Refinement and revalidation of the Equine Ophthalmic Pain Scale: R-EOPS a new scale for ocular pain assessment in horses.

This study addresses the refinement and revalidation of a composite pain scale that focuses on equine facial expressions and behavioural indicators as exhibitions of ophthalmic pain. This scale included only Behavioural and Facial and Ocular expression indicators and, compared to the first version of Equine Ophthalmic Pain Scale (EOPS), item descriptors and related ratings were changed. Thirteen horses with ocular diseases that required medical or surgical treatment were enroled (group P). In each animal, the refined EOPS (R-EOPS) was applied prior to any treatment (T0) and one week later (T7). The R-EOPS was applied twice, 7 days apart, to 16 healthy control horses (group C). Two 30-second videos were recorded each time to allow the retrospective analysis by eight observers. Inter-observer reliability of items was moderate or substantial (Krippendorff's alpha, Kα>0.40) while their intra-observer reliability was substantial or almost perfect for most items (Kα ≥0.61). Both inter- and intra-observer reliability of Total Score (TS) were however excellent (Intraclass Correlation Coefficients, ICC>0.75). The TS also showed good reproducibility (Kendall coefficient=0.786, ICC=0.684) and high consistency of its items (Cronbach's α=0.847). The comparison between groups as well as the sensitivity and specificity values supported the validity of the R-EOPS. In particular, for each extra point added to the TS, the risk of the horse having pain increased by more than two times (Odds Ratio=2.079, 95%CI=1.542-2.804; P<0.001). The Receiver Operating Characteristic analysis identified 6 as the threshold value of R-EOPS for discriminating horses with ocular pathology (sensitivity=83%, specificity=100%). This scale may be an effective tool for reliably assessing the pain level in horses with ophthalmic diseases and potentially guiding pain management although it still requires large-scale application and external validation.

Development and preliminary validation of a pain scale for ophthalmic pain in horses: The Equine Ophthalmic Pain Scale (EOPS).

The purpose of this study was to describe the development and preliminary validation of a composite pain scale, called the Equine Ophthalmic Pain Scale (EOPS), to assess ocular pain in horses. Indicators associated with ocular pain were selected and classified as behavioural, physiological or ocular expressions. Eight horses diagnosed with ocular or adnexa diseases that required medical or surgical treatment were enrolled in the study (group P). The developed EOPS was applied at the baseline (T0) and 1 week later (T7). Moreover, the EOPS was applied twice, 1 week apart, to 15 healthy control horses (group C). Videos of 60-80 s duration of all assessments were retrospectively analysed by seven masked observers, who scored items included in the behavioural and ocular expression categories of the EOPS. The inter- and intra-observer reliability was excellent (intraclass correlation coefficients ≥0.75) for most of the scored items. Cronbach's alpha (0.76) indicated that the EOPS had good internal consistency. The total score (TS), calculated as the sum of all scores, differed between groups C and P at T0 (P < 0.001) and reduced after medical/surgical treatment in group P (P = 0.017), indicating the responsiveness of the EOPS. Moreover, the area under the curve (AUC=0.918, 95% confidence interval = 0.815-1.000; P < 0.001) indicated that the EOPS was very accurate for distinguishing healthy from pathological animals. Sensitivity and specificity of EOPS to identify horses with ocular pathology (at the optimal cut-off, i.e. TS ≥ 7) were 81.3% and 100.0%, respectively. However, 'overall behaviour', 'position inside the box', 'ear movements' and 'head position' items as well as physiological parameters, showed sub-optimal reliability, consistency and/or item-total correlation, suggesting that there is still room to improve this composite scale.

Inadvertent injection of medetomidine in the cerebromedullaris cisterna of a dog during myelographic exam.

INTRODUCTION: A mixed breed dog was anesthetized for diagnostic myelography to investigate acute onset neck pain. Instead of contrast medium, 444 µg/kg medetomidine were inadvertently injected into the cerebromedullaris cisterna owing to a human error. Severe bradycardia, undetectable peripheral pulse, respiratory arrest and loss of pupillary, palpebral and corneal reflexes were observed immediately after injection. Profound hypothermia developed and esophageal temperature, measured 20 minutes after medetomidine injection, was 33 °C. Atipamezole at 1 mg/kg im was administered, followed by a second dose of 0,5 mg/kg iv 20 minutes thereafter. In the meantime, cardiorespiratory parameters and body temperature were monitored, and supportive care that included manually assisted pulmonary ventilation, active warming, and administration of 5 µg/kg/min dopamine was initiated. The dog's clinical condition improved within one hour from the beginning of supportive care, at which time ocular reflexes and swallowing returned, spontaneous ventilation was deemed as adequate and the trachea could be extubated. The dog was discharged in good clinical conditions five days later. Human error and distraction led to a potentially life-threatening complication in the dog of this report and could have possibly been prevented with the use of checklists and with a clearer definition of roles and responsibilities of the personnel involved prior to commencing the clinical procedure. Profound cardiovascular, respiratory, and thermoregulatory depression caused by intracisternal injection of medetomidine responded to parenteral administration of its antagonist and supportive care.

