Clinical and neuropathological features of West Nile virus equine encephalomyelitis in Italy

West Nile (WN) virus infection is a mosquito-borne flavivirosis endemic in Africa and Asia. Clinical disease is usually rare and mild and only in a few cases the infection causes encephalomyelitis in horses, fever and meningoencephalitis in man. We report here the clinical and pathological findings in an epidemic of the disease involving 14 horses from Tuscany, Italy. All cases were observed from August to October 1998. Affected horses showed ataxia, weakness paresis of the hindlimbs and, in 6 cases, there was paraparesis progressing to tetraplegia and recumbency within 2 to 9 days. Eight animals recovered without any important consequences. Serological investigations revealed positivity to WN virus in all the 14 horses and the agent was isolated from the cerebellum and spinal cord of an affected horse. Postmortem examination was carried out on 6 horses. The neuropathological pattern was that of a mild to moderate, nonsuppurative polioencephalomyelitis with constant involvement of the ventral horns of the thoracic and lumbar spinal cord, where focal gliosis and haemorrhage were also apparent in some cases. Differential diagnoses with other equine viral encephalomyelitides are discussed. Climatological and environmental characteristics of the geographic area in which the outbreaks occurred suggest the existence of suitable conditions for the development of the disease. This is the first report of WN virus equine encephalomyelitis in Italy.

A comparison of the sedative effects of three α2-adrenoceptor agonists (romifidine, detomidine and xylazine) in the horse

The sedative effects of a new alpha 2-adrenoceptor agonist, romifidine, were compared with those of xylazine and detomidine. Five horses were treated with two doses of romifidine (40 micrograms/kg body weight and 80 micrograms/kg body weight), two doses of detomidine (10 micrograms/kg body weight and 20 micrograms/kg body weight) and one dose of xylazine (1 mg/kg body weight) given by intravenous injection using a Latin-square design. The dose of 80 micrograms/kg romifidine appeared equipotent to 1 mg/kg xylazine and 20 micrograms/kg detomidine, although at these doses both xylazine and detomidine had a shorter action. Detomidine 20 micrograms/kg and xylazine both produced greater lowering of the head and a greater degree of ataxia than romifidine at either dose. Romifidine produced sedation similar to that of the other drug regimes. The effect upon imposed stimuli was similar.

Clinical aspects of 27 cases of neosporosis in dogs

Twenty-seven cases of neosporosis in European dogs are described. The disease was confirmed by immunohistochemistry, electron microscopy, or a favourable response to treatment in the dogs with appropriate clinical signs, and by the presence of antibodies to Neospora caninum but not to Toxoplasma gondii. The affected dogs were two days to seven years old, and of 13 different breeds. Both sexes were affected and in most cases littermates remained normal. Twenty-one cases had an initial hindlimb paresis or ataxia, in which muscle atrophy was the most consistent clinical sign. Rigid hyperextension developed in approximately half of the cases. Anorexia and pyrexia were rare. Other clinical signs included forelimb ataxia, head tremors with tetraparesis and sudden collapse due to myocarditis. Titres of > or = 1:800 in the N caninum indirect fluorescent antibody test were detected in the 20 cases from which serum samples were taken. Such high titres are rare in healthy dogs and strongly suggest a diagnosis of neosporosis. Sixteen of the dogs received appropriate antiprotozoal treatment with clindamycin, potentiated sulphonamides and/or pyrimethamine; 10 made a full or functional recovery. Recovery was less likely in peracute cases with severe clinical signs, and when the treatment was delayed.

Epidural injection of ketamine for perineal analgesia in the horse

OBJECTIVE

To determine the analgesic, sedative, and cardiopulmonary effects of epidural ketamine in the horse.

ANIMAL POPULATION

Six healthy horses (three males and three females) weighing between 350 and 450 kg.

METHODS

Three doses of ketamine were selected (0.5, 1, 2 mg/kg). Two months before the beginning of experiments, the carotid artery was exteriorized, and 1 week before experiments began, an epidural catheter was placed percutaneously in all animals with the tip located 12 cm cranially in the midsacrum. One week later, either saline (control) or one of three doses of ketamine was injected epidurally. Each animal received each ketamine dose and saline in random order at 1-week intervals. Ketamine was diluted in saline 0.9% before the experiment, and the volume used was adjusted to horse size and correlated to clinically used volumes. All the animals received a standard noxious stimulus consisting of needle insertion into the skin and deep muscle using a 3-point scale for scoring the response. A second scale was used to score the degree of sedation. The response to a noxious stimulus, the degree of sedation, and arterial blood pressure were assessed at previously determined intervals: before drug and 2, 5, 10, and 15 minutes and every 15 minutes to 210 minutes after ketamine or saline administration. Arterial blood samples were drawn for blood gas analysis before drug and at 15, 30, 60, and 90 minutes.

