 2021; 82:502-509. [PMID: 34032479 DOI: 10.2460/ajvr.82.6.502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the pharmacokinetics of mycophenolate mofetil (MMF) following single-dose IV or PO administration, characterize the pharmacokinetics of MMF following long-term PO administration, and describe the clinicopathologic effects of long-term MMF administration in horses. ANIMALS 12 healthy adult horses. PROCEDURES In phase 1, 6 horses received a single IV (2.5 mg/kg) or PO (5 mg/kg) dose of MMF in a randomized balanced crossover assessment (≥ 2-week interval between administrations). In phase 2, 6 other horses received MMF for 60 days (5 mg/kg, PO, q 24 h for 30 days and then 5 mg/kg, PO, q 48 h for an additional 30 days). RESULTS Following IV (single-dose) or PO (single- or multiple-dose) administration, MMF was rapidly converted to mycophenolic acid. For single-dose PO administration, mean ± SD maximum plasma mycophenolic acid concentration was 1,778.3 ± 441.5 ng/mL at 0.71 ± 0.29 hours. For single-dose IV administration, mean systemic clearance and volume of distribution at steady state were 0.689 ± 0.194 L/h/kg and 1.57 ± 0.626 L/kg, respectively. Following single doses, mean terminal half-life was 3.99 ± 0.865 hours for IV administration and 4.02 ± 1.01 hours for PO administration. The accumulation index following long-term PO administration was 1.0 ± 0.002, and the terminal half-life was 4.59 ± 1.25 hours following the final dose on day 60. None of the horses developed abnormal clinical signs or had any consistently abnormal clinicopathologic findings. CONCLUSIONS AND CLINICAL RELEVANCE Further investigation of the clinical efficacy of long-term MMF treatment of horses with autoimmune diseases is warranted.
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Haseler CJ, Jarvis GE, McGovern KF. Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Equine Vet J 2020; 53:895-901. [PMID: 33174264 DOI: 10.1111/evj.13361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. OBJECTIVES To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses. STUDY DESIGN Retrospective observational cohort study. METHODS Clinical records of horses registered with one large UK equine practice were reviewed retrospectively to identify all horses receiving intrasynovial TA treatment between 1 January 2007 and 31 December 2017. A total of 1510 horses were selected and records investigated for incidence of laminitis over a 4-month period following treatment. For each TA-treated horse, an untreated horse, individually matched by age, sex, date of treatment and client type, was selected from the clinical records. Untreated horses were then investigated for laminitis over the same 4-month period. Data were analysed in a 2 × 2 contingency table using Fisher's exact test. RESULTS A total of 489 horses were lost to follow-up and 55 horses were excluded, leaving 966 treated and matched, untreated horses. The incidence of laminitis over the 4-month study period in both groups was identical: 3/966 horses (0.31%) (95% C.I. [0.08%, 0.91%]), equivalent to 0.93 cases per 100 horses per year (P > .9). MAIN LIMITATIONS Retrospective study; large proportion (489/1510) of horses lost to follow-up; large proportion of study population were racehorses; selection method resulted in disproportionate selection of horses born before 2013; similar incidence between groups may reflect existing risk-based selection by clinicians. CONCLUSIONS intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
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Affiliation(s)
- Callum J Haseler
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.,Westover Veterinary Centre, Hainford, UK
| | - Gavin E Jarvis
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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Peng Z, Xu G, Zhou H, Yao Y, Ren H, Zhu J, Liu H, Liu W. Early warning of nursing risk based on patient electronic medical record information. J Infect Public Health 2020; 13:1562-1566. [DOI: 10.1016/j.jiph.2019.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 11/26/2022] Open
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Knowles EJ. What is the risk that corticosteroid treatment will cause laminitis? EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. J. Knowles
- Bell Equine Veterinary Clinic, Kent and The Royal Veterinary College Hatfield UK
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Potter K, Stevens K, Menzies-Gow N. Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids. Vet Rec 2019; 185:82. [DOI: 10.1136/vr.105378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/15/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Katya Potter