INTRODUCTION: Un chien croisé a été anesthésié pour une myélographie diagnostique afin d'étudier une douleur aiguë au niveau du cou. Au lieu du produit de contraste, 444 µg/kg de médétomidine ont été injectés par inadvertance dans la citerne cérébello-médullaire en raison d'une erreur humaine. Une bradycardie sévère, un pouls périphérique indétectable, un arrêt respiratoire et une perte des réflexes pupillaire, palpébral et cornéen ont été observés immédiatement après l'injection. Une hypothermie profonde s'est développée et la température oesophagienne, mesurée 20 minutes après l'injection de médétomidine, était de 33 °C. De l'atipamézole à 1 mg/kg im a été administré, suivi d'une seconde dose de 0,5 mg / kg iv 20 minutes après. Dans l'intervalle, les paramètres cardiorespiratoires et la température corporelle ont été surveillés et des soins de soutien comprenant une ventilation assistée manuellement, un réchauffement actif et l'administration de 5 µg/kg/min de dopamine ont été initiés. L'état clinique du chien s'est amélioré dans l'heure qui a suivi le début des soins, moment où les réflexes oculaires et la déglutition sont réapparus, la ventilation spontanée a été jugée adéquate et où on a pu procéder à l'extubation. Le chien est sorti dans de bonnes conditions cliniques cinq jours plus tard. Une erreur humaine et de la distraction ont conduit à une complication potentiellement mortelle chez le chien décrit dans ce rapport et auraient pu être évitées grâce à l'utilisation de listes de contrôle et avec une définition plus claire des rôles et des responsabilités du personnel impliqué avant le début de la procédure clinique. Une profonde dépression cardiovasculaire, respiratoire et de la thermorégulation causée par l'injection intracisternale de médétomidine a répondu à l'administration parentérale de son antagoniste et à des soins de soutien.

Mini-invasive approach for removal of iliopsoas migrating grass awns with an atraumatic wound retractor.

This case series describes a novel mini coeliotomy approach using a radial, atraumatic self-retaining retractor for the retrieval of migrant plant foreign bodies from the iliopsoas muscles of six male dogs under intra-operative ultrasonographic guidance. Four dogs had a history of pulmonary disease potentially compatible with inhalation of a foreign body approximately 2-4 months before presentation. Under ultrasonographic guidance, the grass awns were identified in the iliopsoas muscle and were completely removed. In this case series, the annular ring device provided an excellent view of the surgical field for intra-abdominal manipulations. Patient follow-up at 15 days and 6 to 12 months after surgery indicated a full recovery, and no grass awn fragment residues were identified.

Atomic and Electronic Structure of Solid-Density Liquid Carbon.

A liquid carbon (l-C) sample is generated through constant volume heating exposing an amorphous carbon foil to an intense ultrashort laser pulse. Time-resolved x-ray absorption spectroscopy at the C K edge is used to monitor the dynamics of the melting process revealing a subpicosecond rearrangement of the electronic structure associated with a sudden change of the C bonding hybridization. The obtained l-C sample, resulting from a nonthermal melting mechanism, reaches a transient equilibrium condition with a temperature of about 14 200 K and pressure in the order of 0.5 Mbar in about 0.3 ps, prior to hydrodynamic expansion. A detailed analysis of the atomic and electronic structure in solid-density l-C based on time-resolved x-ray absorption spectroscopy and theoretical simulations is presented. The method can be fruitfully used for extending the experimental investigation of the C phase diagram in a vast unexplored region covering the 10^{3}-10^{4} K temperature range with pressures up to 1 Mbar.

Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome.

NSAIDs are often used in horses with colic syndrome during the postoperative period, due to their ability to contrast endotoxemia and to promote an analgesic and anti-inflammatory effect. As the pharmacokinetics of a drug are often modified in unhealthy animals compared to healthy subjects, the aim of this study was to evaluate the pharmacokinetic profile of meloxicam after i.v. administration in horses undergoing laparotomy for colic syndrome. Eight horses received 0.6 mg/kg of meloxicam i.v. towards the end of surgery. Blood samples were taken at scheduled time points during the following 24 hr. The serum concentration of the drug was determined by HPLC. Terminal half-life (6.88 ± 2.96 hr), volume of distribution at steady-state (186.53 ± 61.20 ml/Kg) and clearance (27.91 ± 5.72 ml kg-1  hr-1 ) were similar to those reported in literature for healthy horses. This result suggests that no adjustment of the approved dose should be necessary when meloxicam is used to treat horses in the immediate postoperative period after surgery for colic syndrome.

