Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations

BACKGROUND

Behavioural models are widely used within human medicine to understand beliefs and intention associated with major health interventions.

OBJECTIVES

To investigate horse-owner beliefs and practices associated with emergency colic planning.

STUDY DESIGN

Cross-sectional study.

METHODS

An online survey incorporating the Trans-Theoretical Model of behaviour change and the Theory of Planned Behaviour was developed to assess owner intention to adopt three areas of emergency colic planning: (1) prevention/recognition, (2) involvement of others and (3) personal preparation. Participants were recruited using a snowball sampling strategy; multivariable logistic regression of data was performed.

RESULTS

There were 701 horse-owners who completed the survey. Respondents fell into one of two categories: no intention to adopt or already implementing emergency planning recommendations. Most agreed that emergency colic plans would improve their horse's welfare (68%) and aid in decision making (78%). Most disagreed that colic was inevitable (66%) and that treatment options were not within their control (69%). Multivariable analysis showed that those who believed emergency plans were worth creating were more likely to adopt preventive (OR: 2.33, 95% CI: 1.27-4.30, p = 0.007) and personal preparation (OR: 1.61, 95% CI: 1.31-1.97, p < 0.001) recommendations. Preventive recommendations were also associated with 'REACT' campaign awareness (OR 2.36, 95% CI: 1.40-3.97, p = 0.001). Favourable behavioural beliefs, such as the acknowledgement of welfare and decision-making benefits, were linked to the involvement of others in planning (OR: 2.93, 95% CI: 1.78-4.81, p < 0.001).

MAIN LIMITATIONS

Potential response bias and small sample size.

CONCLUSIONS

The majority of owners were either unwilling to adopt suggested recommendations or believed that their approach was currently sufficient. Most owners perceived veterinary professionals as most influential on their decision to plan for a colic emergency, highlighting their importance in any educational campaign.

Prospective case study of critical decision making for horses referred for treatment of colic

BACKGROUND

There is limited evidence on factors affecting critical decision making for horses with colic. This study's aim was to describe the assessment and decision making involved in horses referred for management of colic.

METHODS

An in-depth case analysis was used to document case presentation, decision making and outcomes for horses referred for colic to two UK equine veterinary practices over a 12-month period. The data recorded included previous history, presenting signs, response to treatment, case outcome and factors affecting decisions for further treatment or euthanasia.

RESULTS

Data were available for 60 cases: 55 were hospitalised for medical or surgical treatment and five horses were euthanased following initial assessment. The main factors affecting treatment decisions were severity of clinical signs (80%, 47/59), financial concerns (10%, 6/59) and ongoing health issues or previous history of colic (5%, 3/59). Factors associated with euthanasia decisions were postoperative complications (5/18), poor prognosis (4/18), deteriorating clinical signs (3/18) and financial concerns (3/18).

LIMITATION

The limited study population may affect the extent to which the findings can be generalised.

CONCLUSION

The severity of clinical signs was the key factor in treatment decision making. The main factors affecting euthanasia decisions were clinical deterioration, poor prognosis and financial constraints. These findings should be incorporated into clinical case recording to capture the multifactorial nature of decision making.

A Prospective Cohort Study Investigating the Impact of Neutering Bitches Prepubertally or Post-Pubertally on Physical Development

No previous large prospective cohort studies have been identified that have investigated the impact of the surgical neutering of bitches before or after known puberty on their growth and physical development. This study was designed to examine the data on physical development, vulval size, and conformation for bitches neutered by ovariohysterectomy before puberty (PPN, n = 155) or after puberty (control, n = 151) using a prospective cohort study design. Data were gathered at six- and 17-months of age using bespoke physical assessment forms and digital images of the vulva. PPN bitches had greater changes in height measurements (mean difference = 2.039, SEM = 0.334, 91% CI = 1.471 to 2.608, p < 0.001) and smaller changes in the measurements of vulval length (mean difference = -0.377, SEM = 0.079, 91% CI = -0.511 to -0.243, p < 0.001) and width (mean difference = -0.221, SEM = 0.063, 91% CI = -0.328 to -0.113, p < 0.001) between six- and 17-months of age than for the control bitches. Although not significant, the PPN bitches were taller (mean 58.5 vs. 56.6 cm) and heavier (mean 28.3 vs. 27.3 kg) with smaller vulval size measurements (mean vulval length 2.8 vs. 3.2 cm, mean vulval width 1.7 vs. 2.1 cm) at 17-months of age. At 17-months of age, significantly more PPN bitches had vulvas that appeared juvenile (Yates' Chi-square = 14.834, D.F. = 1, p < 0.001) and recessed (Yates' Chi-square = 7.792, D.F. = 1, p = 0.005) at the physical assessment, and significantly more PPN bitches had vulvas that appeared 'recessed/inverted' on the examination of digital images (Chi-square = 9.902, D.F. = 1, p = 0.002). The results from this study suggest no contraindications to prepubertal ovariohysterectomy for large breed bitches. However, any longer-term health implications of these differences in physical development need to be investigated and better understood prior to recommendations being made.

Effect of neutering timing in relation to puberty on female dog behaviour-A scoping review

BACKGROUND

There are contradictory findings in the literature relating to the effects of timing of neutering on bitch behaviour that make decision making regarding neutering timing difficult.

METHODS

A scoping review was designed to identify and chart the evidence on the effect of neutering timing in relation to puberty on the behaviour of female domesticated dogs. A protocol was registered, and literature searches were conducted in CAB Abstracts, Medline and Web of Science. Studies were reviewed against the inclusion criteria. Data on study and population characteristics and behavioural outcomes were extracted for the final included studies.

RESULTS

A total of 1048 publications were reviewed; 13 were retained for inclusion and charting. Only one of the two studies that classified bitches as pre- or postpubertal presented results for the analysis of behaviours. The remaining 11 studies classified bitches by age at neutering.

LIMITATIONS

Since the scoping review searches were conducted, further relevant studies may have become available. The search strategy may not have identified all available literature; however, databases were used that provide high levels of coverage of veterinary literature.

CONCLUSION

This scoping review identified a lack of evidence to document the impact of neutering bitches before or after puberty on behaviour.

A prospective cohort study investigating the peri- and postoperative outcomes following ovariohysterectomy in bitches neutered prepubertally or post-pubertally

The aim of this prospective cohort study was to investigate perioperative and postoperative outcomes for bitches that were neutered at different times in relation to puberty (rather than age). Three hundred and six Labrador and Golden Retriever crossbreed bitches were neutered before (prepubertal neuter [PPN], n = 155) or after puberty (Control, n = 151) by experienced veterinarians at one of four veterinary practices (VP1-4). Data were gathered from veterinarians at the time of neutering and from bitch caregivers for the 14-day period after neutering using purpose-designed questionnaires. PPN bitches had shorter surgery durations than Control bitches (OR = 0.877, 91% CI = 0.800 to 0.961, P = 0.015). Longer surgery durations were reported for bitches that had intraoperative complications (OR = 1.620, 91% CI = 1.397 to 1.879, P < 0.001). Shorter surgery durations were reported for VP1 compared to all other veterinary practices (OR = 1.189 to 1.534, P < 0.001). There was no difference in the number of PPN or Control bitches that had perioperative complications (PPN: 3.9%, n = 6; Control: 7.7%, n = 11) and no bitch had more than one perioperative complication reported. For the 14-day postoperative period, fewer PPN (1.3%, n = 2) compared to Control bitches (8.9%, n = 13) had wound discharge (Chi-square = 11.151, D.F = 1, P = 0.001) or showed inappetence (PPN: 2.9%, n = 4; Control: 17.3%, n = 19, Chi-square = 14.884, D.F. = 1, P < 0.001). There was no difference in the number of PPN and Control bitches that had redness or swelling of the wound (52 PPN, 48 Control), showed attention to the wound (6 PPN, 6 Control), required veterinary attention (25 PPN, 23 Control), or that showed any other unusual behaviours: discomfort (27 PPN, 16 Control), uncharacteristic irritability (2 PPN, 4 Control), or uncharacteristic licking or chewing of parts of the body (15 PPN, 6 Control). Bitches neutered at VP2-4 were more likely to have wound redness or swelling reported than those neutered at VP1 (OR = 3.109 to 4.076, P = 0.003). Future studies should consider the impact of veterinary practice on results. These results for peri and postoperative complications could suggest that prepubertal ovariohysterectomy may be a suitable option for neutering bitches. However, it is recommended that they be interpreted together with evidence relating to the impacts on other factors including behaviour and longer-term health in order to make fully informed decisions.

