Unilateral laser ventriculocordectomy results in increased arytenoid stability in horses with severe left sided recurrent laryngeal neuropathy

BACKGROUND

There is no objective information reporting the effect of unilateral laser ventriculocordectomy (VeC) on arytenoid abduction or stability.

OBJECTIVES

To evaluate arytenoid stability and abduction in horses with severe recurrent laryngeal neuropathy (RLN) before and after unilateral laser VeC.

STUDY DESIGN

Prospective cohort.

METHODS

Eight horses with grade C or D exercising laryngeal function that underwent unilateral laser VeC were included. Exercising endoscopy was performed before and ≥6 weeks after left-sided laser VeC. Arytenoid stability at maximal exercise was calculated by measuring the left-to-right quotient angle ratio (LRQ) of the corniculate processes at the points of maximal arytenoid abduction (expiration) and maximal arytenoid collapse (inspiration). For each horse, means of measurements obtained for four breaths pre- and post-operatively were used for statistical analysis.

RESULTS

The difference in LRQ between inspiration and expiration was lower post-operatively (median 0.039; interquartile range [IQR] 0.032-0.047) compared with pre-operatively (median 0.158; IQR 0.083-0.249; p = 0.01) confirming the left arytenoid was more stable following unilateral laser VeC. The degree of improvement was significantly greater for grade D horses compared with grade C horses (p = 0.04). The LRQ measured on maximal abduction was also lower post-operatively (median 0.467; IQR 0.444-0.506) compared with pre-operatively (median 0.578; IQR 0.554-0.655; p = 0.02) indicating the left arytenoid was less abducted following surgery.

MAIN LIMITATIONS

The sample size was small, no racehorses were included and post-operative assessment was conducted at a variable time after surgery.

CONCLUSION

Unilateral laser VeC in grade C and D RLN-affected horses results in slightly reduced left arytenoid abduction but increased arytenoid stability.

Factors affecting measurement of basal adrenocorticotropic hormone in adult domestic equids: A scoping review

Measurement of basal adrenocorticotropic hormone (ACTH) concentration is the most commonly used diagnostic test for pituitary pars intermedia dysfunction (PPID). Although several pre-analytical and analytical factors have been reported to affect basal ACTH concentrations in equids, the extent to which these have been evaluated in the context of PPID diagnosis is unclear. The objectives of this scoping review were to identify and systematically chart current evidence about pre-analytical and analytical factors affecting basal ACTH concentrations in adult domestic equids. Systematic searches of electronic databases and conference proceedings were undertaken in June 2022, repeated in October 2022 and updated in August 2023. English language publications published prior to these dates were included. Screening and data extraction were undertaken individually by the authors, using predefined criteria and a modified scoping review data extraction template. After removal of duplicates, 903 publications were identified, of which 235 abstracts were screened for eligibility and 134 publications met inclusion criteria. Time of year, exercise, breed/type and transportation were the factors most frequently associated with significant increases in ACTH concentration (n = 26, 16, 13 and 10 publications, respectively). Only 25 publications reported inclusion of PPID cases in the study population, therefore the relationship between many factors affecting basal ACTH concentration and diagnostic accuracy for PPID remains undefined. However, several factors were identified that could impact interpretation of basal ACTH results. Findings also highlight the need for detailed reporting of pre-analytical and analytical conditions in future research to facilitate translation of evidence to practice.

BEVA primary care clinical guidelines: Diagnosis and management of equine pituitary pars intermedia dysfunction

BACKGROUND

Pituitary pars intermedia dysfunction (PPID) is a prevalent, age-related chronic disorder in equids. Diagnosis of PPID can be challenging because of its broad spectrum of clinical presentations and disparate published diagnostic criteria, and there are limited available treatment options.

OBJECTIVES

To develop evidence-based primary care guidelines for the diagnosis and treatment of equine PPID based on the available literature.

STUDY DESIGN

Evidence-based clinical guideline using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework.

METHODS

Research questions were proposed by a panel of veterinarians and developed into PICO or another structured format. VetSRev and Veterinary Evidence were searched for evidence summaries, and systematic searches of the NCBI PubMed and CAB Direct databases were conducted using keyword searches in July 2022 and updated in January 2023. The evidence was evaluated using the GRADE framework.

RESULTS AND RECOMMENDATIONS

The research questions were categorised into four areas: (A) Case selection for diagnostic testing, pre-test probability and diagnostic test accuracy, (B) interpretation of test results, (C) pharmacological treatments and other treatment/management options and (D) monitoring treated cases. Relevant veterinary publications were identified and assessed using the GRADE criteria. The results were developed into recommendations: (A) Case selection for diagnostic testing and diagnostic test accuracy: (i) The prevalence of PPID in equids aged ≥15 years is between 21% and 27%; (ii) hypertrichosis or delayed/incomplete hair coat shedding provides a high index of clinical suspicion for PPID; (iii) the combination of clinical signs and age informs the index of clinical suspicion prior to diagnostic testing; (iv) estimated pre-test probability of PPID should be considered in interpretation of diagnostic test results; (v) pre-test probability of PPID is low in equids aged <10 years; (vi) both pre-test probability of disease and season of testing have strong influence on the ability to diagnose PPID using basal adrenocorticotropic hormone (ACTH) or ACTH after thyrotropin-releasing hormone (TRH) stimulation. The overall diagnostic accuracy of basal ACTH concentrations for diagnosing PPID ranged between 88% and 92% in the autumn and 70% and 86% in the non-autumn, depending on the pre-test probability. Based on a single study, the overall diagnostic accuracy of ACTH concentrations in response to TRH after 30 minutes for diagnosing PPID ranged between 92% and 98% in the autumn and 90% and 94% in the non-autumn, depending on the pre-test probability. Thus, it should be remembered that the risk of a false positive result increases in situations where there is a low pre-test probability, which could mean that treatment is initiated for PPID without checking for a more likely alternative diagnosis. This could compromise horse welfare due to the commencement of lifelong therapy and/or failing to identify and treat an alternative potentially life-threatening condition. (B) Interpretation of diagnostic tests: (i) There is a significant effect of breed on plasma ACTH concentration, particularly in the autumn with markedly higher ACTH concentrations in some but not all 'thrifty' breeds; (ii) basal and/or post-TRH ACTH concentrations may also be affected by latitude/location, diet/feeding, coat colour, critical illness and trailer transport; (iii) mild pain is unlikely to have a large effect on basal ACTH, but caution may be required for more severe pain; (iv) determining diagnostic thresholds that allow for all possible contributory factors is not practical; therefore, the use of equivocal ranges is supported; (v) dynamic insulin testing and TRH stimulation testing may be combined, but TRH stimulation testing should not immediately follow an oral sugar test; (vi) equids with PPID and hyperinsulinaemia appear to be at higher risk of laminitis, but ACTH is not an independent predictor of laminitis risk. (C) Pharmacologic treatments and other treatment/management options: (i) Pergolide improves most clinical signs associated with PPID in the majority of affected animals; (ii) Pergolide treatment lowers basal ACTH concentrations and improves the ACTH response to TRH in many animals, but measures of insulin dysregulation (ID) are not altered in most cases; (iii) chasteberry has no effect on ACTH concentrations and there is no benefit to adding chasteberry to pergolide therapy; (iv) combination of cyproheptadine with pergolide is not superior to pergolide alone; (v) there is no evidence that pergolide has adverse cardiac effects in horses; (vi) Pergolide does not affect insulin sensitivity. (D) Monitoring pergolide-treated cases: (i) Hormone assays provide a crude indication of pituitary control in response to pergolide therapy, however it is unknown whether monitoring of ACTH concentrations and titrating of pergolide doses accordingly is associated with improved endocrinological or clinical outcome; (ii) it is unknown whether monitoring the ACTH response to TRH or clinical signs is associated with an improved outcome; (iii) there is very weak evidence to suggest that increasing pergolide dose in autumn months may be beneficial; (iv) there is little advantage in waiting for more than a month to perform follow-up endocrine testing following initiation of pergolide therapy; there may be merit in performing repeat tests sooner; (v) timing of sampling in relation to pergolide dosing does not confound measurement of ACTH concentration; (vi) there is no evidence that making changes after interpretation of ACTH concentrations measured at certain times of the year is associated with improved outcomes; (vii) evidence is very limited, however, compliance with PPID treatment appears to be poor and it is unclear whether this influences clinical outcome; (viii) evidence is very limited, but horses with clinical signs of PPID are likely to shed more nematode eggs than horses without clinical signs of PPID; it is unclear whether this results in an increased risk of parasitic disease or whether there is a need for more frequent assessment of faecal worm egg counts.