Umbilical infections in foals: microbiological investigation and management.

This study aims to investigate the bacteria involved in equine omphalitis and their susceptibility to antimicrobial drugs, and consequently to provide guidelines concerning the most suitable treatment protocol in accordance with the clinical, ultrasound and laboratory findings. Forty foals aged between one and 30 days were evaluated in the course of this investigation. An ultrasound examination of all umbilical remnants was carried out carefully in all foals; umbilical swabs were collected for bacteriological examination, and blood samples were collected for blood culture from 19 foals with fever and abnormal blood values. Bacterial omphalitis was observed in 95 per cent of foals and bacterial septicaemia was diagnosed in 11 cases. Enterobacteria and coccoid Gram-positive bacteria were isolated more frequently than Serratia marcescens, Pantoea agglomerans and Trueperella pyogenes Omphalectomy was performed in 77.5 per cent of the foals examined; the remainder were treated only medically with antimicrobial drugs as recommended by antibiotic susceptibility testing performed for all bacteria isolated. Antibiotic therapy was successful in all foals that only received medical treatment; nevertheless, omphalectomy was performed in most cases particularly in situations of clinical decline despite antibiotic therapy and when involvement of umbilical vein, fever and joint disorders were observed.

Retrograde maxillary nerve perineural injection: A tomographic and anatomical evaluation of the infraorbital canal and evaluation of needle type and size in equine cadavers.

The aim of this study was to investigate a new approach for equine maxillary nerve blocks, which can facilitate several orofacial surgeries. Current techniques aim at the maxillary foramen and approach via the zygomatic arch, conferring the risk of injury to several delicate structures in the target area. To investigate the feasibility of a retrograde approach from the infraorbital foramen, an anatomic study of the infraorbital canal and its surrounding structures was performed on 13 cadaveric skulls using computed tomography and anatomical dissection. Measurements included canal length and volume, its conformation and relationship with the enclosed structures, and infraorbital foramen diameters. The technical approach to simulate the distribution of local anaesthetic within the infraorbital canal was further defined, including needle selection among seven different needles, evaluating ease of insertion, trauma to surrounding tissues and spread of contrast medium toward the target area. To validate the technique, two Tuohy needles were randomly inserted at 12 infraorbital foramina and 10 mL of contrast medium was injected. CT verified the spread of the solution and possible complications. Each canal had a serpentine-curved pathway. Anatomical dissections evidenced gaps between the infraorbital nerve, vessels and the infraorbital canal. The integrity of these structures had been preserved from the passage of the selected Tuohy needles. This study suggests a feasible approach to the maxillary nerve block within the infraorbital canal providing an appropriate needle selection and technique to limit complications.

Quantitative resonant soft x-ray reflectivity of ultrathin anisotropic organic layers: Simulation and experiment of PTCDA on Au.

Resonant soft X-ray reflectivity at the carbon K edge, with linearly polarized light, was used to derive quantitative information of film morphology, molecular arrangement, and electronic orbital anisotropies of an ultrathin 3,4,9,10-perylene tetracarboxylic dianhydride (PTCDA) film on Au(111). The experimental spectra were simulated by computing the propagation of the electromagnetic field in a trilayer system (vacuum/PTCDA/Au), where the organic film was treated as an anisotropic medium. Optical constants were derived from the calculated (through density functional theory) absorption cross sections of the single molecule along the three principal molecular axes. These were used to construct the dielectric tensor of the film, assuming the molecules to be lying flat with respect to the substrate and with a herringbone arrangement parallel to the substrate plane. Resonant soft X-ray reflectivity proved to be extremely sensitive to film thickness, down to the single molecular layer. The best agreement between simulation and experiment was found for a film of 1.6 nm, with flat laying configuration of the molecules. The high sensitivity to experimental geometries in terms of beam incidence and light polarization was also clarified through simulations. The optical anisotropies of the organic film were experimentally determined and through the comparison with calculations, it was possible to relate them to the orbital symmetry of the empty electronic states.

The effects of intravenous lidocaine before propofol induction in premedicated dogs.