Outcomes and Quality of Care in Rheumatoid Arthritis With or Without Video Telemedicine Follow-Up Visits

OBJECTIVE

Telemedicine has been proposed to improve access to care in rheumatology, but few studies of telerheumatology have been published. The objective of this study was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine follow-up compared to in-person only.

METHODS

Individuals in the Alaska Tribal Health System with a diagnosis of RA were recruited when seeing a rheumatologist either in-person or by video telemedicine, both of which were offered as part of usual follow-up care. At baseline, participants completed the Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telemedicine perception survey and agreed to medical record review. Participants repeated surveys by telephone at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures.

RESULTS

At the 12-month outcome assessment, 63 of 122 RA patients (52%) had ever used telemedicine for RA. In univariate analysis, functional status improved over 12 months in the telemedicine group. In multivariate analysis, RAPID3 score and functional status were associated with telemedicine group (higher), with no statistically significant change over the 12-month period. The only quality measure that differed between groups at 12 months in univariate analysis was the proportion of visits in which disease activity was documented (higher in the in-person group, 40% versus 25%; P = 0.02), but this was not significant after multivariate analysis.

CONCLUSION

In short-term follow-up, there was no significant difference in most outcome and quality measures in patients with RA who incorporated telemedicine follow-up in their care compared to in-person only.

A scoping review of the current evidence on treatment and outcomes following synovial sepsis

BACKGROUND

Synovial sepsis is a frequent cause of morbidity and mortality in horses. Despite advances in diagnostics and treatments, persistent infection or chronic lameness can occur.

OBJECTIVES

To perform a scoping review to identify and evaluate the current evidence on the factors implicated in the success of treatment for synovial sepsis.

STUDY DESIGN

Joanna Briggs Institute scoping review.

METHODS

A protocol was registered, and a systematic literature search was performed on CAB abstracts, Medline, Scopus and Embase. Inclusion and exclusion criteria were developed and studies systematically reviewed against this. Studies relating to factors affecting treatment success following synovial sepsis were retained and data was extracted on study method, population characteristics and factors significantly associated with treatment outcome.

RESULTS

In total, 2338 studies were identified, and 61 were included to full paper analysis. Eight papers reported significant factors, identifying 15 risk factors associated with two measurements of outcome, either survival and/or return to athletic function. The 15 factors were identified and categorised into pre-, intra- and post-operative factors. Risk factors that were identified included the number or type of synovial structures involved, the presence of pannus, tendon and bone pathology, and the use of systemic antimicrobials. There were many discrepancies in inclusion criteria of cases of synovial sepsis as well as measurement and description of outcome variables.

MAIN LIMITATIONS

Non-English language studies or conference proceedings were not included. Only small numbers of papers had similar findings.

CONCLUSIONS

Standardisation of inclusion criteria is essential to enable comparisons and analysis between studies on synovial sepsis. Future studies should use methodologies to reduce bias including multicentre and multinational studies, prospective study design and robust statistical modelling.

Factors Associated With Use of Telemedicine for Follow-up of Rheumatoid Arthritis

OBJECTIVE

Telemedicine is increasingly being offered to patients for rheumatology care, but few studies have examined factors associated with telemedicine use or outcomes of telemedicine in rheumatology. The objective of this analysis was to determine factors associated with the use of video telemedicine when offered as part of usual care for follow-up of rheumatoid arthritis (RA).

METHODS

Individuals in the Alaska Tribal Health System with a diagnosis of RA were recruited when seeing a rheumatologist either in-person or by video telemedicine, both of which were offered as part of usual care. At the study visit, participants completed the Routine Assessment of Patient Index Data 3 (RAPID3) and a telemedicine perception survey and agreed to a medical record review for demographics and disease characteristics. Data from this visit were analyzed to determine factors associated with using telemedicine for RA, compared to being seen in-person only.

RESULTS

Of 122 participants enrolled in the study, 56 (46%) had been seen by telemedicine at least once. Factors associated with telemedicine use in univariate analysis included a higher RAPID3 score, a higher number of rheumatologist visits in the preceding year, more positive perceptions of telemedicine, and seeing a physician who used telemedicine more often. On multivariate analysis, these 4 factors all remained significant. Demographic and other disease-related factors or comorbidities were not associated with telemedicine use.

CONCLUSION

When offered as an option for rheumatology care, video telemedicine was more likely to be used by RA patients with higher disease activity and more positive perceptions of telemedicine, and by patients whose physicians used telemedicine more often.

Normal and abnormal response to sperm deposition in female dogs: A review and new hypotheses for endometritis

In mammalian species there are significant physiological responses of the female reproductive tract to the deposition of sperm. These are particularly notable in species where sperm are deposited directly into the uterus, and function both to facilitate sperm transport to the sperm reservoir, and to eliminate introduced contaminants. In the bitch, sperm are deposited into the vagina and are rapidly transported through the open cervix. Sperm are then distributed around the uterus by uterine contractions such that transportation to the tip of the uterine horns occurs within 1 min of the start of mating. The main sperm reservoir appears to be the distal part of the utero-tubal junction which forms a pre-uterine tube reservoir. Sperm remain attached here by their heads to uterine epithelium and remain viable. In non-capacitating conditions sperm slowly detach from this site and this seems important to replenish the uterine tube reservoir, where sperm may re-attach to the epithelium. Post-ovulatory signals trigger capacitation changes and subsequent hyperactivated motility that is associated with detachment of sperm from both reservoirs; thus facilitating fertilization. After mating, a physiological post-mating uterine inflammatory response occurs, evidenced by an influx of polymorphonuclear neutrophils, increased uterine contractions, an increased uterine artery blood flow and a decrease of the resistance index indicating a short-duration vasodilation. Disturbance of this tightly regulated system has the potential to impact fertility by a failure of elimination of the introduced contaminants (such that a clinically-significant post-breeding endometritis ensues) but also by impairing sperm transport.

Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study

BACKGROUND

Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession.

OBJECTIVE

To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making.

STUDY DESIGN

Participatory action research using mixed-methods approach.

METHODS

An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources.

RESULTS

There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice.

MAIN LIMITATIONS

Limited sample population.

CONCLUSIONS

This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.

Indicators of 'critical' outcomes in 941 horses seen 'out-of-hours' for colic

BACKGROUND

This study aimed to describe the presentation and outcomes of horses with signs of colic (abdominal pain) seen 'out-of-hours' in equine practice.

