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Turin L, Piccione MM, Crosa F, Dall'Ara P, Filipe J, Zarucco L. Therapeutic Applications of Botulinum Neurotoxins in Veterinary Medicine. Vet Sci 2023; 10:460. [PMID: 37505863 PMCID: PMC10386576 DOI: 10.3390/vetsci10070460] [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: 06/08/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Botulinum neurotoxins (BoNTs) are emerging as multipurpose therapeutic compounds for the treatment of several different syndromes involving peripheral and central nervous systems, and muscular and musculoskeletal disorders both in human and veterinary medicine. Therefore, the study of BoNTs is rapidly developing and identifying newly produced BoNT variants. Efforts should be made to clarify the biological and pharmacological characteristics of these novel BoNTs as well as the natural ones. The high potential of BoNTs as a therapeutic compound for medical syndromes lies in its ability to reach a specific cell type while bypassing other cells, thus having mild or no side effects. In this paper the recent developments in BoNTs are reviewed with the aim of analyzing the current knowledge on BoNTs' biological mechanisms of action, immunogenicity, formulations, and therapeutic applications in the veterinary field, highlighting advantages and drawbacks and identifying the gaps to be filled in order to address research priorities.
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Affiliation(s)
- Lauretta Turin
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, 26900 Lodi, LO, Italy
| | - Marina Michela Piccione
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, 26900 Lodi, LO, Italy
| | - Fabio Crosa
- Department of Veterinary Sciences (DSV), University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy
| | - Paola Dall'Ara
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, 26900 Lodi, LO, Italy
| | - Joel Filipe
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, 26900 Lodi, LO, Italy
| | - Laura Zarucco
- Department of Veterinary Sciences (DSV), University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy
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Chandra S, Suresh NL, Afsharipour B, Rymer WZ, Holobar A. Anomalies of motor unit amplitude and territory after botulinum toxin injection. J Neural Eng 2022; 19. [PMID: 35671714 DOI: 10.1088/1741-2552/ac7666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/07/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Botulinum toxin (BT) induced cholinergic denervation of hyperactive motor units is a clinically accepted and extensively practiced way of managing focal spasticity after stroke. The denervation potentially initiates a temporary reorganization of the motor unit (MU) structure by inducing the emergence of a large number of newly innervated muscle fibers. In this study, we quantify the effect of the BT on motor unit action potential (MUAP) amplitudes and on the motor unit territory areas (MUTA) as seen on the surface of the skin over the biceps brachii (BB) muscle. APPROACH We have used a 128 channel high-density electromyography (HDsEMG) grid on the spastic and contralateral BB muscle and recorded the myoelectric activity along with the contraction force during isometric contraction of elbow muscles. We have decomposed the recorded EMG signal into individual MU potentials and estimated the MUAP amplitudes and territory areas before and two weeks after a BT injection. MAIN RESULT We found that there were significantly larger median (47±9%) MUAP amplitudes as well as reduction of MUTA (20±2%) two weeks after the injection compared to the respective pre-injection recording. SIGNIFICANCE The observed covariation of the amplitude and the territory area indicates that the large amplitude MUs that appeared after the BT injection have a relatively smaller territory area. We discuss the potential contributing factors to these changes subsequent to the injection in the context of the investigated subject cohort.
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Affiliation(s)
- Sourav Chandra
- Shirley Ryan Ability Lab, Arms and Hands Laboratory, Northwestern University, 355 East Erie street,, Chicago, Illinois, 60611, UNITED STATES
| | - Nina L Suresh
- Shirley Ryan Ability Lab, Northwestern University, 355 East Erie street, Arms and Hands Laboratory, Chicago, Illinois, 60611, UNITED STATES
| | - Babak Afsharipour
- University of Alberta, 116 St & 85 Ave,, Edmonton, Alberta, T6G 2R3, CANADA
| | - William Zev Rymer
- Shirley Ryan Ability Lab, Northwestern University Medical School, 355 East Erie street, Arms and Hands Laboratory, Chicago, IL 60611, USA, Chicago, Illinois, 60611, UNITED STATES
| | - Ales Holobar
- Electrical Engineering and Computer Science, University of Maribor, Koroška cesta 46, Maribor, 2000, SLOVENIA
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Beck AA, Paz LB, Frank MI, Engelmann AM, Krause A, Côrte FDDL. Safety and synovial inflammatory response after intra-articular injection of botulinum toxin type A in healthy horses. J Equine Vet Sci 2022; 110:103865. [PMID: 35017040 DOI: 10.1016/j.jevs.2022.103865] [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: 05/08/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Botulinum toxin type A (BoNT-A) is a promising alternative for patients suffering from chronic joint pain. The aim of this study was to investigate whether a single injection of BoNT-A would produce adverse effects on clinical parameters and synovial parameters as well as lameness. One randomly selected radiocarpal joint was treated with 50 U of BoNT-A in eight horses, and the contralateral joint received saline solution. All horses received injections at day 0 and were re-evaluated twice daily for seven days for heart rate (HR), respiratory rate (RR), rectal temperature (RT), mucous membrane color, capillary refill time, intestinal motility, appetite, water intake, defecation, urination, and attitude. At these same time points, joint pain and circumference were assessed. Objective lameness evaluations were performed once daily for seven days and synovial fluid samples were collected at baseline, post-injection hour (PIH) 24 and PIH 168 and evaluated for synovial fluid parameters. HR and RT remained clinically unaltered, despite oscillations over time (p=0.001). The remaining clinical parameters were unaltered by treatment or time (p>0.05). Joint pain was not elicited by flexion and palpation in both limbs as well as carpal circumference was not altered (p=0.88). Lameness was observed only on saline limbs. Cellular parameters evaluated in synovial fluid samples from both carpi had significantly increased from baseline to PIH 24, decreasing at PIH 168 (p<0.05). It was concluded that the injection of 50 U BoNT-A is suggested to be a safe therapy for intra-articular use in horses and must be verified by further investigation.