MAIN LIMITATIONS

Limited relevant publications in the veterinary scientific literature.

CONCLUSIONS

These findings should be used to inform decision-making in equine primary care practice.

Evaluation of seasonal influences on adrenocorticotropic hormone response to the thyrotropin-releasing hormone stimulation test and its accuracy for diagnosis of pituitary pars intermedia dysfunction

Pituitary pars intermedia dysfunction (PPID) is an age-related neurodegenerative disorder, affecting >20 % of older horses. There is a need for improved endocrine tests for early disease detection, and the thyrotropin-releasing hormone (TRH) stimulation test has been recommended for diagnosis of early or mild cases. However, it is currently not recommended for year-round use due to marked seasonal variability. The aims of this cohort study were to evaluate effects of month and season on adrenocorticotropic hormone (ACTH) responses to TRH stimulation and to derive monthly cut-offs for PPID diagnosis. Sixty-three horses were assigned to control (n = 17), subclinical PPID (n = 21) and clinical PPID (n = 25) groups, based on a composite reference standard that combined clinical history and examination findings with endocrine test results. TRH stimulation tests were performed monthly for a 12-month period. Circannual changes were evaluated with one- and two-way repeated-measures analysis of variance and receiver operating characteristic curve analysis was used to derive cut-off values for basal and TRH-stimulated ACTH. TRH-stimulated ACTH concentrations were lowest in February-May and highest in August-October. Specificity of both basal and 30 min post-TRH ACTH was generally higher than sensitivity, and TRH stimulation had improved diagnostic accuracy compared to basal ACTH, although its sensitivity was not significantly greater year-round. TRH stimulation tests yielded considerably more positive results than basal ACTH in the subclinical group, but few additional positive results in clinical PPID cases. There were large differences between cut-offs that maximised sensitivity or specificity for TRH-stimulated ACTH, highlighting the importance of considering clinical presentation alongside test results in diagnostic decision-making.

Diagnosis of equine pituitary pars intermedia dysfunction

Equine pituitary pars intermedia dysfunction (PPID) is common in aged horses. The majority of horses respond well to treatment, but treatment is lifelong, meaning accurate diagnosis of PPID is important. Similar to any condition, there is no perfect laboratory test to diagnose PPID and accuracy is affected by the characteristics of the population in which the test is being evaluated. This review details the importance of consideration of clinical factors and diagnostic test accuracy. Basal adrenocorticotrophic hormone (ACTH) concentration is used most frequently in practice and has very good diagnostic accuracy when used in combination with clinical judgement and the correct application of diagnostic thresholds. The thyrotropin-releasing hormone stimulation test can be used in horses with equivocal test results following basal ACTH testing, or to evaluate subtle cases due to its improved accuracy.

Equine Endocrine Disease: Challenges With Case Definition for Research

Equine endocrine disease is an important area for equine research, requiring an appropriate case definition for inclusion and criteria for exclusion from disease. Defining a case for research may be different from criteria for clinical diagnosis. Further, clinical diagnosis recommendations have been changing regularly, making this area challenging for equine scientists. This review discusses the diagnosis of major equine endocrine diseases, pituitary pars intermedia dysfunction, equine metabolic syndrome and insulin dysregulation, focusing on the most appropriate diagnostic methods for research case definitions. Different diagnostic methods, including use of reference intervals and clinical decision limits, will be discussed with their relative merits for use in case definition for research.

Implementation of biosecurity on equestrian premises: A narrative overview

Biosecurity measures are designed to prevent the introduction and spread of pathogens, and play a vital role in the equine industry, controlling endemic diseases and reducing the threat of exotic disease incursion. Equestrian premises differ with respect to disease risks, biosecurity requirements and available facilities. This narrative review summarises reported frequency of implementation for selected biosecurity measures, as well as evidence relating to potential barriers to implementation of biosecurity on equestrian premises. Possible opportunities for improvement in the adoption of equine biosecurity measures are also discussed.

Risk factors for a first episode of primary uveitis in the UK and proportion of cases that experience recurrence following this first episode

BACKGROUND

Risk factors for a first episode of primary uveitis in horses have not been determined. In addition, disease progression and the proportion of horses that develop recurrence following the original episode are not known.

OBJECTIVES

To determine the risk factors for the development of a first episode of primary uveitis in horses in the UK and to document the proportion of cases that experience recurrence following this first episode.

STUDY DESIGN

Prospective case-control longitudinal study.

METHODS

Horses with a first episode of primary uveitis between July 2014 and August 2018 were recruited to the study. For each case, two controls were selected. A questionnaire was completed for each horse and multivariable logistic regression analysis was carried out to identify associations between horse and management-level variables and the risk of uveitis. Each case was then followed longitudinally to determine the rate of recurrence of uveitis.

RESULTS

Twenty-three cases and 46 controls were recruited. Being close to a pig farm (OR 27.8, CI 1.31-592.06) and a recent history of flooding of the pasture (OR 15.43, CI 2.80-84.98) was associated with increased risk of uveitis. Being in the same owner's possession for a longer amount of time had a protective effect (OR 0.79, CI 0.68-0.93). Horses recovered uneventfully following treatment and showed no evidence of recurrence in 59.1% of the cases (n = 13). In five horses (22.7%), the initial episode of uveitis could not be controlled and required surgical therapy. Recurrence was observed in four horses (18.2%).

MAIN LIMITATIONS

Small sample size. Recall bias from owners for some of the data. Possibility of selection bias.

CONCLUSIONS

Clinicians can use this information to identify horses with increased risk of uveitis and provide advice to the owners of these horses. The proportion of cases that experience recurrence appears low in the UK.

Management of pituitary pars intermedia dysfunction in practice: A clinical audit

In horses/ponies with pituitary pars intermedia dysfunction (PPID), pergolide mesylate treatment, with monitoring of therapeutic response, is recommended by contemporaneous literature and equine endocrinologists. However, it is unknown whether these recommendations are adhered to in private practice. This clinical audit aimed to compare treatment and monitoring of PPID cases in veterinary practice against available recommendations. Case data and basal plasma adrenocorticotropic hormone (ACTH) concentrations from all equids tested for PPID between 2012 and 2016 from a single veterinary practice in the UK were obtained. Records were reviewed and information on treatment and monitoring over the subsequent 2-6 years was extracted and compared with published recommendations. After exclusions, the audit population was 480 animals (median age, 20 years). The most common presenting signs were laminitis and/or historical laminitis (51.2%) and hypertrichosis and/or delayed coat shedding (24.5%). Based on seasonally adjusted reference intervals for basal ACTH concentration, 51.7% (n = 248) of animals were classified as positive, 37.1% (n = 178) as negative and 11.3% (n = 54) as equivocal for PPID. Records were available for 459 animals; of which pergolide treatment was initiated in 78.7% (n = 185/235) of positive cases, 19.2% (n = 10/52) of equivocal cases and 6.4% (n = 11/172) of cases classified as negative. Overall, 87.2% (n = 129/148) of cases commenced treatment as per recommendations. Only 77.7% (n = 160/206) of pergolide-treated animals had documented PPID monitoring and of these, only 48.1% (n = 77/160) had follow-up basal ACTH testing in the first 1-3 months following diagnosis. The findings confirm that management of PPID in veterinary practice fell below contemporaneous recommendations, especially for monitoring.