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Kim Stevens
- Department of Pathobiology and Population Sciences; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Nicola Menzies-Gow
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
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14
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Rendle D. Steroids and laminitis - the value of evidence over anecdote. Vet Rec 2019; 185:79-81. [DOI: 10.1136/vr.l4730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- David Rendle
- Rainbow Equine Hospital; Malton North Yorkshire UK
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15
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Ekstrand C, Bondesson U, Giving E, Hedeland M, Ingvast-Larsson C, Jacobsen S, Löfgren M, Moen L, Rhodin M, Saetra T, Ranheim B. Disposition and effect of intra-articularly administered dexamethasone on lipopolysaccharide induced equine synovitis. Acta Vet Scand 2019; 61:28. [PMID: 31221173 PMCID: PMC6585085 DOI: 10.1186/s13028-019-0464-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 06/13/2019] [Indexed: 11/16/2022] Open
Abstract
Background Dexamethasone is used for the intra-articular route of administration in management of aseptic arthritis in horses. Despite its widespread use there is very little quantitative data of the disposition and response to dexamethasone. The aim of this study was to investigate and describe the synovial fluid and plasma dexamethasone concentration over time and to explore the relation between synovial fluid concentration and response using clinical endpoints as response biomarkers after IA injection of dexamethasone disodium salt solution in an equine model of synovitis. Results Inflammation was induced in the radiocarpal joint of six horses by injection of 2 ng lipopolysaccharide (LPS). Two hours later either saline or dexamethasone was injected in the same joint in a two treatment cross over design. Each horse was treated once with one of the six doses dexamethasone used (0.01, 0.03, 0.1, 0.3, 1 or 3 mg) and once with saline. Dexamethasone was quantified by means of UHPLC–MS/MS. Dexamethasone disposition was characterised by means of a non-linear mixed effects model. Lameness was evaluated both objectively with an inertial sensor based system and subjectively scored using a numerical scale (0–5). Joint circumference, skin temperature over the joint and rectal temperature were also recorded. The LPS-challenge induced lameness in all horses with high inter-individual variability. Dexamethasone significantly decreased lameness compared with saline. Other variables were not statistically significant different between treatments. Objective lameness scoring was the most sensitive method used in this study to evaluate the lameness response. A pharmacokinetic/pharmacodynamic model was successfully fitted to experimental dexamethasone and lameness data. The model allowed characterization of the dexamethasone synovial fluid concentration–time course, the systemic exposure to dexamethasone after intra-articular administration and the concentration–response relation in an experimental model of synovitis. Conclusions The quantitative data improve the understanding of the pharmacology of dexamethasone and might serve as input for future experiments and possibly contribute to maintain integrity of equine sports.
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de Laat MA, Reiche DB, Sillence MN, McGree JM. Incidence and risk factors for recurrence of endocrinopathic laminitis in horses. J Vet Intern Med 2019; 33:1473-1482. [PMID: 30972832 PMCID: PMC6524073 DOI: 10.1111/jvim.15497] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/29/2019] [Indexed: 12/27/2022] Open
Abstract
Background Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. Objectives To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. Animals Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). Methods This prospective cohort study collected data on veterinary‐diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non‐endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow‐up data were collected at regular intervals to determine whether the laminitis recurred in the 2‐year period after diagnosis. Results The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2‐year study period increased with basal, fasted serum insulin concentration (P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0‐20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely (P = .05) to recur sooner. Conclusions and clinical importance Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.