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Affiliation(s)
- Antônio Alcemar Beck
- Department of Large Animal Clinics, Federal University of Santa Maria, Veterinary Teaching Hospital, Roraima Avenue, 1000 - Camobi, 97105900 Santa Maria, Rio Grande do Sul, Brazil.
| | - Letícia Bisso Paz
- Department of Large Animal Clinics, Equine Sports Medicine and Surgery, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Maria Inês Frank
- College of Veterinary Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Ana Martiele Engelmann
- Department of Small Animal Clinics, Veterinary Clinical Pathology Laboratory, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Alexandre Krause
- Department of Small Animal Clinics, Veterinary Clinical Pathology Laboratory, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Flávio Desessards De La Côrte
- Department of Large Animal Clinics, Equine Sports Medicine and Surgery, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Atkins CA, Pond KR, Madsen CK, Moorman VJ, Roman-Muniz IN, Archibeque SL, Grandin T. Sensor analysis and initial assessment of detectable first hoof contacts and last break-overs as unique signal fluctuations for equine gait analysis. Transl Anim Sci 2019; 3:1389-1398. [PMID: 32704902 PMCID: PMC7200566 DOI: 10.1093/tas/txz089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/03/2019] [Indexed: 11/14/2022] Open
Abstract
The objective of the control study was to assess 2 prominent fluctuations in a single optical signal as being either a true first hoof contact or a last break-over based on descriptive measures. The study builds on initial findings from a preliminary investigation of the embedded-optical-base system’s (EOBS) capabilities in signal capturing and feasibility as potential alternative to existing gait technologies, such as piezoelectric (e.g., load cell) systems. Hoof contacts and break-overs were measured (0 to 1 au; arbitrary units) using a 2.4-m (length) × 0.9-m (width) platform containing 1 EOBS. Three mixed-breed horses (n = 3) were injected with saline or either 100 IU or 200 IU Botox (i.e., onabotulinumtoxinA) with a 2.5-mL final volume. Injections were made into the deep digital flexor muscle at the motor end plates, with electromyography and ultrasound guidance. Horses were observed for 3 time points (pre-, post-, and recovery test days) over the span of a 4-mo period. Signal fluctuations [i.e., amplitude of hoof impacts based on true first hoof contacts (ΔSTS) and true last break-overs (ΔSTL)] and kinematics [i.e., complete gait pass (CGP) time duration (T)] were recorded from each horse. Visual observations and video analysis were used for determining gait pattern categories. Individual horse measurements were analyzed for each trial, compared with video data and classified. Comparison of primary signal fluctuations (i.e., ΔSTS vs. ΔSTL; forelimb vs. hindlimb) exhibited significant differences between hoof contacts and break-overs (P < 0.05). Right and left forelimb hoof contacts and hindlimb break-overs were not significantly different (P = 0.966; 0.063 ± 0.135; Estimate ± SE; P = 0.606; 0.176 ± 0.142; Estimate ± SE, respectively). Additionally, treatment vs. saline forelimbs did not exhibit significant difference (P = 0.7407; −0.098 ± 0.279; Estimate ± SE). Overall, data showed that the EOBS can collect repeatable and unique primary signal fluctuations as prominent and different gait measurements providing evidence to further development and research of the sensing system.