Approaches to endocrinopathic laminitis in the field: Results of a survey of veterinary practitioners in North America

Endocrinopathic laminitis is the most common cause of laminitis in the field. Insulin has recently been implicated as a key factor in development of endocrinopathic laminitis; however, it is unclear whether diagnostic and treatment approaches reflect insights derived from recent research. This study sought to evaluate North American veterinary practitioners' approach to endocrinopathic laminitis in the field. Demographic information, approach to diagnosis, management, and prognosis of endocrinopathic laminitis, as well as factors influencing changes in approach to laminitis were collected. To compare regional differences in approach to laminitis, results were compared to a recently published study from the United Kingdom. Findings of the present study suggest that North American practitioners have changed their approach to laminitis to more readily incorporate diagnostic testing for endocrine disease.

Efficacy of pergolide for the management of equine pituitary pars intermedia dysfunction: A systematic review

Pergolide, a dopamine agonist, is commonly administered to manage pituitary pars intermedia dysfunction (PPID), a progressive neurodegenerative disease prevalent in aged horses. However, available evidence regarding pergolide's efficacy in improving clinical and endocrine parameters is limited. The aim of this systematic review was to assess published literature and evaluate evidence regarding whether pergolide treatment results in improvement of clinical signs and/or adrenocorticotrophic hormone (ACTH) concentration compared to no treatment or other unlicensed treatments. Systematic searches of electronic databases were undertaken in April 2019, repeated in August and October 2019, and updated in July 2020. English language publications published prior to these dates were included. Screening, data extraction and quality assessment of publications was undertaken individually by the authors using predefined criteria and subsequently cross-checked. Modified critically appraised topic data collection forms were used to extract data. Due to marked between-study variations, meta-analysis was not undertaken. After removal of duplicate records; 612 publications were identified, of which 129 abstracts were screened for eligibility and 28 publications met criteria for inclusion in the review. Most studies were descriptive case series, cohort studies or non-randomised, uncontrolled field trials. Despite marked variation in study populations, case selection, diagnostic protocols, pergolide dose, follow-up period and outcome measures, in the vast majority of the included studies, pergolide was reported to provide overall clinical improvement in >75% of cases. However, reported improvements in individual clinical signs varied widely. A reduction in plasma ACTH concentrations was reported in 44-74% of cases, while normalisation to within reported reference intervals occurred in 28-74% of cases.

Relationships of inflamm-aging with circulating nutrient levels, body composition, age, and pituitary pars intermedia dysfunction in a senior horse population

Similarly to aged humans, senior horses (≥20 years) exhibit chronic low-grade inflammation systemically, known as inflamm-aging. Inflamm-aging in the senior horse has been characterized by increased circulating inflammatory cytokines as well as increased inflammatory cytokine production by lymphocytes and monocytes in response to a mitogen. Little is currently known regarding underlying causes of inflamm-aging. However, senior horses are also known to present with muscle wasting and often the endocrinopathy pituitary pars intermedia dysfunction (PPID). Despite the concurrence of these phenomena, the relationships inflamm-aging may have with measures of body composition and pituitary function in the horse remain unknown. Furthermore, nutrition has been a focus of research in an attempt to promote health span as well as life span in senior horses, with some nutrients, such as omega-3 fatty acids, having known anti-inflammatory effects. Thus, an exploratory study of a population of n = 42 similarly-managed senior horses was conducted to determine relationships between inflamm-aging and measures of circulating nutrients, body composition, age, and PPID. Serum was collected to determine vitamin, mineral, and fatty acid content. Peripheral blood mononuclear cells were also isolated to determine inflammatory cytokine production of interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) following stimulation with a mitogen, as well as to determine gene expression of interleukin(IL)-1β, IL-6, IL-10, IFN-γ, and TNF-α. Serum IL-6 and C-reactive protein were determined by enzyme-linked immunosorbent assay. Whole blood was collected for hematological and biochemical analysis. Body composition was evaluated via ultrasound and muscle scoring for all 42 horses as well as by deuterium oxide dilution for a subset of n = 10 horses. Pituitary function was evaluated by measuring basal adrenocorticotropin hormone concentrations as well as by thyrotropin releasing hormone stimulation testing (to determine PPID status). Results showed various relationships between inflammatory markers and the other variables measured. Most notably, docosadienoic acid (C22:2n6c), docosapentaenoic acid (C22:5n3c), and folate were positively associated with numerous inflammatory parameters (P ≤ 0.05). Although no relationships were found between inflamm-aging and PPID, being positive for PPID was negatively associated with vitamin B12 (P ≤ 0.01). No relationships between inflammation and body composition were found. Even within this senior horse population, age was associated with multiple parameters, particularly with numerous inflammatory cytokines and fatty acids. In summary, inflamm-aging exhibited relationships with various other parameters examined, particularly with certain fatty acids. This exploratory study provides insights into physiological changes associated with inflamm-aging in the senior horse.

Comparison of fasted basal insulin with the combined glucose-insulin test in horses and ponies with suspected insulin dysregulation

Fasting horses for measurement of basal serum insulin concentration (fasting insulin; FI) has been recommended to standardise testing for insulin dysregulation (ID), yet limited data exist comparing it to dynamic tests. This study aimed to compare FI with the combined glucose-insulin test (CGIT) in horses suspect for ID. We hypothesised that FI would have poor sensitivity for detecting ID compared to CGIT using conventional cut-offs. Records were retrieved from CGITs performed in horses fasted for approximately 8h. Serum insulin and glucose concentrations were measured before and for 150min following an IV bolus of glucose followed by insulin. Correlations between FI and CGIT values were assessed. Youden's index analysis was used to determine the optimal cut-off for FI. Logistic regression and Mann-Whitney U tests were used to determine factors affecting the results. CGITs (n=130) from 62 horses were evaluated. Compared to CGIT, sensitivity and specificity of FI for diagnosis of ID were 14.6% and 100% at a cut-off of 20μIU/mL and 63.4% and 87.2% at a cut-off of 5.2μIU/mL, respectively. FI was significantly correlated with insulin at 45min (r_s=0.66) and 75min (r_s=0.72); area under the curve for insulin (AUC_insulin; r_s=0.67); glucose at 45min (r_s=0.53); and AUC_glucose (r_s=0.50). Obesity was significantly associated with increased odds of a positive CGIT and horses with a positive CGIT were significantly older (P<0.05). In conclusion, FI correlated well with CGIT results and had adequate sensitivity and specificity at lower cut-offs, despite poor sensitivity at conventional cut-off values. Further research to derive cut-off values relevant to the fasting period is warranted.