OBJECTIVE: The effects of lidocaine, administered before induction of anaesthesia with propofol, on arterial blood pressure, heart rate, respiratory rate, cough reflex, ease of intubation, extrapyramidal signs and required dose of propofol in healthy premedicated dogs were evaluated. METHODS: Twenty-four client-owned dogs were premedicated intramuscularly with 1 µg/kg dexmedetomidine and 0·2 mg/kg methadone, and randomly allocated to receive 2 mg/kg lidocaine (group L) or saline (group P) 120 seconds before induction of anaesthesia with propofol. Heart rate, non-invasive arterial blood pressure and respiratory rate were assessed at pre-established intervals. Quality of intubation, cough reflex and the occurrence of adverse effects were scored according to predefined scales. The total amount of propofol administered was also recorded. RESULTS: Cardiovascular and respiratory variables changed over time but were not significantly different between treatments. No significant differences between groups were found for the incidence of coughing, quality of intubation, adverse effects and propofol intubation dose. CLINICAL SIGNIFICANCE: Intravenous administration of lidocaine 2 mg/kg before propofol induction was not associated with significant cardiovascular and respiratory benefits compared to standard induction and did not result in a propofol dose-sparing effect or improvement of the quality of intubation in dogs premedicated with dexmedetomidine and methadone.

Free electron laser-driven ultrafast rearrangement of the electronic structure in Ti.

High-energy density extreme ultraviolet radiation delivered by the FERMI seeded free-electron laser has been used to create an exotic nonequilibrium state of matter in a titanium sample characterized by a highly excited electron subsystem at temperatures in excess of 10 eV and a cold solid-density ion lattice. The obtained transient state has been investigated through ultrafast absorption spectroscopy across the Ti M2,3-edge revealing a drastic rearrangement of the sample electronic structure around the Fermi level occurring on a time scale of about 100 fs.

A pharmacokinetic/clinical approach to postulate a local action of intra-articular xylazine administration in the horse: a preliminary study.

The study aims to evaluate whether the analgesic effect of intra-articular (IA) route of xylazine administered to horses following arthroscopic surgery is due to a local or a systemic action. Two connected studies were performed. In the first, 1 mg/kg b.w. of xylazine was injected IA, and blood samples were taken to assess drug systemic absorption. In addition, systemic effects of the drug (sedation, ataxia or reduction of respiratory and cardiac rate) were registered. Control horses injected with saline IA were included in the study to exclude the influence of anaesthesia in the occurrence of these manifestations. In the second study, 1 mg/kg b.w. of xylazine was administered intravenously (i.v.) in healthy horses. Blood samples were collected to determine the concentrations of xylazine, and the same signs of systemic effects of the drug were recorded. By correlating these parameters, a systemic 'no effect' concentration was defined. Pharmacokinetic data after IA administration resulted in some xylazine absorption (bioavailability equal to 58.12%) with values above the systemic 'no effect' concentration. The occurrence of some signs related to systemic effects in horses receiving IA xylazine was significant compared with horses receiving saline. In conclusion, a systemic action of the drug after IA administration cannot be excluded.

Evaluation of transabdominal ultrasound as a tool for predicting the success of abdominocentesis in horses.

The aim of this study was to evaluate the transabdominal ultrasonography as a tool for predicting the success of abdominocentesis in horses. Patients were included in the study if a complete transabdominal ultrasonography examination and abdominocentesis were performed as part of the clinical work-up. Ultrasonographically, the amount of peritoneal fluid was assessed using a 4-point grading system, as well as the amount of peritoneal fluid collected. A χ(2) or Fischer exact test was performed to test for an association between the ultrasonography findings and fluid retrieved, and between the two grading scales. Interobserver and intraobserver agreement values were calculated using k statistics. Values of P<0.05 were considered significant; 109 horses met the inclusion criteria. Peritoneal fluid was identified ultrasonographically in 72 per cent of horses, and it was collected from 93 per cent of these cases. In horses with no peritoneal fluid identified at ultrasonography (28 per cent), fluid was collected in 70 per cent of cases. There is a significant association between transabdominal ultrasonography detection of peritoneal fluid and the likelihood to obtain a diagnostic amount of peritoneal fluid at abdominocentesis; however, even when peritoneal fluid is not detected during abdominal ultrasonography examination, an amount of peritoneal fluid useful for gross, clinicopathological and cytological evaluation can frequently be obtained.

Fibroblastic osteosarcoma in a lion (Panthera leo).

This report describes a case of spontaneous fibroblastic osteosarcoma in the humerus of a lion from a private park in Perugia, Italy. The tumor had an irregular, smooth, brown surface and a generally firm, rubbery consistence with gritty to hard areas interspersed. The mass was poorly vascularized with areas of necrosis at the periphery. The cut surface showed a multilobulated mass that had breached the humeral cortex, with periosteal production of reactive bone. The mass invaded the epiphysis, the synovial membrane, the joint capsule and ligaments. A mild hemorrhagic effusion appeared in the joint space. Clinical signs, gross and histopathologic findings are described in this rare case of a malignant bone tumor.

