Multi-drug-resistant Enterococcus spp. as a cause of non-responsive septic synovitis in three horses.

CASE HISTORY: Three Thoroughbred horses, a 6-week-old filly (Case 1), a 15-year-old broodmare (Case 2) and a yearling filly (Case 3), sustained synovial sepsis secondary to trauma. CLINICAL FINDINGS: Case 1 presented with a heel bulb laceration communicating with the distal interphalangeal joint. Arthroscopic lavage was performed and treatment commenced using systemic and local broad spectrum antimicrobial drugs. A pure growth of multi-drug-resistant (MDR) Enterococcus gallinarum was cultured from samples of synovium and joint fluid. Antimicrobial treatment was changed according to the susceptibility results. Response to treatment was poor and despite repeat arthroscopic lavage and intra-osseous regional perfusion of antimicrobials the filly was subject to euthanasia 24 days after the initial injury. Post-mortem examination confirmed septic synovitis, cartilage degeneration and osteomyelitis. Case 2 sustained a full thickness wound to the carpus which was sharply debrided and closed. The wound dehisced with effusion within the tendon sheath. Drainage was established and treatment included systemic broad spectrum antimicrobials, topical lavage with povodine-iodine and manuka honey infusion. A mixed infection including MDR Enterococcus faecalis was cultured from the synovial fluid. Antebrachiocarpal joint effusion developed 21 days after initial injury and joint sepsis was confirmed. Arthroscopic lavage and tendon sheath debridement were performed, followed by treatment with systemic and local antimicrobials. The mare improved and was discharged. Three months later lameness recurred and corticosteroids were administered intra-articularly. The mare became non-weight bearing lame and was subject to euthanasia. Post-mortem examination confirmed joint sepsis of the antebrachiocarpal and intercarpal joint. Case 3 presented with a complete articular open fracture of the tibial crest. Under general anaesthesia the fracture was stabilised and the wounds debrided and closed. Systemic broad-spectrum antimicrobials were administered. Six days later the wound dehisced and a bone fragment was removed. Three weeks post-surgery the wound deteriorated with a purulent discharge. Culture of the discharge revealed a mixed bacterial infection, including a MDR Enterococcus faecalis. Femoropatellar joint involvement was confirmed, and treatment included joint lavage, local and systemic antibiosis, and manuka honey instilled into the wound. The filly initially improved, and then deteriorated such that euthanasia was performed. DIAGNOSIS: All three cases had synovial sepsis with MDR Enterococcus spp. CLINICAL RELEVANCE: Increased awareness of MDR pathogens in equine wound infections is essential. Prompt diagnostic testing, appropriate therapy, infection control strategies and on-going monitoring and management are vital to limit the clinical impact of these organisms.

Granulosa theca cell tumour in a pregnant mare: concentrations of inhibin and testosterone in serum before and after surgery.

CASE HISTORY: A 14-year-old Thoroughbred mare was presented for evaluation of a rapidly enlarging ovary at 73 days gestation. The mare's owner reported behavioural changes in the mare since she returned from stud, notably aggression towards other horses. CLINICAL FINDINGS: Transrectal palpation and ultrasonography of the reproductive tract revealed a viable pregnancy, an enlarged, multiloculated right ovary, and a normal-sized left ovary with a corpus luteum present. Concentrations of inhibin and testosterone in serum were 13.8 ng/mL and 1,150 pg/mL, respectively, being markedly higher than reference ranges. Concentration of progesterone was 4.5 ng/mL, consistent with the presence of functional luteal tissue. A presumptive diagnosis of a granulosa theca cell tumour (GTCT) was made, and the ovary was surgically removed. Histopathological examination of the removed ovary confirmed a benign GTCT. At 31 days after surgery concentrations of inhibin in serum had decreased 18-fold, and testosterone had decreased 10-fold. Pregnancy was reconfirmed at 115 days gestation by rectal palpation and transrectal ultrasonography. DIAGNOSIS: Granulosa theca cell tumour associated with elevated concentrations of inhibin and testosterone in serum. CLINICAL RELEVANCE: While ovarian enlargement and aggressive behaviour may be considered normal in some pregnant mares, a GTCT should be included as a differential diagnosis. Measurement of concentrations of inhibin and testosterone in serum are useful to support a presumptive diagnosis of GTCT in mares.