RESULTS

All the tested doses of ketamine were effective in producing analgesia of the tail, perineum, and upper hindlimb. Total tail and perineal analgesia times were similar depending on dosage (30 minutes for 0.5 and 1.0 mg/kg and 75 minutes for 2.0 mg/kg). A sedative effect of ketamine was also observed in a dose-response manner with a peak effect between 15 and 30 minutes postadministration. No cardiopulmonary effects were observed with any dose of ketamine.

CONCLUSIONS

Results indicate that epidurally administered ketamine in the horse produces local spinal and central nervous system effects with analgesia and sedation but minimal cardiopulmonary effects.

CLINICAL RELEVANCE

Further studies are required to determine whether the analgesia is sufficient for surgery.

Sedative and analgesic effects of detomidine and romifidine in horses

In a double blind study, eight horses were treated intravenously at seven-day intervals with detomidine at doses of 10, 20 and 40 micrograms/kg, or with romifidine at doses of 40, 80 and 120 micrograms/kg, or with a placebo solution. Their sedative and analgesic effects were evaluated by objective measurements and by a clinician at 15-minute intervals for three hours and the horses' instability in stocks, locomotor ataxia and heart rate were recorded simultaneously. The administration of both drugs at all doses resulted in sedation. The sedation achieved with romifidine was significantly shallower and shorter-lived than with detomidine at the recommended doses (P < 0.05). The results obtained with the highest dose of romifidine were in some cases significantly inferior and shorter-lived than those obtained with the medium dose (P < 0.05). Detomidine at the 10 micrograms/kg dose was similar in its effects to the two highest doses of romifidine. At all doses detomidine had analgesic properties against the effects of electrical pain stimulation at the withers, the coronary bands on the front and hind legs, and in the perianal region, which were dose-dependent in depth and duration, whereas romifidine was devoid of any analgesic effect. Instability and ataxia were more pronounced with detomidine than with romifidine but the effects were only slight to moderate and not regarded as a hindrance to procedures for which sedation is needed. Bradycardia was evident with both drugs at all doses; its severity and duration was related to the sedative properties of the drugs and was dose related. No other side effects were observed.

Interactions of heat stress and bovine somatotropin affecting physiology and immunology of lactating cows

During summer, 34 cows received daily injections of placebo or 25 mg of bST and were placed in a thermoregulated or a heat stress environment. Heat stress increased rectal temperatures, respiration rates, and plasma cortisol concentrations and decreased milk yield. Four of 9 bST-treated cows and none of 8 control cows became atactic on the 1st d of heat stress. When exposed to heat stress, cows treated with bST experienced higher rectal temperatures throughout the trials than cows treated with placebo. Nonetheless, bST increased milk yields in both environments. The major effect of heat stress on immune function was decreased migration of leukocytes to the mammary gland after chemotactic challenge. This effect of heat stress was not altered by bST. In summary, hyperthermia induced by heat stress and associated changes were greater for cows treated with bST. Detected effects of heat stress on the immune system were few and were not alleviated by bST. Use of bST during summer in subtropical climate zones requires careful management to avoid overexposure of bST-treated cows to heat stress.

Clinical report of a paralytic syndrome affecting stallions, mares and foals on a thoroughbred studfarm

An outbreak of ataxia and paralysis on a Thoroughbred studfarm is reported. The cause of the disease was attributed to equid herpesvirus (EHV1) infection which stemmed from a single 10-month abortion on the studfarm. Stallions, mares and foals were all affected but the most serious clinical signs occurred in the mares. there were 35 out of 39 mares, 2 out of 4 stallions and 5 out of 39 foals which exhibited signs of ataxia. Nine mares became recumbent and died or were euthanased. Treatment with betamethasone and antibiotics was given. The outbreak was contained to one area of the stud apart from secondary spread to 2 in-contact mares on different premises.

Comparison of the sedative effects of medetomidine and xylazine in horses

The sedative effects in horses of the new alpha 2 agonist medetomidine were compared with those of xylazine. Four ponies and one horse were treated on separate occasions with two doses of medetomidine (5 micrograms/kg bodyweight and 10 micrograms/kg bodyweight) and with one dose of xylazine (1 mg/kg bodyweight) given by intravenous injection. Medetomidine at 10 micrograms/kg was similar to 1 mg/kg xylazine in its sedative effect but produced more severe and more prolonged ataxia, and one animal fell over during the study. Medetomidine at 5 micrograms/kg produced less sedation but a similar degree of ataxia to 1 mg/kg xylazine.