Impacting on factors promoting intra-group aggression in secure psychiatric settings

Three preliminary and linked studies investigate the impact of making alterations to factors considered relevant to engaging in and experiencing intra-group aggression (bullying) among adult male patients detained in a single secure forensic hospital. Study one (n = 44) outlines the institutional factors, attitudes towards bullying and environmental factors that increase the likelihood of engaging in bullying and/or being victimised. Study two (n = 53 patients and 167 staff) assesses the effect of three variations of intervention that aimed to reduce intra-group aggression through direct alteration of the physical and psychosocial environment, using data from both patients and staff. Study three (n = 414) looks at the effects of two variations of the intervention used in study two, which offered patients’ participation in individual and communal activities. It was predicted that changes to the physical and social environment would produce a reduction in the factors shown to predict intra-group aggression. Attitudes supportive of bullying and the presence of social hierarchies each increased the likelihood of engaging in bullying. Indirect changes to the social environment on the wards had more positive effects than those incorporating direct alterations to the physical and social environment. The differences in effectiveness of the two approaches are discussed in relation to the established predictors of intra-group aggression. The research concludes by noting the preliminary nature of the research and outlining potential directions for future research and intervention.

Prevalence of owner-reported ocular problems and veterinary ocular findings in a population of horses aged ≥15 years

BACKGROUND

Previous studies suggest that ocular disease is common among aged horses but owners may fail to identify or underestimate their clinical relevance.

OBJECTIVES

To document the prevalence of owner-reported ocular disease in horses aged ≥15 years. In a subset of these horses, to document ophthalmic findings from veterinary examination and compare with owner-reported ocular disease, and to determine risk factors for veterinary ophthalmic findings.

STUDY DESIGN

Cross-sectional study.

METHODS

Owners of aged horses completed a survey on management, clinical signs and medical history. Risk factors for the presence of ocular disease as reported by the owner were determined. A subset of these horses underwent an ophthalmological examination. Risk factors for the presence of ocular disease detected during this examination were determined. Agreement between owner-reported data and veterinary ophthalmic findings was assessed.

RESULTS

Abnormal ocular findings were detected in 287/327 horses aged ≥15 years that underwent a complete ophthalmic examination, whereas the presence of ocular disease as reported by the horse-owners was only 3.3%. Agreement between owner-reported ocular disease and results of the veterinary examination was low for all categories analysed. An owner-reported history of ocular discharge was associated with increased odds of veterinary-reported diminished vision. Increasing age was associated with increased odds of the presence of an eye abnormality (any) and cataracts. Appaloosa horses had increased odds of cataract compared with other breeds. Horses in work were less likely to have an eye abnormality.

MAIN LIMITATIONS

Volunteer bias may have influenced our results with owners of sick horses or those more concerned about their horses more likely to volunteer at the initial recruitment phase.

CONCLUSIONS

This study showed a high prevalence of ocular lesions in aged horses which was not reflected in owner-reported disease. This has highlighted problems in obtaining information on ocular conditions from horse-owners.

Evaluation of the diagnostic accuracy of skeletal scintigraphy for the causes of front foot pain determined by magnetic resonance imaging

There is good correlation between increased radiopharmaceutical uptake anywhere in the feet of sports or leisure horses and the presence of foot pain. However, low sensitivity of scintigraphy for identifying lesions contributing to foot pain as determined by magnetic resonance imaging (MRI) has been reported. The aim of this retrospective, cross-sectional, analytical study was to assess the accuracy of scintigraphy for identifying the cause(s) of foot pain, using MRI as the reference standard. Sports and leisure horses that underwent both skeletal scintigraphy and MRI of the front feet between March 2008 and December 2014 and for which a definitive diagnosis of the cause(s) of front foot pain was reached were included (121 feet of 70 horses). Imaging studies were evaluated retrospectively, blindly. Agreements between scintigraphic localization of increased radiopharmaceutical uptake and subjective categorization of lesions with MRI diagnosis were assessed using Kappa statistics (κ). Measures of diagnostic accuracy were calculated. Sensitivity of increased radiopharmaceutical uptake varied among regions (31.8-76.2%) but specificity was at least high for all (84.6-100%). Agreements between both scintigraphy measures and MRI diagnosis were substantial for the distal phalanx (palmar processes and body) (κ = 0.77 and κ = 0.74, respectively), and ungular cartilages and chondral ligaments (κ = 0.62, for both). When all regions were combined, agreements of increased radiopharmaceutical uptake (κ = 0.49) and relevance categorization (κ = 0.45) with MRI diagnosis were moderate. In conclusion, skeletal scintigraphy does not meet the minimum reliability level for a diagnostic test, but is reliable for identification of osseous trauma to the distal phalanx and ungular cartilages.

Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors

Pituitary pars intermedia dysfunction (PPID) is caused by an age-related degenerative disease of dopaminergic neurones. Despite its importance in equine practice, available information regarding its epidemiology is limited. This systematic review aimed to assess published literature to evaluate available evidence regarding the clinical presentation, prevalence and risk factors for PPID in horses and ponies. Electronic database searches were undertaken using a range of terms, and English language publications published prior to August 2016 were included. Both authors independently reviewed screened papers for inclusion, extracted data, and assessed the quality of reporting using predefined criteria. Data were extracted using modified critically appraised topic data collection forms. Meta-analysis was not undertaken due to marked between-study variations. Following removal of duplicate records, of 358 published papers yielded by the search, 97 abstracts were screened for eligibility and 29 publications meeting inclusion criteria were included in the review. Most studies reviewed were case series or cross-sectional studies, with considerable variation in study populations and PPID case definition. Hypertrichosis and/or other hair coat abnormalities, laminitis and epaxial muscle wastage or muscle atrophy are the most frequently reported clinical signs, with prevalence of these signs increasing with increasing horse age. The most robust prevalence estimates for PPID were 21.2% in horses and ponies aged ≥15 years and 2.9% amongst the general equine population. Findings regarding breed and sex predispositions were equivocal and only increasing age has been identified as a significant risk factor for PPID.

A multicentre study of long-term follow-up and owner satisfaction following enucleation in horses

BACKGROUND

Horses are reported to return to a variety of disciplines following unilateral enucleation; however, owners of horses with ocular disease are frequently reluctant to consider the procedure. There is little published information investigating owners' attitudes towards, and satisfaction following, enucleation.

OBJECTIVES

To investigate the hypotheses: 1) horses return to their previous level of work following unilateral enucleation and 2) their owners are satisfied with the post-operative outcome.

STUDY DESIGN

Retrospective case series with cross-sectional survey.

METHODS

Clinical records from eight equine referral centres in the United Kingdom were reviewed to identify horses that underwent enucleation between August 2006 and March 2015. Owner questionnaires were completed to corroborate information provided by medical records and obtain information on client perceptions.

RESULTS

A total of 170 cases were identified and 119 owner questionnaires completed. The most frequent primary uses of horses in the study were pleasure/leisure riding, showjumping and dressage, with 25.2% (n = 30) of horses used for competition. Following enucleation, 77.3% (n = 92) of horses were performing at an equivalent or higher level than prior to enucleation and 60.0% (n = 18/30) of competition horses were competing at an equivalent or higher level. Complications related to the surgical site (predominantly mild post-operative swelling) were reported in 3.7% of cases and nonocular complications in 3.7% of cases. Of owners who reported being concerned or very concerned about certain factors prior to surgery, ≥86.8% reported that these factors caused little or no issue post-surgery. Most owners, 90.8% (n = 108) were pleased with the outcome following surgery, with 21.3% (n = 23/108) wishing the procedure had been undertaken sooner.

MAIN LIMITATIONS

Retrospective data collection from clinical records and the potential for recall bias.

CONCLUSIONS

Horses can return successfully to a variety of disciplines following enucleation. Owners are satisfied with the outcome and pleased that enucleation was performed.