Gestation length and occurrence of daytime foaling of Standardbred mares on two stud farms in New Zealand.

AIMS: To examine the gestation lengths and occurrence of daytime foaling of Standardbred mares foaling outdoors at stud farms in Southland, New Zealand (latitude 45˚S). METHODS: Data were collected prospectively at two commercial Standardbred stud farms (Farms A and B), during the 2008/9 and 2009/10 breeding seasons (October to February). For each foaling, the identity of the mare, date and time of foaling, gender of foal, time the mare passed the fetal membranes, time the foal stood, and foaling problems including dystocias, were recorded. The effect of farm, season, gender of foal, month of artificial insemination (AI) or foaling, age and parity of mare on gestation length, percentage of mares foaling during daylight hours, and percentage of foalings recorded as dystocia, were examined. RESULTS: A total of 614 foaling records were obtained from 507 mares. For 594 foalings with complete records, mean gestation length was 349 (SE 0.5) days. Mean gestation length was shorter for fillies (347.8 (SE 0.6) days) than colts (350.3 (SE 0.6) days) p = 0.021) and decreased with month of AI, from October to February (p = 0.001). The time of foaling was bimodally distributed with the primary peak around 0200 hours and a secondary smaller peak around 1300 hours. The percentage of mares foaling in daylight was lower on Farm A (69/285 (24%)) than Farm B (128/313 (41%)) (p = 0.001). Colt foals were less likely to be born during the day than fillies (OR = 0.63; (95% CI = 0.44-0.88); p = 0.008), but there was no effect of age or parity of mare or month of foaling (p>0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Mean gestation length of mares in this study was longer than that previously reported from other countries. Longer gestation length decreases the time available for these mares to get back into foal in the same season. It is important that managers take this into account and ensure optimum conditions for conception; breeding at the first postpartum oestrus may be essential. There were more mares foaling in daylight hours on one stud than has previously been reported. Under these conditions mares should be monitored for foaling during daytime as well as at night.

Cutaneous fungal granulomas due to Alternaria spp. infection in a horse in New Zealand.

Equine cutaneous fungal granulomas have been previously referred to in New Zealand (Fairley 1998), and are described in the veterinary literature from around the world, including North America and Australia (Pascoe and Summers 1981; Genovese et al. 2001; Valentine et al. 2006), but no peer-reviewed reports appear published in the literature in New Zealand. Described here is a case of multiple cutaneous fungal granulomas caused by Alternaria spp. in a horse in New Zealand.

Metabolism of unsaturated fatty acids by RBL-1 5-lipoxygenase: influence of substrate solubility and product inactivation.

Several alternative fatty acid substrates have been employed to characterise the kinetics of rat basophilic leukaemia cell (RBL-1) 5-lipoxygenase. Using arachidonic acid (AA) as substrate, enzymes rates declined at high substrate concentrations (greater than 25 microM) and were associated with pronounced lag phases. The concentrations of AA at which apparent substrate inhibition and lag phases were observed were comparable with those at which AA induced emulsion formation in aqueous media. No evidence for substrate inhibition or lag phases was observed using eicosapentaenoic acid (EPA), a more soluble substrate which did not induce emulsion formation at concentrations up to 100 microM. Reactions catalysed by RBL-1 5-lipoxygenase terminated before exhaustion of substrate. AA and EPA induced time-dependent enzyme inactivation at concentrations 100-fold lower than their apparent Km values for the enzyme. The ability of several fatty acids to induce time-dependent inactivation was directly proportional to their substrate potency. We conclude that apparent substrate inhibition is a consequence of a change from monomeric to micellar substrate which has a lower affinity for the enzyme and that premature termination of the enzyme reactions is a consequence of product-induced enzyme inactivation.