METHODS

This was a retrospective study of horses seen 'out-of-hours' with colic by two equine veterinary practices between 2011 and 2013. Case outcomes were categorised as 'critical' or 'not critical'. A critical outcome was defined as requiring medical or surgical hospital treatment, or resulting in euthanasia or death. A non-critical outcome was defined as resolving with simple medical treatment. A hierarchical generalised linear model was used to identify 'red flag' parameters (aspects of signalment, history and presenting clinical signs) associated with critical outcomes.

RESULTS

Data were retrieved from 941 cases that presented with colic; 23.9 per cent (n=225/941) were critical. Variables significantly associated with the likelihood of a critical outcome in the final multivariable model were increased heart rate (P<0.001), age of the horse (P=0.013) and abnormal mucous membrane colour (P<0.001). Overall 18 per cent (n=168/941) of cases were euthanased.

CONCLUSIONS

This study highlights the mortality associated with colic. The 'red flag' parameters identified should be considered an essential component of the primary assessment of horses with colic.

Retrospective case series to identify the most common conditions seen 'out-of-hours' by first-opinion equine veterinary practitioners

BACKGROUND

The study aim was to describe conditions seen 'out-of-hours' in equine practice.

METHODS

This was a retrospective case series of first opinion 'out-of-hours' cases seen at two equine practices between 2011 and 2013. Data were retrieved on case presentation, diagnostic testing, treatment administered and outcome, and diseases categorised using a systems-based coding system. A hierarchical logistic regression, formulated using a generalised linear model, was used to identify clinical variables associated with a binary outcome of 'critical' cases (required hospitalisation or euthanasia or died).

RESULTS

Data from 2602 cases were analysed. The most common reasons for 'out-of-hours' visits were colic (35 per cent, n=923/2620), wounds (20 per cent, n=511/2620) and lameness (11 per cent, n=288/2,620). The majority of cases required a single treatment (58 per cent, n=1475/2550), 26 per cent (n=656/2550) needed multiple treatments and 13 per cent (n=339/2550) were euthanased. Eighteen per cent (n=480/2602) of cases had a critical outcome. Increased heart rate at primary presentation was associated with critical outcome in both practices (Practice A, OR 1.07 (95 per cent confidence interval 1.06 to 1.09), Practice B OR 1.08 (95 per cent confidence interval 1.07 to 1.09; p<0.001)).

CONCLUSION

Colic, wounds and lameness were the most common equine 'out-of-hours' conditions; 13 per cent of cases were euthanased. Further research is required into out-of-hours euthanasia decision-making.

BEVA primary care clinical guidelines: Wound management in the horse

BACKGROUND

There are currently no evidence summaries on wounds in the horse.

OBJECTIVES

To develop evidence-based guidelines on wound management in the horse.

STUDY DESIGN

Evidence review using the GRADE framework.

METHODS

Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence.

RESULTS AND RECOMMENDATIONS

The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13 psi. Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions.

MAIN LIMITATIONS

Low quality evidence in veterinary literature; majority of recommendations were based on human evidence.

CONCLUSIONS

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

Assessment of costs and insurance policies for referral treatment of equine colic

Colic is the most common emergency problem in horses. The aims of this study were to survey costs of different referral treatments and to review insurance policies relevant to horses with colic. Data were collected retrospectively from nine equine hospitals for case costs, categorised into four different outcomes: admitted and euthanased; euthanased during or immediately after surgery; medical treatment and survived more than 24 hours; and surgical treatment and survived more than 24 hours. Data from five UK equine insurance companies were extracted and analysed using a standardised case example. Costs were obtained for 108 cases. The mean cost for horses admitted and euthanased was £873.89 (range £459.72-£1471.51), and for surgical treatment and survival more than 24 hours was £6437.80 (range £3178.87-£9100.00). Insurance cover for veterinary fees ranged from £5000 to £7500, and monthly premium rates for a standardised case ranged from £27.06 to £47.06. The terms and conditions for the insurance policies ranged in length from 2098 to 17,701 words; Flesch Kincaid Reading Ease scores ranged from 21.6 to 57.7, indicating a high degree of complexity and low readability. This study highlights the complexity and challenges for decision-making in critical cases of colic.

Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes

Acute abdominal pain (colic) is the most common reason for emergency veterinary treatment in the horse. Consolidation of data through a systematic review is important to inform evidence-based medicine and clinical guidelines, but there are currently no published systematic reviews on colic in the horse. The aim of this study was to identify, categorize and appraise the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal disease in the adult horse. A scoping review was performed to identify and categorize evidence on all risk factors for colic. A systematic review of management-related risk factors was then performed following PRISMA guidelines. Both searches were conducted in Medline, CAB Abstracts and Web of Science databases, and publications were assessed against inclusion and exclusion criteria. For the scoping review, study and participant characteristics of included publications and key results were extracted and tabulated. For the systematic review, cohort, case-control or cross-sectional studies investigating acute abdominal pain in horses within two weeks of management changes were assessed. Study characteristics, participant characteristics and study results of included publications for the systematic review were extracted and tabulated. Included publications were appraised using the Joanna Briggs Institute Critical Appraisal Tools for cohort, case-control and cross-sectional studies. The scoping review search identified 3,756 publications. Fifty eight studies met final inclusion criteria, and 22 categories of risk factors were identified. These were grouped into three broad areas: horse-related factors, management-related factors and environment-related factors. The largest body of evidence related to management change. The systematic review of management change identified 410 publications: 14 met inclusion criteria for analysis. These consisted of one cohort, eight case-control and five cross-sectional studies. The studies were conducted between 1990-2008, and the majority of studies were located in the USA (8/14) or UK (3/14). The risk factors related to management change that were assessed were feed, carer, exercise, pasture, water and housing. The largest bodies of evidence for increased risk of colic associated with management change were changes in feed (5/14 publications) and recent change in housing (3/14). Most studies (8/14) did not meet the JBI criterion on confounding factors. There was marked heterogeneity of study methodologies and measures. This is the first study to use a combined scoping and systematic review to analyse evidence for modifiable risk factors for a common condition in the horse. It provides a comprehensive review that will be a key resource for researchers, veterinary practitioners and horse owners. It identified modifiable risk factors associated with an increased risk of colic which should be a key target for preventative health programmes. The findings from the critical appraisal were used to develop recommendations for future research to improve the quality of evidence-based veterinary medicine.

Ultrasonographic scoring system for superficial digital flexor tendon injuries in horses: intra- and inter-rater variability

Superficial digital flexor tendon (SDFT) tendinopathy is an important musculoskeletal problem in horses. The study objective was to validate an ultrasonographic scoring system for SDFT injuries. Ultrasonographic images from 14 Thoroughbred racehorses with SDFT lesions (seven core; seven diffuse) and two controls were blindly assessed by five clinicians on two occasions. Ultrasonographic parameters evaluated were: type and extent of the injury, location, echogenicity, cross-sectional area and longitudinal fibre pattern of the maximal injury zone (MIZ). Inter-rater variability and intra-rater reliability were assessed using Kendall's coefficient of concordance (KC) and Lin's concordance correlation coefficient (LC), respectively. Type of injury (core vs. diffuse) had perfect inter/intra-rater agreement. Cases with core lesions had very strong inter-rater agreement (KC ≥0.74, P<0.001) and intra-rater reliability (LC ≥0.73) for all parameters apart from echogenicity. Cases with diffuse lesions had strong inter-rater agreement (KC ≥0.62) for all parameters, but weak agreement for echogenicity (KC=0.22); intra-rater reliability was excellent for MIZ location and fibre pattern (LC ≥0.82), and moderate (LC ≥0.58) for cross-sectional area and number of zones affected. This scoring system was reliable and repeatable for all parameters, except for echogenicity. A validated scoring system will facilitate reliable recording of SDFT injuries and inter-study meta-analyses.