Equine atypical myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival

BACKGROUND

Equine atypical myopathy (AM) is a toxic rhabdomyolysis associated with ingestion of hypoglycin A, derived typically in Europe, from Acer pseudoplatanus tree. Despite the wide distribution of this tree species in the UK, the number of cases reported annually varies, and there has been an apparent increase in prevalence in recent years. Although AM was first recognised in the UK, epidemiological studies have never been conducted focused solely on this country.

OBJECTIVES

To describe the spatiotemporal distribution, presentation, treatment and outcome of AM cases reported in the UK.

STUDY DESIGN

Retrospective case series.

METHODS

British AM cases reported to the atypical myopathy alert website, between 2011 and 2015 were included (n = 224). Data were obtained via standardised epidemiological questionnaires from owners and veterinarians. Factors associated with survival were assessed using logistic regression.

RESULTS

Most cases reported were from England (87.9%). Survival was 38.6% (n = 73/189). Clinical factors associated with reduced odds of survival included, hypothermia (odds ratio [OR] 0.18; 95% confidence interval [CI] 0.06-0.57; P = 0.01), bladder distension (OR 0.11; CI 0.02-0.59; P = 0.01), tachycardia (OR 0.97; CI 0.94-0.99; P = 0.04) and serum creatine kinase activity >100,000 IU/L (OR 0.17; CI 0.04-0.68; P = 0.01) in the univariable analysis as well as recumbency. The latter was the only sign retained in multivariable analysis (OR = 0.19; CI 0.06-0.62; P = 0.006). Administration of vitamins during the disease was associated with survival (OR 3.75; CI 1.21-11.57; P = 0.02).

MAIN LIMITATIONS

Reporting cases to the Atypical Myopathy Alert Group is voluntary; therefore, under-reporting will result in underestimation of AM cases; furthermore, direct owner-reporting could have introduced misdiagnosis bias.

CONCLUSION

Some areas of the UK reported AM cases more commonly. Clinical signs such as recumbency, rectal temperature, distended bladder and serum creatine kinase activity might be useful prognostic indicators though should be considered in the context of the clinical picture. Treatment with vitamins increases odds of survival.

Demographics, Management, Preventive Health Care and Disease in Aged Horses

Gerontology has become increasingly important in equine veterinary medicine, with aged animals representing a significant proportion of the equine population. Horses are defined as geriatric or aged from age 15 years onwards but can have a life span of more than 40 years. Despite a high level of owner concern for the well-being of their geriatric animal, provision of preventive health care may be suboptimal. Owners seem to under-recognize some of the most prevalent diseases identified in geriatric horses. This review focuses on the demographic characteristics of the equine geriatric population and management and preventive care practices of older horses.

Designing a field trial of an equine grass sickness vaccine: A questionnaire-based feasibility study

Without an experimental model of equine grass sickness (EGS), a randomised controlled field trial (RCT) represents the only method of evaluating the efficacy of Clostridium botulinum type C vaccination in preventing naturally occurring disease. Clinical trial feasibility is an important aspect of preliminary work undertaken prior to initiating RCTs, estimating parameters that are important for study design. This cross-sectional study aimed to assess the feasibility of conducting a nationwide RCT of a candidate vaccine for EGS based on responses from a sample of British equine veterinary practices (n = 119/284). Seventy-three percent of practices had attended ≥1 EGS case within the preceding 2 years (median four cases), and 51.3% regularly attended recurrently affected premises. Veterinary surgeons had greater confidence diagnosing acute/subacute EGS based solely on history and clinical signs compared to chronic EGS. Ninety-one percent of respondents (n = 103/113) considered the proposed RCT to be important/very important to equine veterinary research. Ninety-one percent of respondents (n = 102/112) indicated preparedness to assist in owner recruitment and 92.9% (n = 104/112) indicated willingness to participate in a RCT. The most frequent reasons for practices declining to participate were low incidence of EGS (n = 4), did not believe clients would wish to participate (n = 3) and amount of paperwork/data collection involved (n = 2). There was considerable support amongst participating veterinary practices for a RCT evaluating the efficacy of Clostridium botulinum vaccination for the prevention of EGS in Britain. Substantial proportions of participating practices would be prepared to participate in the RCT and regularly attended EGS-affected premises that would meet trial inclusion criteria.

Does oral prednisolone treatment increase the incidence of acute laminitis?

REASONS FOR PERFORMING STUDY

It is accepted among equine practitioners that glucocorticoid treatment is a risk factor for the development of laminitis. However, there is little published evidence of a link between glucocorticoids and laminitis.

OBJECTIVES

To determine whether horses receiving oral prednisolone are at increased risk of laminitis.

STUDY DESIGN

Retrospective case-control study.

METHODS

Clinical records of horses registered with the ambulatory service at Liphook Equine Hospital between January 2001 and November 2014 were reviewed retrospectively to identify horses that had received treatment with oral prednisolone. For each treated horse, 2 time-matched controls that received veterinary attention but were not treated with prednisolone were selected. Incidence of laminitis was compared between the 2 groups and factors associated with laminitis were assessed using Cox regression analysis.

RESULTS

Of the 416 horses treated with prednisolone, 16 (3.8%) were diagnosed with laminitis subsequent to the initiation of prednisolone treatment with an overall incidence of 2.60 (95% CI 1.49-4.22) cases per 100 horse-years at risk. A total of 7 horses (1.7%) developed laminitis during the course of their treatment and 3 (0.7%) of the horses treated with prednisolone were ultimately subjected to euthanasia as a result of laminitis. A total of 46 (5.7%), of the 814 time-matched control horses were diagnosed with laminitis during the study period with an overall incidence of 3.46 (95% CI 2.54-4.62) cases per 100 horse-years at risk. Of these, 12 (1.5%) were subjected to euthanasia as a result of laminitis. There were no significant differences in the overall laminitis incidence rate (P = 0.8), incidence rate during prednisolone treatment (P = 0.09), or probability of laminitis (P = 0.3) between the 2 groups. Mean survival time was greater in the prednisolone than the control group. Equine metabolic syndrome and increasing age were associated with increased risk of laminitis.

CONCLUSIONS

Administration of oral prednisolone did not increase the risk of laminitis.

Preventive health care and owner-reported disease prevalence of horses and ponies in Great Britain

This study aimed to describe the provision of preventive health care and owner-reported disease prevalence in horses and ponies within Great Britain (GB), and to assess geographical variations in health care provision. A cross-sectional survey was conducted, using a postal questionnaire administered to a random sample of veterinary-registered owners of horses and ponies in GB (n=797). The majority of animals received regular preventive health care: 95.6% had regular hoof care; 71.3% were vaccinated for both influenza and tetanus and median time since last anthelmintic administration was 8.7 weeks. Thirty-one percent of owners indicated their animal was overweight/obese. A new health problem within the previous 7 days was reported for 7.4% of animals, 59.3% of which were veterinary-diagnosed. Thirty-two percent of animals were reported to have a long-term/recurrent condition, of which osteoarthritis (13.9%) was the most prevalent. Obesity, musculoskeletal disorders, and dermatological conditions were the most prevalent conditions affecting veterinary-registered horses/ponies.

Comparison of owner-reported health problems with veterinary assessment of geriatric horses in the United Kingdom

REASONS FOR PERFORMING STUDY

Previous studies suggest that owners underestimate or incorrectly recognise or report health problems in geriatric horses. However, few studies have directly compared owner-reported and veterinary assessed disease.

OBJECTIVES

To compare the findings of veterinary clinical examination of geriatric horses with owner-reported clinical signs and disease.