Equine degenerative myeloencephalopathy: a vitamin E deficiency that may be familial

Two horse farms, on which there was a high incidence of proven and suspected equine degenerative myeloencephalopathy (EDM), were studied. Symmetric ataxia and paresis, along with laryngeal adductor, cervicofacial, local cervical, and cutaneous trunci hyporeflexia, characterized the syndrome. Serum vitamin E concentration reflected a deficient state in affected and unaffected horses on both farms when compared with selected reference groups and with published values. A high incidence of the disease was evident in offspring of two particular sires on one farm. Vitamin E supplementation resulted in correction of the deficient state in most horses and was associated with a drastic reduction in the incidence of EDM on one farm from 40% to less than 10% the year following vitamin E supplementation. In addition, during the last year, the severity of signs in the few cases was dramatically reduced. This information substantiates the hypothesis that EDM is a vitamin E-responsive disorder of Equidae with a possible familial predisposition.

Neospora caninum-associated equine protozoal myeloencephalitis

Equine protozoal myeloencephalitis (EPM) was clinically diagnosed in a 20-year-old horse with severe ataxia. The cerebrospinal fluid was positive for Sarcocystis neurona antibodies by western blot. The horse was administered corticosteroids to facilitate in vitro culture of S. neurona from its spinal cord following necropsy. Microscopic lesions of EPM were present in the brain and in the spinal cord, including multifocal inflammatory cellular infiltrates and several large groups of protozoa. Immunohistochemical, and light and electron microscopic examinations revealed that the protozoa were Neospora caninum and not S. neurona. The protozoa divided by endodyogeny, tachyzoites had rhoptries, and organisms reacted specifically to N. caninum antibodies. Veterinarians should be aware of increasing diagnosis of N. caninum as another etiological agent responsible for the lesions of EPM.

Neurological disease associated with EHV-1-infection in a riding school: clinical and virological characteristics

An outbreak of neurological disease caused by EHV-1 infection is described with emphasis on diagnosis and prognosis for recumbent horses. In April 1995, an outbreak of the neurological form of Equine herpesvirus type 1 (EHV-1) occurred in a well-managed riding school with 41 horses: 34 horses showed a temperature spike and 20 some degree of neurological signs, of which 10 were nursed intensively in the indoor arena of the riding school for 3 to 20 days, 8 having to be maintained in slings for 2-18 days, while 9 needed bladder catheterisation b.i.d. for 2-16 days. Within the first 3 days, one horse was subjected to euthanasia and another horse died. Postmortem examination revealed a mild vasculitis with perivascular mononuclear cuffing and axonal degeneration in the central nervous system. Clinical diagnosis was confirmed by serology and virology: 28 horses seroconverted in one or more tests during the outbreak, whereas 12 had already high CF and SN titres in the first sample, suggestive of recent infection. Virus was isolated from nasal swabs of 4 horses, and identified as EHV-1 with type-specific monoclonal antibodies. Restriction enzyme analysis revealed that the EHV-1 strains from this outbreak belonged to genome type EHV-1.IP. The electropherotypes were identical to those from another, epidemiologically unrelated, outbreak of neurological disease 2 months earlier. The timing of the temperature spikes and seroconversions indicated that the infection was probably introduced by a horse purchased 3 weeks before neurological signs occurred. At follow-up one year later, the 10 horses that showed mild neurological signs had recovered completely. Of the 8 horses that survived intensive care, 3 had returned to around their former performance level (2 of which had been in slings), while the other 5 had become pasture-sound. At follow-up 4 years later, all pasture-sound horses had been subjected to euthanasia because of persistent mild ataxia and incontinence. In conclusion, the prognosis for recumbent horses due to EHV-1 infection is grave. For virological diagnosis, extensive and strategic sampling of febrile in-contact horses is required, and the EHV-1-specific glycoprotein G (gG) ELISA is a valuable tool for specific serological diagnosis of EHV-1 infection causing neurological disease.

A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse

OBJECTIVE

To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse.

STUDY DESIGN

A blinded, randomized, prospective, experimental cross-over study.

ANIMALS

Seven healthy horses, 15.7 +/- 4.9 years (mean +/- SD) of age, weighing 536 +/- 37 kg.