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Affiliation(s)
- Melody A de Laat
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Dania B Reiche
- Animal Health, Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
| | - Martin N Sillence
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James M McGree
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
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Pollard D, Wylie CE, Verheyen KLP, Newton JR. Identification of modifiable factors associated with owner-reported equine laminitis in Britain using a web-based cohort study approach. BMC Vet Res 2019; 15:59. [PMID: 30755193 PMCID: PMC6373032 DOI: 10.1186/s12917-019-1798-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/25/2019] [Indexed: 12/27/2022] Open
Abstract
Background Equine laminitis is a complex disease that manifests as pain and lameness in the feet, often with debilitating consequences. There is a paucity of data that accounts for the multifactorial nature of laminitis and considers time-varying covariates that may be associated with disease development; particularly those that are modifiable and present potential interventions. A previous case-control study identified a number of novel, modifiable factors associated with laminitis which warranted further investigation and corroboration. The aim of this study was to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors previously identified in the case-control study. Results Self-selected horse/pony owners in GB submitted initial baseline and follow-up health and management questionnaires for 1070 horses/ponies between August 2014 and December 2016. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary-diagnosed episodes of active laminitis using a previously-validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with the previous case-control study, a prior history of laminitis (particularly non-veterinary-diagnosed episodes), soreness after shoeing/trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel, and require further investigation to explore their relationship with laminitis and their applicability as potential interventions. Conclusions This study has demonstrated a temporal relationship between a number of horse- and management-level factors and laminitis, identifying potential interventions and important risk groups for which these interventions would be of particular importance. These results serve as a sound evidence-base towards the development of strategic recommendations for the horse/pony-owning population to reduce the rate of laminitis in GB. Electronic supplementary material The online version of this article (10.1186/s12917-019-1798-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D Pollard
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK. .,Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK.
| | - C E Wylie
- Rossdales Equine Hospital, Exning, Newmarket, UK.,University of Sydney, School of Medical Sciences, Camperdown, Sydney, Australia
| | - K L P Verheyen
- Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
| | - J R Newton
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK
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Held F, Ekstrand C, Cvijovic M, Gabrielsson J, Jirstrand M. Modelling of oscillatory cortisol response in horses using a Bayesian population approach for evaluation of dexamethasone suppression test protocols. J Pharmacokinet Pharmacodyn 2019; 46:75-87. [PMID: 30673914 PMCID: PMC6394511 DOI: 10.1007/s10928-018-09617-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/31/2018] [Indexed: 11/12/2022]
Abstract
Cortisol is a steroid hormone relevant to immune function in horses and other species and shows a circadian rhythm. The glucocorticoid dexamethasone suppresses cortisol in horses. Pituitary pars intermedia dysfunction (PPID) is a disease in which the cortisol suppression mechanism through dexamethasone is challenged. Overnight dexamethasone suppression test (DST) protocols are used to test the functioning of this mechanism and to establish a diagnosis for PPID. However, existing DST protocols have been recognized to perform poorly in previous experimental studies, often indicating presence of PPID in healthy horses. This study uses a pharmacokinetic/pharmacodynamic (PK/PD) modelling approach to analyse the oscillatory cortisol response and its interaction with dexamethasone. Two existing DST protocols were then scrutinized using model simulations with particular focus on their ability to avoid false positive outcomes. Using a Bayesian population approach allowed for quantification of uncertainty and enabled predictions for a broader population of horses than the underlying sample. Dose selection and sampling time point were both determined to have large influence on the number of false positives. Advice on pitfalls in test protocols and directions for possible improvement of DST protocols were given. The presented methodology is also easily extended to other clinical test protocols.
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Affiliation(s)
- Felix Held
- Fraunhofer-Chalmers Centre, Chalmers Science Park, Gothenburg, Sweden.
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden.