METHODS

A total of 200 horses aged ≥ 15 years were randomly selected to receive a veterinary examination, from responses to a cross-sectional postal questionnaire survey. Veterinary examinations were performed within 2 months of questionnaire return, and agreement between owner-reported data and veterinary clinical findings was assessed.

RESULTS

Owners under-reported many clinical signs and disease conditions detected on veterinary clinical examination. For example, dental abnormalities (detected in 95.4% of horses, reported by 24.5% of owners); cardiac murmurs (detected in 20% of horses, reported by 0.5% of owners); lameness (present in 50% of horses, reported by 23% of owners) and hoof abnormalities (detected in 80% of horses, reported by 27% of owners). Agreement between owner-reported and veterinary assessed respiratory disease (Kappa 0.02-0.2), body condition score (Kappa 0.24) and coat abnormalities (Kappa 0.42) was poor, fair and moderate, respectively. Range of motion (ROM) of the tarsal and metacarpophalangeal joints was lower in horses with owner-reported osteoarthritis (P = 0.005 and <0.001, respectively).

CONCLUSIONS AND POTENTIAL RELEVANCE

The low prevalence and relatively poor agreement of owner-reported disease compared to that detected on veterinary examination suggests inaccurate or under-recognition, or inaccurate reporting of health problems by owners of geriatric horses, which could lead to a delay in presentation for veterinary treatment. Increased veterinary involvement and improved owner education in the care of geriatric horses should facilitate earlier identification of disease, particularly that which is not readily detectable by owners, and aid management of health and welfare problems.

Effects of oestradiol and progesterone on secretion of gonadotrophins and health of first wave follicles during the oestrous cycle of beef heifers

Antral follicle development in cattle is initially FSH dependent and then LH dependent. The aim of the present study was to determine the effects of oestradiol- and progesterone-induced suppression of FSH and LH on growth and differentiation of first wave follicles. Cyclic heifers (n = 45, n = 6-10 per group) received the following i.m. injections or treatments beginning 30 h after oestrus: (i) saline (controls); (ii) 0.75 mg oestradiol benzoate (ODB); (iii) insertion of a progesterone-releasing intravaginal device (PRID) for 42 h (progesterone); (iv) 0.75 mg oestradiol benzoate plus PRID (ODB plus progesterone); (v) 0.75 mg ODB plus injection of 1 mg Ovagen(TM) at 33, 39 and 45 h after onset of oestrus (ODB plus FSH). In Expt 1, follicle development was monitored by ovarian ultrasonography once a day. In Expt 2, heifers were ovariectomized. Emergence of the first follicle wave and dominant follicle selection were delayed in ODB plus progesterone-treated heifers compared with controls. Interval to nadir FSH concentration was shorter in ODB-, progesterone- and ODB plus progesterone-treated heifers compared with controls. Frequency of LH pulses was unaffected in ODB- or ODB plus FSH-treated heifers, decreased in progesterone-treated heifers and further decreased in ODB plus progesterone-treated heifers. Intrafollicular oestradiol concentrations were lower in the largest follicle from ODB plus progesterone-treated heifers compared with control (66 h) heifers, but follicle diameter and concentrations of insulin-like growth factor binding proteins (IGFBPs) and inhibin forms were unaffected. Treatment with ODB decreased follicular oestradiol concentration in smaller follicles in the cohort. It is concluded that growing cohort follicles are uniformly responsive to increased FSH concentration but differentially responsive to suppressed FSH and LH release, which is consistent with an LH-mediated survival advantage of the largest follicle in the cohort before cessation of the growth of remaining follicles in the cohort occurs.

Alterations in intrafollicular regulatory factors and apoptosis during selection of follicles in the first follicular wave of the bovine estrous cycle

Changes in follicular fluid (FF) concentrations of estradiol, inhibin forms, and insulin-like growth factor binding proteins (IGFBPs), percentage of apoptotic granulosa cells (%A), and follicular size for individual follicles in a growing cohort were determined throughout the first wave of follicular development during the bovine estrous cycle and related to FSH decline. Four groups of heifers (n = 31) were ovariectomized between Days 1.5 and 4.5 of the estrous cycle at 5 +/- 1, 33 +/- 2, 53 +/- 1, and 84 +/- 2 h after the periovulatory peak in FSH concentrations. Follicles > or = 2.5 mm were dissected, measured, and FF aspirated. The five largest follicles were ranked based on their diameter (F1 to F5). Diameters of F1 to F5 were positively correlated with interval from FSH peak (r > or = 0.6, P < 0.05). Five hours after the FSH peak, follicular diameter and FF concentrations of estradiol, inhibins, and IGFBPs were similar for F1 to F5. From 5 to 33 h, amounts of the six precursor inhibin forms (> or = 48 kDa) increased (P < 0.05) in F1 follicles. The IGFBPs in F1 follicles remained low at all time periods. At 33 h, amounts of IGFBP-4 and -5 were higher (P < 0.05) in F4 and F5 compared with F1 follicles. At 84 h, IGFBP-2, -4, and -5 were increased (P < 0.05) in F3, F4, and F5 compared with F1. At 5, 33, or 53 h, %A was not different between follicles in any size class. At 84 h %A was increased (P < 0.05) in follicles <6 mm in diameter. However, at that time, %A did not differ between the selected DF and the largest subordinate follicle. For individual heifers, the selected DF at 84 h was largest in size, highest in estradiol, and lowest in IGFBP-2 and -4. The F1 follicle had highest estradiol in 23 of 27 heifers irrespective of stage of the wave and lowest IGFBP-4 in 19 of 21 heifers from 33 h. We concluded that the earliest intrafollicular changes that differentiate a dominant-like follicle from the growing cohort are enhanced capacity to produce estradiol and maintenance of low levels of IGFBPs.

A descriptive analysis of self-harm reports among a sample of incarcerated adolescent males

The present study examines 89 separate incidents of self-injurious behaviour displayed by 60 male young offenders, incidents which were recorded by prison staff on "self-harm" forms. The results show that the reasons for raising a self-harm form can be separated into two main categories: actual self-injury by the inmate or behaviours believed by staff to indicate a risk of self-injury. A believed risk of self-injury as opposed to actual self-injury was the most frequently reported reason for opening a self-harm form, with verbal threats of self-injury being the most frequently reported type of behaviour. Self-injury does appear to occur relatively early on in periods of custody and inmates who display self-injurious behaviour appear distinct from the rest of the prisoner population in a number of ways. Differences are also evident between those with only one form raised on them and those with more than one form raised. Directions for future research are discussed.

Identification of potential intrafollicular factors involved in selection of dominant follicles in heifers

A surgical procedure to aspirate follicular fluid concurrently from individual follicles from the same heifer was validated and used to determine if intrafollicular amounts of estradiol, progesterone, inhibins, activin-A, follistatins, and insulin-like growth factor binding proteins (IGFBP) differed for the future dominant compared with subordinate follicles during selection of the first wave dominant follicle. Heifers were subjected to surgery and aspiration of follicular fluid from the two or three largest follicles on Day 3 of the estrous cycle (approximately 1.5 days after emergence). Ultrasound was used to determine the fate of each aspirated follicle after surgery. At aspiration, diameter of the future dominant and largest subordinate follicle was similar in heifers. However, estradiol was higher, whereas IGFBP-4 was lower in the future dominant compared with the largest or next largest subordinate follicles. Also, the future dominant follicle in most cohorts had the highest estradiol and lowest IGFBP-4 compared with future subordinate follicles. We concluded that: IGFBP-4 and estradiol may have key roles in determining the physiological fate of follicles during selection of the first wave dominant follicle in heifers, and that both are reliable markers to predict which follicle in a growing cohort of 5- to 8.5-mm follicles becomes dominant.