Environmental chemicals impact dog semen quality in vitro and may be associated with a temporal decline in sperm motility and increased cryptorchidism

Adverse temporal trends in human semen quality and cryptorchidism in infants have been associated with exposure to environmental chemicals (ECs) during development. Here we report that a population of breeding dogs exhibit a 26 year (1988–2014) decline in sperm quality and a concurrent increased incidence of cryptorchidism in male offspring (1995–2014). A decline in the number of males born relative to the number of females was also observed. ECs, including diethylhexyl phthalate (DEHP) and polychlorinated bisphenol 153 (PCB153), were detected in adult dog testes and commercial dog foods at concentrations reported to perturb reproductive function in other species. Testicular concentrations of DEHP and PCB153 perturbed sperm viability, motility and DNA integrity in vitro but did not affect LH stimulated testosterone secretion from adult testis explants. The direct effects of chemicals on sperm may therefore contribute to the decline in canine semen quality that parallels that reported in the human.

An Investigation into the Clinical Reasoning Development of Veterinary Students

Clinical reasoning is a fundamental skill for veterinary clinicians and a competency required of graduates by the Royal College of Veterinary Surgeons. However, it is unknown how veterinary students develop reasoning skills and where strengths and shortcomings of curricula lie. This research aimed to use the University of Nottingham School of Veterinary Medicine and Science (SVMS) as a case study to investigate the development of clinical reasoning among veterinary students. The analysis was framed in consideration of the taught, learned, and declared curricula. Sixteen staff and sixteen students from the SVMS participated separately in a total of four focus groups. In addition, five interviews were conducted with recent SVMS graduates. Audio transcriptions were used to conduct a thematic analysis. A content analysis was performed on all curriculum documentation. It was found that SVMS graduates feel they have a good level of reasoning ability, but they still experience a deficit in their reasoning capabilities when starting their first job. Overarching themes arising from the data suggest that a lack of responsibility for clinical decisions during the program and the embedded nature of the clinical reasoning skill within the curriculum could be restricting development. In addition, SVMS students would benefit from clinical reasoning training where factors influencing "real life" decisions (e.g., finances) are explored in more depth. Integrating these factors into the curriculum could lead to improved decision-making ability among SVMS graduates and better prepare students for the stressful transition to practice. These findings are likely to have implications for other veterinary curricula.

Veterinary practitioners' selection of diagnostic tests for the primary evaluation of colic in the horse

The aim of this study was to survey veterinary practitioners’ selection of diagnostic tests for horses with clinical signs of abdominal pain. A questionnaire was distributed to veterinary surgeons involved in the primary evaluation of horses with abdominal pain, including the respondent's demographics, selection of diagnostic tests and factors affecting decision-making. Data analysis included descriptive analysis, categorisation of free text and simple univariable correlations to explore the relationships between independent variables and the relative self-estimated frequency that diagnostic tests were performed. A total of 228 responses were analysed. Participants worked in mixed practice (55.7 per cent), first opinion equine (22.8 per cent), first and second opinion equine (17.9 per cent) and referral practice (3.1 per cent). The majority (48.2 per cent, 105/218) were very confident managing a colic case (confidence level 4/5). The most frequently used diagnostic tests were ‘response to analgesia’ (87.2±24.0 per cent cases), rectal examination (75.9±21.2 per cent) and nasogastric intubation (43.8±27.6 per cent). Approach varied between practitioners, and for all diagnostic tests with frequency of use ranging from 0 to 100 per cent of cases. ‘Risk to personal safety’ was the most common reason for not using rectal examination. Practitioner's opinion of their confidence level in managing a colic case was associated with how frequently they used different diagnostic tests. There was marked variation in practitioners’ approaches, highlighting the need for further evidence to support decision-making.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015

REASONS FOR PERFORMING STUDY

Colic is a common reason for owners to seek veterinary treatment for their working equids in Morocco. There is no information available regarding cultural, religious or educational barriers to obtaining treatment or about the typical workload of these animals which may predispose them to colic.

OBJECTIVES

To characterise the typical workload and feeding regimens of working equids in Morocco; to characterise the ability of owners to recognise the clinical signs and causes of colic; and to identify specific barriers to the veterinary treatment of colic.

STUDY DESIGN

Questionnaire-based survey.

METHODS

A standardised, structured questionnaire was administered, with the assistance of an Arabic speaking interpreter, to the owners of working equids presenting their animals to 2 centres run by SPANA (The Society for the Protection of Animals Abroad). Participation was voluntary and informed consent was obtained prior to the interview.

RESULTS

All of the 102 participants that completed questionnaire were male. Ninety-eight owners used their animals for pulling carts, with 12% of animals working 7 days per week. 14% of animals were offered water by their owner once per day and 2% every other day. 25% of animals were loose and allowed free to feed unsupervised when not working. 29% of owners were not able to name any cause of colic and 25% did not recognise any clinical signs; only 12% associated colic with gastrointestinal pain. 83% of owners would not seek veterinary treatment due to financial constraints if free treatment at SPANA centres were not available.

CONCLUSIONS

Colic remains a common problem amongst working equids in Morocco. Improved knowledge of management factors associated with colic and how to recognise abdominal pain may reduce the incidence of colic and improve prognosis. The findings presented can be used to inform and develop owner education programmes. Ethical animal research: The study was reviewed and approved by the Ethics Committee, School of Veterinary Medicine and Science, University of Nottingham. Informed consent for participation in the study was obtained from all owners and was delivered in the native language. No details identifying the owner were recorded.

SOURCE OF FUNDING

None. Competing interests: None declared.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015

REASONS FOR PERFORMING STUDY

Colic is the most common equine emergency problem, and one of the main causes of equid deaths. The horse owners' ability to recognise colic is a critical first step in determining case outcome.

OBJECTIVES

To assess equine owners' knowledge and recognition of colic.

STUDY DESIGN

Online questionnaire of horse owners.

METHODS

An online survey was designed to evaluate owners' approach to colic in the horse. The survey included questions on owner demographics, their recognition of colic (including owner's opinions of their ability to recognise colic, their approach, and their recognition of colic using case vignettes), and their knowledge of normal ranges for clinical parameters. Descriptive and chi squared statistical analysis was performed.

RESULTS

The survey was completed by 1061 UK respondents. Six per cent of owners thought they could recognise all types of colic, 61% said they could recognise most cases and 30% said they could recognise some but not all cases. Owners said they would assess faecal output (73% of respondents), gastrointestinal sounds (69%), respiratory rate (62%) and heart rate (50%) in horses with suspected colic. One fifth (22%) of owners would call a vet immediately without assessing any parameters. Many respondents either did not know, or provided incorrect estimates of normal values for clinical parameters: 30.4% were 'unsure' of the normal heart rate and 35.5% gave heart rate values which were outside reference ranges; only 24.5% gave appropriate values for normal respiratory rates and only 31% gave normal temperature values. There was no statistical significance between participants' age, educational qualifications, or their experience with horses and their knowledge of normal clinical parameters.

CONCLUSIONS

Owners varied in their approach and ability to recognise colic, and many had significant gaps in their knowledge of normal parameters. Educational materials and/or training to assist owners could help address these issues. Ethical animal research: The study did not involve animal research. The study was reviewed and approved by the Ethics Committee, School of Veterinary Medicine and Science, University of Nottingham. The questionnaire was conducted in accordance with the 1998 Data Protection Act, and the British Educational Research Association's Revised Ethical Guidelines for Educational Research (2004).