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Affiliation(s)
- Colton A Atkins
- Department of Animal Sciences, College of Agriculture Sciences, Colorado State University, Fort Collins, CO
| | - Kevin R Pond
- Paul Engler College of Agriculture and Natural Sciences, West Texas A&M, Canyon, TX
| | - Christi K Madsen
- Department of Electrical and Computer Engineering, College of Engineering, Texas A&M University, College Station, TX
| | - Valerie J Moorman
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO
| | - Ivette N Roman-Muniz
- Department of Animal Sciences, College of Agriculture Sciences, Colorado State University, Fort Collins, CO
| | - Shawn L Archibeque
- Department of Animal Sciences, College of Agriculture Sciences, Colorado State University, Fort Collins, CO
| | - Temple Grandin
- Department of Animal Sciences, College of Agriculture Sciences, Colorado State University, Fort Collins, CO
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van Weeren PR, Back W. Musculoskeletal Disease in Aged Horses and Its Management. Vet Clin North Am Equine Pract 2016; 32:229-47. [PMID: 27449390 DOI: 10.1016/j.cveq.2016.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Musculoskeletal disorders are the most prevalent health problem in aging horses. They are not life threatening, but are painful and an important welfare issue. Chronic joint disease (osteoarthritis) and chronic laminitis are the most prevalent. Treating osteoarthritis in the elderly horse is similar to treating performance horses, but aims at providing a stable situation with optimal comfort. Immediate medical treatment of flare-ups, long-term pain management, and adaptation of exercise and living conditions are the mainstays of treatment. Laminitis in the geriatric horse is related often to pituitary pars intermedia dysfunction, which may be treated with additional pergolide.
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Affiliation(s)
- Paul René van Weeren
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, 3584CM Utrecht, the Netherlands.
| | - Willem Back
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, 3584CM Utrecht, the Netherlands; Department of Surgery and Anaesthesiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9280 Merelbeke, Belgium
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Hardeman LC, van der Meij BR, Back W, van der Kolk JH, Wijnberg ID. The use of electromyography interference pattern analysis to determine muscle force of the deep digital flexor muscle in healthy and laminitic horses. Vet Q 2015; 36:10-5. [PMID: 26610153 DOI: 10.1080/01652176.2015.1106116] [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: 10/22/2022] Open
Abstract
BACKGROUND In equine laminitis, the deep digital flexor muscle (DDFM) appears to have increased muscle force, but evidence-based confirmation is lacking. OBJECTIVES The purpose of this study was to test if the DDFM of laminitic equines has an increased muscle force detectable by needle electromyography interference pattern analysis (IPA). ANIMALS AND METHODS The control group included six Royal Dutch Sport horses, three Shetland ponies and one Welsh pony [10 healthy, sound adults weighing 411 ± 217 kg (mean ± SD) and aged 10 ± 5 years]. The laminitic group included three Royal Dutch Sport horses, one Friesian, one Haflinger, one Icelandic horse, one Welsh pony, one miniature Appaloosa and six Shetland ponies (14 adults, weight 310 ± 178 kg, aged 13 ± 6 years) with acute/chronic laminitis. The electromyography IPA measurements included firing rate, turns/second (T), amplitude/turn (M) and M/T ratio. Statistical analysis used a general linear model with outcomes transformed to geometric means. RESULTS The firing rate of the total laminitic group was higher than the total control group. This difference was smaller for the ponies compared to the horses; in the horses, the geometric mean difference of the laminitic group was 1.73 [geometric 95% confidence interval (CI) 1.29-2.32], and in the ponies this value was 1.09 (geometric 95% CI 0.82-1.45). CONCLUSION AND CLINICAL RELEVANCE In human medicine, an increased firing rate is characteristic of increased muscle force. Thus, the increased firing rate of the DDFM in the context of laminitis suggests an elevated muscle force. However, this seems to be only a partial effect as in this study, the unchanged turns/second and amplitude/turn failed to prove the recruitment of larger motor units with larger amplitude motor unit potentials in laminitic equids.