| | - Carl Ekstrand
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Marija Cvijovic
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Johan Gabrielsson
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Mats Jirstrand
- Fraunhofer-Chalmers Centre, Chalmers Science Park, Gothenburg, Sweden
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Pollard D, Wylie CE, Newton JR, Verheyen KLP. Incidence and clinical signs of owner-reported equine laminitis in a cohort of horses and ponies in Great Britain. Equine Vet J 2019; 51:587-594. [PMID: 30516850 DOI: 10.1111/evj.13059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/30/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Previous robust epidemiological studies of equine laminitis have utilised only veterinary-diagnosed episodes of disease, potentially underestimating true disease frequency. OBJECTIVES To estimate the incidence of, and describe clinical signs associated with, owner-reported active laminitis in horses/ponies, using both veterinary-diagnosed and nonveterinary-diagnosed episodes. STUDY DESIGN Prospective cohort. METHODS Data were collected from horse/pony owners in Great Britain between August 2014 and December 2016 using a web-based application. The incidence of owner-reported laminitis was estimated using both first incident and repeat episodes reported during the study period via a previously validated laminitis reporting form. Owner-reported clinical signs present in these episodes were recorded. RESULTS A total of 1070 horses/ponies contributed 1068 horse-years at risk (HYAR) and 123 active laminitis episodes were reported in 97 animals. Sixty-two of these episodes (50.4%, 95% confidence interval [CI] 41.6, 59.2%) were veterinary-diagnosed and 75.3% (CI 66.7, 83.8%; n = 73) of horses/ponies reported to have laminitis during the study had a previous laminitis history. Overall owner-reported first episode incidence was 9.6 episodes (CI 7.8, 11.7)/100 HYAR, whereas incidence including repeat episodes was 11.5 episodes (CI 9.7, 13.7)/100 HYAR. Laminitis occurred throughout the year with no significant differences between seasonal incidence estimates. Incidence was highest in Connemara and New Forest and lowest in Draught and Cob breed categories. The most prevalent owner-reported clinical signs (≥70%) were difficulty turning and a short/stilted or lame walk. Laminitis was reported in all limbs, however; both forelimbs were most commonly affected (62.9%, CI 54.1, 71.7%; n = 73/116). MAIN LIMITATIONS Self-selection enrolment of participants may limit generalisability of the findings. CONCLUSIONS Laminitis remains a considerable year-round welfare issue of horses and ponies, with frequency estimates utilising owner-reported data more representative of the true impact of the disease. The clinical signs reported by horse/pony owners were reflective of those previously described by veterinary surgeons.
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Affiliation(s)
- D Pollard
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK.,Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
| | - C E Wylie
- Rossdales Equine Hospital, Exning, Newmarket, Suffolk, UK
| | - J R Newton
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK
| | - K L P Verheyen
- Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK
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21
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Loeffler A, Herrick D, Allen S, Littlewood JD. Long-term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions. Vet Dermatol 2018; 29:526-e176. [PMID: 30175879 DOI: 10.1111/vde.12685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Allergic pruritus and urticaria in the horse are challenging for veterinarians and owners; little is known about their long-term management. OBJECTIVES To summarize intradermal allergen test results (IDT), and to assess owners' perceptions of skin disease and the effects of medical treatment and management changes in their atopic horses over time. ANIMALS Eighty two horses with atopic dermatitis in southeastern England between 2006 and 2011. METHODS AND MATERIALS The IDT results were reviewed retrospectively. Owners completed telephone questionnaires on skin changes, medication, effect of allergen-specific immunotherapy (ASIT) and management. RESULTS Sixty one owners (74.4%) could be contacted, an average of 5.9 years (range 28-88 months) after IDT; of those, three could not be enrolled. Of the 58 remaining horses, eleven (19%) were deceased at the time of owner interview, including four (6.9%) euthanized due to uncontrollable skin disease. The remaining 47 owners reported that the signs of skin disease had not been seen for at least two years in 18 horses (38.3%), including two that only flared with known triggers. Twenty nine horses (61.7%) still required medication to control skin disease although 25 (53.2%) required less since testing. Owners reported benefit from ASIT in nine of 14 horses (64.3%) from glucocorticoids in 33 of 35 (94.3%) and from antihistamines in 17 of 28 (60.7%). Specific management changes were implemented for 22 horses and reported as beneficial in nine of 22 (40.9%). CONCLUSIONS Equine atopic dermatitis may not always be chronic, but severe cases appear difficult to control. IDT may help to formulate ASIT and can help to guide management changes.
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Affiliation(s)
- Anette Loeffler
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Desiree Herrick
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Serena Allen
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
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