SOURCE OF FUNDING

Adelle Bowden's studentship is funded by the School of Veterinary Medicine and Science, University of Nottingham. Competing interests: None declared.

Water intake, faecal output and intestinal motility in horses moved from pasture to a stabled management regime with controlled exercise

Reasons for performing study

A change in management from pasture to stabling is a risk factor for equine colic.

Objectives

To investigate the effect of a management change from pasture with no controlled exercise to stabling with light exercise on aspects of gastrointestinal function related to large colon impaction. The hypothesis was that drinking water intake, faecal output, faecal water content and large intestinal motility would be altered by a transition from a pastured to a stabled regime.

Study design

Within-subject management intervention trial involving changes in feeding and exercise using noninvasive techniques.

Methods

Seven normal horses were evaluated in a within-subjects study design. Horses were monitored while at pasture 24 h/day, and for 14 days following a transition to a stabling regime with light controlled exercise. Drinking water intake, faecal output and faecal dry matter were measured. Motility of the caecum, sternal flexure and left colon (contractions/min) were measured twice daily by transcutaneous ultrasound. Mean values were pooled for the pastured regime and used as a reference for comparison with stabled data (Days 1–14 post stabling) for multilevel statistical analysis.

Results

Drinking water intake was significantly increased (mean ± s.d. pasture 2.4 ± 1.8 vs. stabled 6.4 ± 0.6 l/100 kg bwt/day), total faecal output was significantly decreased (pasture 4.62 ± 1.69 vs. stabled 1.81 ± 0.5 kg/100 kg bwt/day) and faecal dry matter content was significantly increased (pasture 18.7 ± 2.28 vs. stabled 27.2 ± 1.93% DM/day) on all days post stabling compared with measurements taken at pasture (P<0.05). Motility was significantly decreased in all regions of the large colon collectively on Day 2 post stabling (-0.76 contractions/min), and in the left colon only on Day 4 (-0.62 contractions/min; P<0.05).

Conclusions

There were significant changes in large intestinal motility patterns and parameters relating to gastrointestinal water balance during a transition from pasture to stabled management, particularly during the first 5 days.

Prevalence and effect of uterine luminal free fluid on pregnancy and litter size in bitches

Free fluid within the uterine lumen has been identified ultrasonographically as a transient finding in normal bitches in the period immediately after mating, and delayed clearance of the fluid has been documented in bitches with endometrial hyperplasia. This study used B-mode ultrasonography to investigate the prevalence of free fluid in the uterine lumen in normal bitches (n = 53) and bitches with endometrial hyperplasia (n = 10) on Days -7, 0, +5, and +14 in relation to estimated ovulation. For normal bitches without endometrial hyperplasia, 47 (86.6%) bitches become pregnant, whereas for bitches with endometrial hyperplasia, 3 (30%) become pregnant. In both the groups, the presence of uterine fluid on Days -7 and 0 was not associated with the probability of a bitch becoming pregnant, whereas the presence of uterine fluid on either Day +5 or +14 was significantly associated with a reduced likelihood of pregnancy. In pregnant bitches, uterine luminal fluid present on Day 0 was associated with a smaller litter size. This is the first study to establish the prevalence and effect of uterine luminal free fluid in bitches. We postulate that as the uterine luminal free fluid may be detected in normal bitches before mating and has no effect on the pregnancy rate or litter size in either group, this fluid is "physiological." However, it seems that the later in estrus the uterine fluid is present, the more likely it is to have an adverse effect on fertility. In some cases, this is manifest as a reduced litter size, while, importantly, the presence of fluid 5 to 14 days after ovulation is strongly associated with an absence of pregnancy, both in bitches with and without endometrial hyperplasia. We propose that ultrasonographic detection of uterine luminal free fluid after mating may be a useful prognostic indicator for pregnancy outcome, which may allow the targeting of treatments specifically to a population of animals that presumably develop mating-induced endometritis.

Storage and release of spermatozoa from the pre-uterine tube reservoir

In mammals, after coitus a small number of spermatozoa enter the uterine tube and following attachment to uterine tube epithelium are arrested in a non-capacitated state until peri-ovulatory signalling induces their detachment. Whilst awaiting release low numbers of spermatozoa continually detach from the epithelium and the uterine tube reservoir risks depletion. There is evidence of attachment of spermatozoa to uterine epithelium in several species which might form a potential pre-uterine tube reservoir. In this study we demonstrate that: (1) dog spermatozoa attach to uterine epithelium and maintain flagellar activity, (2) in non-capacitating conditions spermatozoa progressively detach with a variety of motility characteristics, (3) attachment is not influenced by epithelial changes occurring around ovulation, (4) attachment to uterine epithelium slows capacitation, (5) capacitated spermatozoa have reduced ability to attach to uterine epithelium, (6) under capacitating conditions increased numbers of spermatozoa detach and exhibit transitional and hyperactive motility which differ to those seen in non-capacitating conditions, (7) detachment of spermatozoa and motility changes can be induced by post-ovulation but not pre-ovulation uterine tube flush fluid and by components of follicular fluid and solubilised zona pellucida, (8) prolonged culture does not change the nature of the progressive detachment seen in non-capacitating conditions nor the potential for increased detachment in capacitating conditions. We postulate that in some species binding of spermatozoa to uterine epithelium is an important component of the transport of spermatozoa. Before ovulation low numbers of spermatozoa continually detach, including those which are non-capacitated with fast forward progressive motility allowing the re-population of the uterine tube, whilst around the time of ovulation, signalling from as-yet unknown factors associated with follicular fluid, oocytes and uterine tube secretion promotes the detachment of large numbers of capacitated spermatozoa with hyperactive motility that may contribute to the fertilising pool.

Enhancing clinical learning in the workplace: a qualitative study

Workplace learning (WPL) is seen as an essential component of clinical veterinary education by the veterinary profession. This study sought to understand this type of learning experience more deeply. This was done utilising observations of students on intramural rotations (IMR) and interviews with students and clinical staff. WPL was seen as an opportunity for students to apply knowledge and develop clinical and professional skills in what is generally regarded as a safe, authentic environment. Clinical staff had clear ideas of what they expected from students in terms of interest, engagement, professionalism, and active participation, where this was appropriate. In contrast, students often did not know what to expect and sometimes felt under-prepared when entering the workplace, particularly in a new species area. With the support of staff acting as mentors, students learned to identify gaps in their knowledge and skills, which could then be addressed during specific IMR work placements. Findings such as these illustrate both the complexities of WPL and the diversity of different workplace settings encountered by the students.

Follicular dynamics, ovulation and conception rates in bitches

Real-time ultrasound imaging was used in a clinical study to estimate the number of follicles of different sizes, ovulation and conception rates, and to study follicle dynamics following oestrus-induction of bitches. Follicles were identified during late anoestrus (between 100 and 60 days prior to the pre-ovulatory LH surge) and there appeared to be a shift in the population from small follicles (1-3 mm in diameter) to large follicles (>4 mm diameter) approximately 2 days prior to the LH surge. Corpora lutea could be reliably identified although the majority were cavitated. High ovulation rates (97-100%) and pregnant rates (86-100%) were detected, and although the conception rate was approximately 70% it varied between 8 and 92%. Within the narrow range of the clinical population studied there were trends relating age to reproduction performance. Oestrus induction with a gonadotrophin regime appeared to result in large numbers of small follicles that did not ovulate, whilst when using cabergoline the number of small and large follicels and the number of copora lutea were similar to those of control cycles.