Effect of long-term immunization against inhibin on sperm output in bulls

To determine the effect of neutralization of inhibin on sperm output, 12 Holstein bulls were paired by birth date and weight on Day 1 of age. Each bull was actively immunized against bovine inhibin alpha1-26 gly-tyr (bINH) conjugated to human alpha globulin (HAG, n = 6 bulls) or HAG alone (controls, n = 6) at 60 days of age; booster immunizations were administered at 90, 104, 124, 270, and 395 days of age. Body weights and scrotal circumferences were measured at the time of primary immunization and at 10 days after each booster. In addition, jugular blood was obtained at 60, 70, 100, 114, 134, 280, and 405 days of age, during the 3-wk sperm collection period, and during a 6-h blood-sampling period after sperm collection to determine bINH antibody titer and concentrations of FSH, LH, testosterone, and estradiol. Beginning at 405 days of age, sperm output was measured 3 days/wk for 3 wk with two successive ejaculates collected each day for a total of 18 ejaculates per bull. During Days 60-405 of age, the increase in titer of bINH antibodies, scrotal circumference, and serum concentration of FSH was greater (p < 0.01) for the bINH-immunized compared with control bulls. There were significant (p < 0.01) pair x treatment interactions for sperm output and serum FSH and LH concentrations. Specifically, bINH-immunized bulls for four of the six pairs had nearly 50% greater serum FSH concentrations and sperm output. For the remaining two pairs, sperm output was lower and FSH was either lower or only marginally higher in the bINH-immunized bulls compared with controls. Also, the control bulls for the two remaining pairs produced more sperm than all but one bINH-immunized bull, and had markedly higher serum LH concentrations than all other bulls. To summarize, enhancement of sperm output after immunization against inhibin depends on the subsequent increment in FSH concentrations. We conclude that inhibin suppresses spermatogenesis. Thus, methods to immunoneutralize inhibin may have merit as a therapeutic route to enhance sperm production in reproductively maturing bulls.

Decline in serum follicle-stimulating hormone concentrations alters key intrafollicular growth factors involved in selection of the dominant follicle in heifers

Declining FSH after a transient rise coincides with selection of a dominant follicle (DF) and atresia of the remaining cohort follicles (subordinates) in cattle. The objectives of this study were to determine 1) whether intrafollicular amounts of inhibins, activin-A, insulin-like growth factor I (IGF-I), and IGF-I-binding proteins (IGFBP) are altered during selection of the first-wave dominant follicle (DF1) and 2) whether these biochemical markers are FSH dependent. Beef heifers received six or eight 6-h injections of saline (controls) or eight 6-h injections of recombinant bovine FSH (1 mg/injection) at 38 to 42 h after estrus (Day 0). Daily ultrasound scanning was used to define selection of DF1. Controls (n = 6 per group) were ovariectomized 1) on Day 3 of the estrous cycle before DF1 selection (preselection follicles) and 2) after DF1 selection on Day 4.8 +/- 0.5. In controls, FSH declined between Days 2 and 3 and selection of DF1 occurred between Days 3 and 5. During this interval, intrafollicular estradiol concentrations increased > 5-fold in DF1, yet declined 4-fold in subordinates (p < 0.05). In DF1, total IGF-I increased 1.3-fold (p < 0.05), whereas the amounts of the 40- to 47-kDa and the 35-kDa IGFBP (ligand hybridization) decreased 2.4- and 2.5-fold, respectively (p < 0.05), compared to values in preselection follicles on Day 3; total dimeric inhibin-A decreased 1.8-fold (p < 0.05). In contrast, amounts of the 30- to 32-kDa IGFBP increased 12.4-fold (p < 0.05) in subordinates on Day 4.8 compared with preselection follicles on Day 3, while the amount of inhibins > 34 kDa decreased 4- to 9-fold (p < 0.05). In FSH-treated heifers, both selection of DF1 and atresia of subordinates were delayed by 2.2 days. Preselection follicles recovered on Day 4.9 +/- 0.1 from FSH-treated heifers were similar (p > 0.05) in almost all biochemical parameters to preselection follicles from control heifers; however, they differed markedly from both DF1 and subordinate follicles recovered from control heifers on Day 4.8 +/- 0.5. In conclusion, the decline in FSH beginning after Day 2 of the heifer estrous cycle causes differential alterations in FSH-dependent growth factors and hormones within the cohort of preselection follicles, simultaneously inducing growth and enhanced estradiol-producing capacity of the DF and atresia of subordinate follicles.

Expression of different molecular mass forms of inhibin in atretic and nonatretic follicles during the early luteal phase and altrenogest-synchronized follicular phase in pigs

This experiment characterized changes in amounts and proportions of different molecular forms of inhibin in porcine follicular fluid as related to stage of follicular development. Thirty-seven follicles (2-4 per pig) were dissected from 12 pigs during early luteal phase of the estrous cycle on Days 5, 6, and 7 of the estrous cycle, whereas 34 follicles (2-4 per pig) were dissected from 11 pigs on Days 1, 3, 5, and 7 of a follicular phase synchronized by altrenogest. Follicles were designated atretic if incidence of apoptotic granulosa cells was > or = 10% as determined by DNA fluorescence flow cytometry. Porcine follicular fluid was fractionated on 12% SDS-PAGE gels under non-reducing conditions and electroblotted to Immobilin P membranes. Inhibin forms were detected by immunoblot analysis using a mink anti-bovine inhibin alpha C1-26 gly.tyr antiserum and quantified. Immunoblots detected seven bands corresponding to inhibin forms of 44, 49, 58, 69, 121, 227, and > 227 kDa in > 91% of porcine follicular fluid samples. Three additional forms of 27, 29, and 32 kDa were detectable in only 52%, 64%, and 48% of samples, respectively. Forms > or = 69 kDa represented 83% of total inhibin immunoblot activity. The 121-kDa form was most abundant, with 39% of the total immunoblot activity in nonatretic follicles. The proportions of individual forms and total immunoblot activity pooled over days did not differ between early luteal and follicular phase follicles. Total inhibin immunoblot activity was 59% less in atretic than in nonatretic follicles. Amounts of the 44-, 49-, 69-, 121-, and 227-kDa forms were 50-80% lower (p < or = 0.05) in atretic than in nonatretic follicles. Total inhibin immunoblot activity in nonatretic follicles decreased (p < or = 0.05) by 60% during the early luteal phase but did not change significantly during the follicular phase. In nonatretic follicles, the 121-kDa form decreased (p < 0.05) during the early luteal and follicular phases. During the early luteal phase, amounts of the other forms did not change, whereas during the follicular phase the 44-kDa form increased (p < 0.05) 10-fold. In atretic follicles, neither amount nor proportion of inhibin forms differed among days. We conclude that follicular production and/or intracellular processing of inhibin dimer and/or inhibin alpha subunits changes during different phases of follicular development, supporting the notion of physiological roles for these peptides.