METHODS

The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg-1 or group L: LIDO, 0.35 mg kg-1) at intervals of at least 28 days. An 18-gauge 80-mm Tuohy epidural needle was placed in the first intercoccygeal space (Co1-Co2) in awake standing horses restrained in stocks. Analgesia was assessed by use of a probe maintained at a constant 62 degrees C by circulating hot water. The maximum stimulation time was 30 seconds. Bilateral stimulation was performed at five defined points. Before drug administration, baseline values of response time to thermal stimuli were obtained. Time to response was then measured 15 and 60 minutes after METH or LIDO administration and then hourly until the response returned to baseline at all stimulation points on two further assessments. Development of any ataxia and/or sedation was recorded. Positive pain responses were defined as purposeful avoidance movements of the head, neck, trunk, limbs and tail. Absence of attempts to kick, bite and turning of the head toward the stimulation site were used to indicate analgesia.

RESULTS

Caudal epidural administration of METH and LIDO significantly increased reaction time to thermal stimulation (one-sample t-test; p = 0.05). Analgesia in the perineal region was present 15 minutes after both METH and LIDO administration and progressed from caudal to cranial dermatones with time. The duration of a significant increase in reaction time was 5 hours after METH injection compared to 3 hours following LIDO. All horses defaecated and urinated normally, and no excitement, sedation or ataxia were observed after METH administration. The horses were unable to defaecate normally and were moderately to severely ataxic with hindlimb weakness after LIDO.

CONCLUSIONS

Caudal epidural administration of methadone has considerable potential in the management of perineal, lumbo-sacral and thoracic pain in horses. Regional differences exist in the onset, duration and intensity of the pain relief.

CLINICAL RELEVANCE

Epidural methadone administration provides analgesia with no measured side effects in these healthy adult horses.

Pathology of the vertebral column of horses with cervical static stenosis

Specimens of ligamentum flavum, joint capsule, and dorsal lamina were collected at surgery or necropsy from 25 horses with cervical static stenosis. All horses had myelographic evidence of dorsal compression of the spinal cord caused by soft tissue and/or bone in the caudal cervical area, primarily at C6-7. Most horses also had radiographic evidence of degenerative joint disease of articular facets. Histologically 19 horses had osteosclerosis and cartilage retention in the dorsal lamina, and 24 horses had increased fibrocartilage at the ligamentum flavum attachment to dorsal lamina. The ligamentum flavum and joint capsule had fibrovascular tissue in 20 horses. Fibrocartilaginous tissue, old hemorrhage, and fat necrosis were not unusual. One horse each had a synovial cyst, eosinophilic granulomas in the joint capsule, and osteochondrosis of articular facets. These findings indicate that abnormal biomechanical forces or instability of articulations result in stretching and tearing of the ligamentum flavum and joint capsule with subsequent fibrovascular and fibrocartilaginous proliferation, osteosclerosis of the dorsal lamina, and osteophyte formation on the articular facets.

Neuronal vacuolation and spinocerebellar degeneration in young Rottweiler dogs

With the recent epizootic of bovine spongiform encephalopathy in Europe, the differential diagnosis of neuronal vacuolation and spongiform change in other species has become critically important. Four Rottweiler puppies of both sexes, presented at 3-8 months of age, had clinical signs of generalized weakness and ataxia that started at 6 weeks of age. In all pups, neurologic examination detected an ataxia and tetraparesis, most severe in the pelvic limbs, and slowed proprioceptive placing reactions. Subsequently, there was rapid progressive neurologic deterioration, with severe placing deficits, knuckling, severe ataxia, and quadraparesis by 8 months of age. At necropsy, no gross lesions were observed. Microscopic lesions were restricted to the nervous system. The major lesion in all dogs was an intracytoplasmic neuronal vacuolation that was most prominent in the cerebellar roof nuclei and in nuclei of the extrapyramidal system. Similar vacuolation was found in neurons in both dorsal nerve root ganglia, myenteric plexus, and other ganglia of the autonomic nervous system. The single or multiple empty vacuoles were between 1 and 45 microm in diameter. A mild spongiform change was seen in the adjacent neuropil. Purkinje cell vacuolation and degeneration with segmental cell loss was seen in the oldest dog. In ventromedial and dorsolateral areas of the spinal cord white matter, there was mild bilaterally symmetrical axonal degeneration. Immunoblotting and immunocytochemical staining of the brain for protease-resistant scrapie prion protein was negative. All forms of vacuoles were negative for immunohistochemical staining with a variety of lectins. Ultrastructurally, the vacuoles were bound by a single membrane and contained granular material and sometimes membranous profiles. There was mild distension of the cytocavitary network but no unequivocal connection with the vacuoles was found. Axosomatic and axodendritic synapses in affected neurons were intact both ultrastructurally and with synaptophysin immunostaining. The clinicopathologic findings were different from those seen in the other neurologic diseases of Rottweilers. The age of the dogs, distribution and type of the lesions, ultrastructural findings, and negative immunoblotting most likely rule out the possibility of a scrapie agent-associated spongiform encephalopathy. However, the etiology of this new disease was not determined.