Cardiopulmonary effects and pharmacokinetics of i.v. dexmedetomidine in ponies

REASONS FOR PERFORMING STUDY

Currently available sedatives depress cardiopulmonary function considerably; therefore, it is important to search for new, less depressive sedatives. The study was performed to assess duration and intensity of cardiopulmonary side effects of a new sedative, dexmedetomidine (DEX), in horses.

OBJECTIVES

To study pharmacokinetics and cardiopulmonary effects of i.v. DEX.

METHODS

Pharmacokinetics of 3.5 microg/kg bwt i.v. DEX were studied in a group of 8 mature (mean age 4.4 years) and 6 old ponies (mean age 20 years). Cardiopulmonary data were recorded in mature ponies before and 5, 10, 20, 30, 45 and 60 mins after administration of DEX 3.5 microg/kg bwt i.v. Data were analysed using ANOVA for repeated measures, and where appropriate Dunnett's t test was used to detect differences from resting values (P < 0.05).

RESULTS

Within 2 h after DEX administration, plasma levels were beyond limits of quantification (0.05 ng/ml). Mean values for kinetic parameters for mature and old ponies were: Cmax (ng/ml) 4.6 and 3.8, t 1/2 (min) 19.8 and 28.9 and AUC (ng.min/ml) 34.5 and 44.3, respectively. Heart rate, central venous pressure, pulmonary artery pressure and pulmonary capillary wedge pressure did not change significantly compared to presedation values throughout the 60 min observation period. Compared to presedation values, stroke volume and mixed venous PO2 were reduced for the first 5 mins, paralleled by an increase in systemic and pulmonary vascular resistance. Cardiac index was reduced for the first 10 mins, arterial blood pressures at 20, 30 and 45 mins and respiratory rate throughout the 60 min observation period, but no change in arterial PO2 or PCO2 occurred.

CONCLUSIONS

DEX administration i.v. causes similar cardiopulmonary changes to those caused by other alpha-2 adrenoceptor agonists, but of very short duration. DEX is redistributed particularly rapidly.

POTENTIAL RELEVANCE

DEX might be safer for sedation of horses because of its very short-lasting cardiopulmonary side effects. For long duration sedation, its kinetics favour its use as a continuous infusion.

Assessment of first-year veterinary students' clinical skills using objective structured clinical examinations

The DVM program at the University of Calgary offers a Clinical Skills course each year for the first three years. The course is designed to teach students the procedural skills required for entry-level general veterinary practice. Objective Structured Clinical Examinations (OSCEs) were used to assess students' performance on these procedural skills. A series of three OSCEs were developed for the first year. Content was determined by an exam blueprint, exam scoring sheets were created, rater training was provided, a mock OSCE was performed with faculty and staff, and the criterion-referencing Ebel method was used to set cut scores for each station using two content experts. Each station and the overall exam were graded as pass or fail. Thirty first-year DVM students were assessed. Content validity was ensured by the exam blueprint and expert review. Reliability (coefficient α) of the stations from the three OSCE exams ranged from 0.0 to 0.71. The three exam reliabilities (Generalizability Theory) were, for OSCE 1, G=0.56; OSCE 2, G=0.37; and OSCE 3, G=0.32. Preliminary analysis has suggested that the OSCEs demonstrate face and content validity, and certain stations demonstrated adequate reliability. Overall exam reliability was low, which reflects issues with first-time exam delivery. Because this year was the first that this course was taught and this exam format was used, work continues in the program on the teaching of the procedural skills and the development and revision of OSCE stations and scoring checklists.

Treatment of spontaneous pyometra in 22 bitches with a combination of cabergoline and cloprostenol

Twenty-two bitches with ultrasonographically diagnosed spontaneous pyometra were treated with a combination of 5 microg/kg cabergoline per day and 5 mug/kg cloprostenol every third day, and potentiated sulphonamide twice a day. Bitches with either open-cervix or closed-cervix pyometra showed a rapid clinical improvement, associated with a reduction in plasma progesterone concentration, increased vulval discharge and a reduction in the diameter of the uterus. The haematological profiles of 21 of the bitches returned to normal within six days of treatment, and their biochemical profiles returned to normal within nine days; 19 of the bitches were managed successfully by a 10-day period of treatment. Two bitches required a further three days of treatment, and in one bitch with a partial uterine torsion the treatment was not successful. Adverse effects of the treatment were limited to the 60 minutes immediately after the administration of prostaglandin, and included retching, vomiting, mild abdominal straining, diarrhoea and panting. The incidence of adverse effects was reduced after each successive dose of prostaglandin. Eleven of the 21 successfully treated bitches were mated at the next oestrus, and seven became pregnant; their litters were smaller than the published breed averages. In four of the bitches the pyometra recurred after the next oestrus.

Relationship between the fertile period and sperm transport in the bitch

Following ejaculation into the vagina, dog sperm remain functionally competent for many days, acquire the ability to fertilize, and are delivered to an appropriate site within the uterine tube synchronously with the appearance of fertile oocytes. The mechanisms involved in regulating this system are complex, and allow for sperm storage within the female reproductive tract. The aim of this paper is to review current knowledge of the transportation of sperm and their biology within the reproductive tract of the bitch.

Luminal glucose sensing in the rat intestine has characteristics of a sodium-glucose cotransporter

The presence of glucose in the intestinal lumen elicits a number of changes in gastrointestinal function, including inhibition of gastric emptying and food intake and stimulation of pancreatic and intestinal secretion. The present study tested the hypothesis that Na(+)-glucose cotransporter (SGLT)-3, a member of the SGLT family of transport proteins, is involved in detection of luminal glucose in the intestine. Gastric emptying, measured in awake rats, was significantly inhibited by perfusion of the intestine with glucose (60 and 90 mg); this effect was mimicked by alpha-methyl glucose (nonmetabolizable substrate of SGLT-1 and -3) but not 2-deoxy-d-glucose (substrate for GLUT-2) or isoosmotic mannitol. Gastric motility and intestinal fluid secretion, measured in anesthetised rats, were significantly inhibited and stimulated, respectively, by duodenal glucose but not galactose, which has a much lower affinity for SGLT-3 than glucose. Duodenal glucose but not galactose stimulated the release of 5-HT into mesenteric lymph and stimulated the discharge of duodenal vagal afferent fibers. mRNA for SGLT-3 was identified in the duodenal mucosa. Together these data suggest that detection of glucose in the intestine may involve SGLT-3, possibly expressed by enterochromaffin cells in the intestinal mucosa, and release of 5-HT.

Nitric oxide inhibitable isoforms of adenylate cyclase mediate epithelial secretory dysfunction following exposure to ionising radiation

BACKGROUND

Hyporesponsiveness of the intestinal epithelium to secretagogues occurs in different models of intestinal injury, including radiation enteropathy, and in human disease. While this impairment of barrier function has been linked to increased inducible nitric oxide synthase (iNOS) activity, the cellular target of NO in this phenomenon is not known, although recent studies suggest that some isoforms of adenylate cyclase are inhibited by NO.

AIMS

To determine adenylate cyclase isoform distribution in colonic epithelial cells and, in particular, the physiological significance of NO inhibitable adenylate cyclase isoforms 5 and 6 in radiation induced epithelial secretory dysfunction.