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Affiliation(s)
- L C Hardeman
- a Department of Equine Sciences , Faculty of Veterinary Medicine, Utrecht University , Yalelaan 114, 3584 CM Utrecht , The Netherlands
| | - B R van der Meij
- a Department of Equine Sciences , Faculty of Veterinary Medicine, Utrecht University , Yalelaan 114, 3584 CM Utrecht , The Netherlands
| | - W Back
- a Department of Equine Sciences , Faculty of Veterinary Medicine, Utrecht University , Yalelaan 114, 3584 CM Utrecht , The Netherlands.,b Department of Surgery and Anaesthesiology , Faculty of Veterinary Medicine, Ghent University , Salisburylaan 133, 9820 Merelbeke , Belgium
| | - J H van der Kolk
- c Department of Clinical Veterinary Medicine , Swiss Institute for Equine Medicine, Vetsuisse Faculty, University of Bern and Agroscope , Bern , Switzerland
| | - I D Wijnberg
- a Department of Equine Sciences , Faculty of Veterinary Medicine, Utrecht University , Yalelaan 114, 3584 CM Utrecht , The Netherlands
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The potential and limitations of quantitative electromyography in equine medicine. Vet J 2015; 209:23-31. [PMID: 26831156 DOI: 10.1016/j.tvjl.2015.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 11/21/2022]
Abstract
This review discusses the scope of using (quantitative) electromyography (EMG) in diagnosing myopathies and neuropathies in equine patients. In human medicine, many EMG methods are available for the diagnosis, pathophysiological description and evaluation, monitoring, or rehabilitation of patients, and some of these techniques have also been applied to horses. EMG results are usually combined with other neurophysiological data, ultrasound, histochemistry, biochemistry of muscle biopsies, and clinical signs in order to provide a complete picture of the condition and its clinical course. EMG technology is commonly used in human medicine and has been subject to constant development and refinement since its introduction in 1929, but the usefulness of the technique in equine medicine is not yet widely acknowledged. The possibilities and limitations of some EMG applications for equine use are discussed.
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Hardeman LC, van der Meij BR, Lamers AAH, van der Kolk JH, Back W, Wijnberg ID. Determination of equine deep digital flexor muscle volume based on distances between anatomical landmarks. Res Vet Sci 2014; 97:397-9. [PMID: 25264361 DOI: 10.1016/j.rvsc.2014.08.006] [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: 11/26/2012] [Revised: 07/01/2014] [Accepted: 08/21/2014] [Indexed: 11/26/2022]
Abstract
In equine medicine the use of Botox® is experimental. Dosages are determined from human treatment-protocols and limited numbers of equine studies. Determination of target-muscle volume can be helpful to extrapolate human dosages. The aim of the study was to calculate a formula enabling the estimation of the deep digital flexor muscle (DDFM) volume based on distances between anatomical landmarks. Nineteen cadaveric limbs were collected and distance A (top of olecranon to Os carpi accessorium) and B (circumference of limb) were measured. Converting mathematical formulas, C was calculated: π × (((0.5B)/π)(2)) × A. DDFM volume was determined by water displacement. Linear Regression Analysis was used to analyse data. The line best fitting the observed points was: Ln(volume[ml]) = -1.89 + 0.98 × Ln(value C[cm(3)]). Correlation was highest when natural logarithm was applied to both variables and was 0.97. The calculated formula enables estimating DDFM volume of a living horse. This estimated volume can be useful to apply human Botox® treatment-protocols.
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Affiliation(s)
- L C Hardeman
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - B R van der Meij
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - A A H Lamers
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - J H van der Kolk
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - W Back
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands; Department of Surgery and Anaesthesiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - I D Wijnberg
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
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Hardeman LC, van der Meij BR, Oosterlinck M, Veraa S, van der Kolk JH, Wijnberg ID, Back W. Effect of Clostridium botulinum toxin type A injections into the deep digital flexor muscle on the range of motion of the metacarpus and carpus, and the force distribution underneath the hooves, of sound horses at the walk. Vet J 2013; 198 Suppl 1:e152-6. [PMID: 24360731 DOI: 10.1016/j.tvjl.2013.09.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. botulinum toxin type A on the gait characteristics of sound horses at the walk are not known. The aim of this study was to test if a reduced DDFM activity would lead to (1) alterations of the sagittal range of motion of the metacarpus (SROM) and range of motion of the carpal joint (CROM); (2) changes in the force distribution underneath the hoof (toe vs. heel region: balance index); and (3) changes in the force distribution between the treated and untreated limb (symmetry index). The DDFMs of the left forelimbs of seven sound Royal Dutch Sport Horses were injected with 200 IU C. botulinum toxin type A using electromyography and ultrasound guidance. Measurements using an inertial sensor system and dynamically calibrated pressure plate were performed before and after injections. The SROM and CROM of the treated limb were significantly increased after C. botulinum toxin type A injections. No significant changes were detected in the balance index or in the symmetry index, indicating that no lameness was induced. C. botulinum toxin type A injections into the DDFM of sound horses do not appear to result in substantial gait alterations at the walk.
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Affiliation(s)
- Lotte C Hardeman
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands
| | - Bram R van der Meij
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands
| | - Maarten Oosterlinck
- Department of Surgery and Anaesthesiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Stefanie Veraa
- Division of Diagnostic Imaging, Department of Companion Animal Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - Johannes H van der Kolk
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands
| | - Inge D Wijnberg
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands.
| | - Willem Back
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands; Department of Surgery and Anaesthesiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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