Granulomatous encephalitis in a neurologically impaired goat kid associated with degeneration of Neospora caninum tissue cysts

Congenital Neospora caninum infection was diagnosed in a Saanen goat from a farm in southern Brazil. The kid was unable to nurse and had difficulty rising, ataxia, and opistothotonos. The neurologic signs became more severe 3 days after birth, when it was euthanized. No gross lesions were observed at necropsy. Multifocal infiltrates primarily of mononuclear cells, nodular microgliosis, and perivascular cuffs of lymphocytes, plasma cells, and few neutrophils were observed in the brain, mostly in the cortex and adjacent to ventricles. Rare multinucleate giant cells were observed adjacent to inflammatory foci. Several tissue cysts with a thick wall that reacted strongly with polyclonal antiserum to N. caninum were in the cerebral cortex and medulla oblongata. Lesions were also present in heart, lungs, and liver, but N. caninum tachyzoites were not found. Distinguishing features in this goat kid included neurologic impairment resulting from congenital infection with N. caninum and the presence of granulomatous inflammation with rare giant cells associated with degeneration of tissue cysts.

Spongy degeneration of the central nervous system in kittens

The paper describes the clinical and morphological features of a congenital neurological disease affecting two in-bred litter-mate kittens. The principal neurological features were ataxia and dysmetria. In one of the kittens light microscopy revealed widespread vacuolation of white and grey matter of the brain and spinal cord. Electron microscopy revealved intra-myelinic vacuolation and some expansion of the extracellular space. Neuronal, axonal and glial changes were not seen, nor was there evidence of myelin breakdown. The entity is compared with congenital brain oedema of calves and spongy degeneration of the CNS in man.

The slap test for laryngeal adductory function in horses with suspected cervical spinal cord damage

The paper describes the assessment and practical implications of a laryngeal adductory reflex in a series of 30 ataxic and 64 non-ataxic horses. The reflex was evoked by slapping the saddle region just caudal to the withers. In normal horses this produced a flickering adductory movement of the contralateral arytenoid cartilage which was observed endoscopically. Abolition of the laryngeal response was encountered in in 3 situations:--(1) Disruption of the afferent impulse occurred in those horses in which there was significant spinal cord pathology affecting the pathway from the cranial thoracic region to the medulla. (2) Disruption of the efferent impulse was manifest when damage to the adductory component of the recurrrent laryngeal nerve prevented normal adduction. (3) The reflex was abolished in tense or frightened horses, possibly due to interference from higher centres. The laryngeal adductory reflex was considered to be a useful diagnostic and prognostic aid in the assessment of ataxia and spinal cord lesions in the horse.

Outbreak of equine herpesvirus type 1 myeloencephalitis: new insights from virus identification by PCR and the application of an EHV-1 -specific antibody detection ELISA

Five of 10 pregnant, lactating mares, each with a foal at foot, developed neurological disease. Three of them became recumbent, developed complications and were euthanased; of the two that survived, one aborted an equine herpesvirus type 1 (EHV-1)-positive fetus 68 days after the first signs were observed in the index case and the other gave birth to a healthy foal on day 283 but remained ataxic and incontinent. The diagnosis of EHV-1 myeloencephalitis was supported by postmortem findings, PCR identification of the virus and by serological tests with an EHV-1-specific ELISA. At the time of the index case, the 10 foals all had a heavy mucopurulent nasal discharge, and PCR and the ELISA were used to detect and monitor EHV-1 infection in them. The status of EHV-1 infection in the five in-contact mares was similarly monitored. Sera from three of the affected mares, taken seven days after the index case were negative or had borderline EHV-1-specific antibody titres. In later serum samples there was an increase in the titres of EHV-1-specific antibody in two of the affected mares. In contrast, sera from the five unaffected in-contact mares were all EHV-1-antibody positive when they were first tested seven or 13 days after the index case.

Aleutian disease in domestic ferrets: diagnostic findings and survey results

Aleutian disease was diagnosed as the cause of posterior ataxia and paresis in domestic ferrets. Six serologically positive animals (four clinically affected and two unaffected) were investigated in detail and seven other clinically affected ferrets were also identified. The diagnostic findings included hypergammaglobulinaemia, histological lesions in the central nervous system and parvovirus-like particles in mesenteric lymph nodes. A wider serological survey of 446 animals owned by members of a ferret club revealed an incidence of 8.5 per cent seropositive animals.