METHODS

Reverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry, and immunohistochemistry were used to examine adenylate cyclase expression. The responsiveness of mouse colon to secretagogues 72 hours post-15 Gy gamma radiation or following in vitro exposure to NO donors was measured in Ussing chambers. Also, cAMP, cGMP, and ATP levels were measured.

RESULTS

RT-PCR, immunocytochemistry, and immunohistochemistry showed that adenylate cyclase 5 was expressed in mouse colon, and isoforms 5 and 6 were expressed in human biopsies and intestinal epithelium. Pharmacological studies showed that these isoforms are functionally important in chloride secretion. NO mediated hyporesponsiveness to secretagogues is primarily a result of decreased adenylate cyclase activity, and not G(i) activation or decreased cellular ATP levels.

CONCLUSIONS

NO inhibitable isoforms of adenylate cyclase are expressed in mouse and human secretory colonic epithelia, and appear to be the target of radiation induced NO to reduce the responsiveness to cAMP dependent secretagogues.

Medetomidine-ketamine anaesthesia induction followed by medetomidine-propofol in ponies: infusion rates and cardiopulmonary side effects

REASONS FOR PERFORMING STUDY

To search for long-term total i.v. anaesthesia techniques as a potential alternative to inhalation anaesthesia.

OBJECTIVES

To determine cardiopulmonary effects and anaesthesia quality of medetomidine-ketamine anaesthesia induction followed by 4 h of medetomidine-propofol anaesthesia in 6 ponies.

METHODS

Sedation consisted of 7 microg/kg bwt medetomidine i.v. followed after 10 min by 2 mg/kg bwt i.v. ketamine. Anaesthesia was maintained for 4 h with 3.5 microg/kg bwt/h medetomidine and propofol at minimum infusion dose rates determined by application of supramaximal electrical pain stimuli. Ventilation was spontaneous (F(I)O2 > 0.9). Cardiopulmonary measurements were always taken before electrical stimulation, 15 mins after anaesthesia induction and at 25 min intervals.

RESULTS

Anaesthesia induction was excellent and movements after pain stimuli were subsequently gentle. Mean propofol infusion rates were 0.89-0.1 mg/kg bwt/min. No changes in cardiopulmonary variables occured over time. Range of mean values recorded was: respiratory rate 13.0-15.8 breaths/min; PaO2 29.1-37.9 kPa; PaCO2 6.2-6.9 kPa; heart rate 31.2-40.8 beats/min; mean arterial pressure 90.0-120.8 mmHg; cardiac index 44.1-59.8 ml/kg bwt/min; mean pulmonary arterial pressure 11.8-16.4 mmHg. Recovery to standing was an average of 31.1 mins and ponies stood within one or 2 attempts.

CONCLUSIONS

In this paper, ketamine anaesthesia induction avoided the problems encountered previously with propofol. Cardiovascular function was remarkably stable. Hypoxaemia did not occur but, despite F(I)O2 of > 0.9, minimal PaO2 in one pony after 4 h anaesthesia was 8.5 kPa.

POTENTIAL RELEVANCE

The described regime might offer a good, practicable alternative to inhalation anaesthesia and has potential for reducing the fatality rate in horses.

Cardiovascular effects of romifidine in the standing horse

The cardiovascular effects of romifidine, an alpha-2 adrenoreceptor agonist, were investigated in six horses using two doses (80 and 120 microg kg(-1)) in a cross-over study design. Cardiac index and mixed venous oxygenation were significantly decreased at 15 and 30 minutes after both doses of romifidine. Systemic vascular resistance was significantly increased with romifidine (120 microg kg(-1)). Arterial blood pressure increased initially and then gradually decreased; the doses of decrease was significant at 90 and 120 minutes with romifidine 80 and 120 microg kg(-1). There were minimal differences between the two doses of romifidine, and both should be used with care especially in horses with cardiovascular compromise, or when used in combination with other cardiovascular depressant drugs.

Effect of romifidine on gastrointestinal motility, assessed by transrectal ultrasonography

A technique of transrectal ultrasonography was developed to investigate the effects of romifidine 80 and 120 microg/kg bwt on intestinal motility in the horse. Motility of the small intestine, caecum and left ventral colon were assessed following injection of romifidine and a saline control, using a blinded, cross-over study design in 6 horses. Measurements were taken at 15, 30, 60, 120, 180 and 240 min after drug administration. There was a slight nonsignificant decrease in motility in the control group over the 4 h study period. Both doses of romifidine produced a marked decrease in gastrointestinal motility and were associated with the presence of reduced (nonpropulsive) contractions. Transrectal ultrasonography proved suitable for monitoring changes in the type and frequency of intestinal motility in the horse.

Cardiopulmonary effects of prolonged anesthesia via propofol-medetomidine infusion in ponies

OBJECTIVE

To determine cardiopulmonary effects of total IV anesthesia with propofol and medetomidine in ponies and effect of atipamezole on recovery.

ANIMALS

10 ponies.

PROCEDURE

After sedation was induced by IV administration of medetomidine (7 microg/kg of body weight), anesthesia was induced by IV administration of propofol 12 mg/kg) and maintained for 4 hours with infusions of medetomidine (3.5 microg/kg per hour) and propofol 10.07 to 0.11 mg/kg per minute). Spontaneous respiration was supplemented with oxygen. Cardiopulmonary measurements and blood concentrations of propofol were determined during anesthesia. Five ponies received atipamezole (60 microg/kg) during recovery.

RESULTS

During anesthesia, mean cardiac index and heart rate increased significantly until 150 minutes, then decreased until cessation of anesthesia. Mean arterial pressure and systemic vascular resistance index increased significantly between 150 minutes and 4 hours. In 4 ponies, PaO2 decreased to < 60 mm Hg. Mean blood propofol concentrations from 20 minutes after induction onwards ranged from 2.3 to 3.5 microg/ml. Recoveries were without complications and were complete within 28 minutes with atipamezole administration and 39 minutes without atipamezole administration.

CONCLUSIONS AND CLINICAL RELEVANCE

During total IV anesthesia of long duration with medetomidine-propofol, cardiovascular function is comparable to or better than under inhalation anesthesia. This technique may prove suitable in equids in which prompt recovery is essential; however, in some animals severe hypoxia may develop and oxygen supplementation may be necessary.

Infusion of a combination of propofol and medetomidine for long-term anesthesia in ponies

OBJECTIVE

To determine the minimal infusion rate of propofol in combination with medetomidine for long-term anesthesia in ponies and the effects of atipamezole on recovery.

ANIMALS

12 ponies.

PROCEDURE

Ponies were sedated with medetomidine (7 microg/kg of body weight, IV). Ten minutes later, anesthesia was induced with propofol (2 mg/kg, IV). Anesthesia was maintained for 4 hours, using an infusion of medetomidine (3.5 microg/kg per hour, IV) and propofol at a rate sufficient to prevent ponies from moving after electrical stimulation. Arterial blood pressures and blood gas analysis, heart rates, and respiratory rates were monitored. For recovery, 6 ponies were given atipamezole (60 microg/kg, IV). Induction and recovery were scored.

RESULTS

Minimal propofol infusion rates ranged from 0.06 to 0.1 mg/kg per min. Mean arterial blood pressure was stable (range, 74 to 86 mm Hg), and heart rate (34 to 51 beats/min) had minimal variations. Variable breathing patterns were observed. Mean PaO2 (range, 116 to 146 mm Hg) and mean PaCO2 (range, 48 to 51 mm Hg) did not change significantly with time, but hypoxemia was evident in some ponies (minimal PaO2, 47 mm Hg). Recovery was fast and uneventful with and without atipamezole (completed in 20.2 and 20.9 minutes, respectively).