Isolation of nine different biologically and immunologically active molecular variants of bovine follicular inhibin

A combination of immunoaffinity chromatography, SDS-PAGE, and electroelution was used to simultaneously isolate 0.36-4.65 mg of nine different molecular forms of inhibin (pro alpha C-29 kDa; fully processed 34 kDa; and large inhibin forms 49, 53, 58, 77, 88, 110, and > 160 kDa) from 0.675 L of bovine follicular fluid (bFF). Each inhibin form, except pro alpha C, cross-reacted with inhibin alpha C 1-26-and beta A 82-114-subunit-directed antibodies during immunoblot analysis. Pro alpha C cross-reacted only with alpha-subunit antibodies. The inhibin forms consisted of 22-, 29-, 49-, or 58-kDa alpha subunits and 17- or 58-kDa beta subunits. During cultures of ovine pituitary cells, a 5-ng/ml dose of each inhibin form (except pro alpha C) suppressed basal accumulation of FSH 30% to 50% but increased GnRH-induced LH release 40% to 248%. The various inhibin forms cross-reacted in parallel fashion with standard curves generated during homologous and heterologous RIAs but with markedly different relative immunopotencies. In the RIAs, pro alpha cross-reacted 3- to 18-fold more than the fully processed inhibin form. The fully processed and the seven different large forms of inhibin cross-reacted with different relative immunopotencies in a two-site dimer-specific ELISA. We concluded that 1) a combination of immunoaffinity extraction, SDS-PAGE, and electroelution simultaneously isolated relatively large amounts of highly enriched preparations of nine different molecular forms of immunologically and biologically active inhibin from bFF; 2) eight different dimeric forms of bovine inhibin may regulate both basal FSH and GnRH-induced LH secretion by the pituitary gland, and 3) eight or nine different molecular forms of inhibin cross-react with different relative immunopotencies in the two-site dimer-specific assay or RIAs.

Alterations in amounts of different forms of inhibin during follicular atresia

An inhibin immunoblot procedure was validated for measurement of inhibins (alpha beta) and inhibin alpha subunits in bovine follicular fluid (bFF) from individual follicles. Bovine FF was removed from nonovulatory follicles (> or = 6 mm in diameter) of cows during early diestrus. Ratio of progesterone (P) to estradiol (E) concentrations was used to classify follicles into three different stages of differentiation and atresia: estrogen-active (EA; PE ratio < 1), atretic (PE = 1-100), and highly atretic (PE = > 100). Bovine inhibin (bINH) was analyzed by an immunoblot procedure, an RIA that cross-reacts with inhibin alpha beta dimers and alpha subunits, and a two-site alpha beta dimer-specific immunoradiometric assay (IRMA). Immunoblots consistently detected 9 different bINH forms in bFF of each follicle. The average molecular mass for the bINH forms ranged from 29 to > 160 kDa, which was similar to those for purified bINH and bINH alpha subunits. The predominant bINH forms were > or = 122 kDa. Amounts of most bINH forms decreased several fold during atresia of EA follicles. However, the 34-kDa form increased 1.9-fold. To examine whether amounts of each bINH form varied independently during atresia, proportion of total bINH immunoblot activity represented by each bINH form was statistically analyzed. The results indicated that the proportion of total immunoblot activity for the 34-, 68-, and > 160-kDa bINH forms increased during atresia, whereas proportions for the 48-, 49-, and 122-kDa forms decreased. Alterations in amounts of most bINH forms were positively correlated with intrafollicular concentrations of E and negatively correlated with P. In contrast, the 34-kDa bINH form was negatively correlated with E, but positively correlated with P. Total bINH concentrations determined by RIA decreased 3-fold during atresia. However, amounts of most forms of bINH, except the 29-kDa form (r = 0.72), were relatively weakly correlated (r < 0.41) or not correlated with the RIA results. In contrast to RIA results, concentration of dimeric forms of bINH measured by IRMA increased 2.5-fold during atresia, but only the 34-kDa form of bINH was correlated (r = 0.77) with IRMA results.(ABSTRACT TRUNCATED AT 400 WORDS)

Changes in expression of inhibin/activin alpha, beta A and beta B subunit messenger ribonucleic acids following increases in size and during different stages of differentiation or atresia of non-ovulatory follicles in cows

Northern and slot blot analyses were used to examine the sizes, variability, and changes in amounts of alpha, beta A and beta B inhibin/activin subunit mRNAs following increases in size and during different stages of differentiation or atresia of bovine non-ovulatory follicles. In Study I, a major 1.3-kb band and minor 2.2-, 3.3- and 6.4-kb bands of alpha mRNA; a major 6.4-kb band and minor 2.6 and 4.0-kb bands of beta A; and major 3.5- and 4.6-kb bands of beta B mRNA were detected in total and/or poly(A)+ RNA isolated from pools of small (1-5 mm), medium (6-10 mm), or large (> 10 mm) follicles. In Study II, 18 of 19 follicles had a 1.3-kb alpha mRNA, and amounts of 1.3 kb alpha mRNA increased with follicle size. However, 0 of 19, 9 of 19, and 3 of 19 follicles had 2.2-, 3.3-, and 6.4-kb alpha mRNA bands. In Study III, the ratio of estradiol (E) to progesterone (P) in follicular fluid (FF) was used to separate follicles into the following three stages of differentiation and atresia: estrogen-active (EA; E > P in FF), atretic (P:E = 1-100), and highly atretic (P:E > 100). Total amounts of alpha and beta A mRNAs were 2.4- and 5.8-fold greater in EA follicles compared with small follicles. Alpha and beta A mRNAs and concentration of total inhibin immunoactivity were 4.4-, 9.8- and 1.8-fold lower in highly atretic follicles compared with EA follicles. Changes in amounts of follicular alpha and beta A mRNAs were highly positively correlated with intrafollicular concentrations of E, ratio of E to P, and total inhibin immunoreactivity, but negatively correlated with P. Ratio of amounts of alpha to beta A mRNAs was 3.9- and 6.5-fold greater in small and highly atretic follicles compared with EA follicles. Amounts of beta B subunit mRNAs were unchanged during follicular development and unrelated to changes in follicular concentrations of E, P, or total inhibin immunoactivity. On the basis of these results, we concluded that 1) multiple forms of each inhibin/activin subunit mRNA are expressed in follicular tissue; 2) alpha and beta A subunit mRNAs and inhibin transiently increase; 3) alpha and beta mRNAs are not co-regulated similarly; and 4) beta B mRNA is constitutively expressed during differentiation and atresia of non-ovulatory follicles.

Immunoneutralization of inhibin suppresses reproduction in female mink

This study determined whether immunoneutralization of inhibin affected gonadotropin secretion, embryo development, and ovarian function in mink. Adult female mink (n = 10) were immunized with bovine inhibin alpha 1-26 gly-tyr (bINH, 100 micrograms) conjugated to human alpha globulins (HAG), or with HAG alone (n = 10, controls), mixed with Freund's complete adjuvant. A series of five boosters containing bINH or HAG were then administered during a 2-yr period. Titers of bINH antibodies and serum concentrations of gonadotropins were determined for each breeding season in 1990 and 1991. Each year after whelping, we determined gestation length; sex, number, and weight of live and dead kits per litter at birth; and number and weight of kits per litter 3 wk after whelping. Results were pooled for statistical analysis. Bovine INH antibody titers (percent 125I-bINH bound to serum diluted 1:8000) were 53 +/- 3% vs. 2 +/- 0.6%, and serum concentrations of FSH were higher (p < 0.05) in bINH-immunized mink compared with controls (144 +/- 23 vs. 67 +/- 12 ng/ml). However, number (3.8 +/- 0.2 vs. 5 +/- 0.4) and weight (8 +/- 0.3 vs. 9.7 +/- 0.4 g) of kits per litter at birth and number of kits per litter alive 3 wk after birth (2.9 +/- 0.5 vs. 4.7 +/- 0.4) were lower (p < 0.05) in bINH-immunized mothers compared with controls. During the nonbreeding season in 1991, a single injection of hCG (100 IU) was administered to bINH-immunized and control mink; 24 h later blood was sampled, and organ weights were determined.(ABSTRACT TRUNCATED AT 250 WORDS)