CONCLUSIONS AND CLINICAL RELEVANCE

Infusion of a combination of medetomidine and propofol was suitable for prolonged anesthesia in ponies. Recovery was rapid and uneventful. A combination of propofol and medetomidine may prove suitable for long-term anesthesia in horses. Monitoring of blood gases is essential because of potential hypoxemia.

Radiation-induced acute intestinal inflammation differs following total-body versus abdominopelvic irradiation in the ferret

PURPOSE

The studies were designed to investigate the differences in the intestinal inflammatory response following abdominopelvic or total-body irradiation in a ferret model.

MATERIALS AND METHODS

Ferrets were exposed either to total-body or to abdominopelvic gamma-radiation (5 Gy) and various parameters of inflammation studied in the jejunum, ileum and colon 2 and 7 days later.

RESULTS

Abdominopelvic and, to a greater extent, total-body irradiation caused weight loss by 7 days. White blood cell counts were reduced in both groups, but more so following total-body irradiation. Myeloperoxidase activity was significantly increased in the ileum 2 days after abdominopelvic irradiation, but it was reduced after total-body irradiation. Total-body irradiation increased tissue prostaglandin E2 levels in all regions at 2 days and decreased jejunal leukotriene B4 levels in the jejunum at both time points. Ileal prostaglandin E2 levels were increased 2 days after abdominopelvic irradiation. Expression of inducible nitric oxide synthase was not altered by either irradiation protocol.

CONCLUSIONS

The data show that there are regional differences in the intestinal response to irradiation, depending on whether it was delivered to the whole body or locally to the abdominopelvic region. In particular, the ileum exhibited an acute increase in myeloperoxidase activity following abdominopelvic but not total-body irradiation.

Cardiopulmonary effects of romifidine and detomidine used as premedicants for ketamine/halothane anaesthesia in ponies

The cardiopulmonary effects of romifidine at 80 microg/kg (R80) or 120 pg/kg (R120), and detomidine at 20 pg/kg (D20) when used as premedicants for ketamine/halothane anaesthesia were investigated in six ponies. Using a blinded crossover design, acepromazine (0-04 mg/kg) was administered followed by the alpha-2 agonist. Anaesthesia was induced with ketamine at 2.2 mg/kg and maintained with halothane (expired concentration 1.0 per cent) in oxygen for three hours. During anaesthesia, arterial blood pressure, cardiac index, PaO2 and PmvO2 decreased, and systemic vascular resistance and PaCO2 increased. The cardiac indices for R80, R120 and D20 were, respectively, 39, 39 and 32 ml/kg/minute at 30 minutes and 29, 29 and 26 ml/kg/minute at 180 minutes. The alpha-2 agonists had similar cardiovascular effects, but PaO2 was significantly lower with R120. The quality of anaesthesia was similar in all three groups.

Investigation of romifidine and detomidine for the clinical sedation of horses

The effects of two intravenous doses of romifidine (80 and 120 microg/kg) and one dose of detomidine (20 microg/kg) were compared in a blinded study in 30 horses requiring to be sedated for routine dental treatment. Several physiological parameters were assessed before and for two hours after the administration of the drugs, and the horses' teeth were rasped 30 minutes after they were administered. Romifidine produced a dose-dependent effect on most parameters. Detomidine at 20 microg/kg was similar to romifidine at 120 microg/kg in the magnitude of its sedative effects, but was similar to romifidine at 80 pg/kg in its duration. There were no significant differences between the three treatments in terms of the clinical procedure score.

Interleukin-12 differentially regulates expression of IFN-gamma and interleukin-2 in human T lymphoblasts

Interleukin-12 (IL-12) is known to upregulate expression of interferon-gamma (IFN-gamma) by activated T cells. However, the effects of IL-12 on production of other Th1-type cytokines are less well defined. In this study, we examined the effects of IL-12 on expression of several cytokines, including IFN-gamma, IL-2, tumor necrosis factor-alpha (TNF-alpha), and IL-10, by primary human CD3(+) T cells. Although purified resting T cells were largely nonresponsive to IL-12 stimulation, anti-CD3-activated T cell blasts were strongly responsive, as demonstrated by the ability of IL-12 to induce Stat4 DNA-binding activity. Restimulation of T lymphoblasts on immobilized anti-CD3 monoclonal antibodies (mAb) induced rapid expression of TNF-alpha mRNA and more gradual increases in mRNA levels for IL-2, IFN-gamma, and IL-10. IL-12 markedly upregulated expression of IFN-gamma and IL-10 but downregulated expression of IL-2 in a dose-dependent and time-dependent manner. The levels of IL-2 produced by IL-12-treated T cells correlated inversely with the levels of IL-10. Moreover, neutralization of IL-10 activity with anti-IL-10 antibodies normalized IL-2 production by IL-12-treated T cells, confirming that the inhibition of IL-2 production by IL-12 was IL-10 mediated. Thus, IL-12 amplified expression of IFN-gamma and IL-10 and, via its ability to upregulate production of IL-10, inhibited expression of IL-2. These findings demonstrate that IL-12 differentially regulates expression of the Th1-type lymphokines, IFN-gamma and IL-2, in T lymphoblasts.

Modulation of hyperoxia-induced TNF-alpha expression in the newborn rat lung by thalidomide and dexamethasone

The effect of high oxygen concentrations on lungs of neonatal rats was studied. In addition, some oxygen-exposed animals were treated with either dexamethasone or thalidomide. No gross histologic changes were noted in the lungs following exposure to 95% oxygen nor were there changes in the total number or the phenotypic distribution of BAL cells obtained from these lungs compared to lungs from air exposed (control) neonatal rats. The majority of the BAL cells were CD45+ leukocytes (macrophages). However, when BAL cells were exposed to LPS in vitro, TNF-alpha production was higher in cells from rats exposed to 95% oxygen compared to cells from rats exposed to ambient air. In addition, lung TNF-alpha and IL-6 mRNA levels were increased after exposure to 95% oxygen. In the lungs of animals treated with either dexamethasone or thalidomide, TNF-alpha mRNA levels were reduced, while only dexamethasone treatment also reduced IL-6 mRNA levels.

Contact of dog spermatozoa with homologous uterine tube epithelium prolongs flagellar activity in relation to the stage of the estrous cycle

There is scant information about the storage of spermatozoa within the reproductive tract of the bitch. In several species the uterine tube plays a significant role in sperm storage. The present study was performed to investigate the interaction between spermatozoa and the epithelium of the uterine tube, in particular how this interaction might influence the flagellar activity of spermatozoa in relation to the stage of the estrous cycle. Epithelium was harvested from uterine tubes of 24 bitches at various stages of the estrous cycle (estrus, luteal phase or anestrus), and cultured with pooled spermatozoa collected from 6 dogs. Spermatozoa rapidly bound to the epithelial surface by their heads and the majority of attached spermatozoa were motile. The intimate association between spermatozoa and the uterine tube epithelium maintained motility in a manner that was related to the stage of the estrous cycle. Flagellar activity was significantly greater for spermatozoa bound to estrous epithelium than epithelium from the luteal phase or anestrus. On average, approximately 10% of spermatozoa that were attached to the uterine tube epithelium of estrous bitches retained their flagellar activity for 48 h after innoculation. There was no apparent influence of the region of the uterine tube on this effect. These findings suggest that the uterine tube may form a functional spermatozoal reservoir in the bitch.