Arthroscopic anatomy of the equine cervical articular process joints.

REASON FOR PERFORMING STUDY: Although arthropathy of the cervical articular process joints (APJs) is common, descriptions of the arthroscopic technique of the cervical APJ have not been reported previously. OBJECTIVES: To develop an arthroscopic approach to the APJ and to describe the arthroscopic anatomy of the APJ. STUDY DESIGN: Descriptive cadaver study and clinical case report. METHODS: The regional anatomy was reviewed and the technique developed on fresh cadaver necks. A series of cadaveric APJ arthroscopies from C2-C3 to C6-C7 were performed to evaluate the procedure, which was then used in 3 clinical cases. A description of the procedure and the potential complications encountered were recorded. RESULTS: The equine APJ consists of cranioventral and caudodorsal recesses; a single entry point at one of these recesses enables almost complete evaluation of cartilage surfaces and the synovial membrane and its villi. Successful entry into both APJ recesses was achieved in 22 cadaveric APJs and 5 APJs in the 3 clinical cases operated upon. An instrument portal was created to assess the feasibility of surgical arthroscopy. Complications were minor, and dissection of the APJs following the arthroscopic exploration revealed that the cartilage and periarticular neurovascular structures were not damaged during the procedure. CONCLUSIONS: This study shows that arthroscopic examination of the APJs of equine cervical vertebra is feasible and can be performed in mature horses. Arthroscopy of the APJs may provide additional diagnostic information compared to conventional diagnostic techniques.

Apophyseal avulsion fracture of the greater trochanter of the femur in a Thoroughbred filly.

The case report of a 14-month-old Thoroughbred filly with acute onset of severe right hindlimb lameness is presented. The horse had a severe and sudden abduction of the hindlimbs due to a side effect of an overdose of lidocaine, which had been administered in a constant rate infusion after a colic surgery. Transcutaneous ultrasonography and standing radiography of the pelvis revealed proximal and cranial displacement of the greater trochanter and free bone fragments consistent with an apophyseal avulsion fracture of the greater trochanter. The complete diagnosis was obtained with the horse in a standing position. The filly was euthanatized because of deterioration resulting from the colic condition and of the poor prognosis of the fracture of the greater trochanter. Postmortem evaluation confirmed an apophyseal avulsion fracture of the right greater trochanter. To the authors' knowledge, ultrasonographic and radiographic findings of this fracture have not been described in the standing horse. The diagnosis was reached quite easily with the horse in a normal standing position when the characteristic ultrasonographic and radiographic findings were detected.

Atomic and electronic structure of ultrathin fluoride barrier layers at the oxide/Si interface.

A SrF(2) ultrathin barrier layer on Si(001) is used to form a sharp interface and block reactivity and intermixing between the semiconductor and a Yb(2)O(3) overlayer. Yb(2)O(3)/Si(001) and Yb(2)O(3)/SrF(2)/Si(001) interfaces grown in ultra high vacuum by molecular beam epitaxy are studied by photoemission and x-ray absorption fine structure. Without the fluoride interlayer, Yb(2)O(3)/Si(001) presents an interface reacted region formed by SiO(x) and/or silicate compounds, which is about 9 Å thick and increases up to 14-15 Å after annealing at 500-700 °C. A uniform single layer of SrF(2) molecules blocks intermixing and reduces the oxidized Si region to 2.4 Å after deposition and to 3.5 Å after annealing at 500 °C. In both cases we estimate a conduction band offset and a valence band offset of ∼ 1.7 eV and 2.4 eV between the oxide and Si, respectively. X-ray absorption fine structure measurements at the Yb L(III) edge suggest that the Yb oxide films exhibit a significant degree of static disorder with and without the fluoride barrier. Sr K edge measurements indicate that the ultrathin fluoride films are reacted, with the formation of bonds between Si and Sr; the Sr-Sr and Sr-F interatomic distances in the ultrathin fluoride barrier film are relaxed to the bulk value.

Is there a statistical correlation between ultrasonographic findings and definitive diagnosis in horses with acute abdominal pain?

REASON FOR PERFORMING STUDY: Abdominal ultrasonography has become a part of the diagnostic investigation for the acute abdomen in many equine clinics. There is limited information on the correlation between abnormalities detected on abdominal ultrasonography and the specific category of small intestine (SI) and large intestine (LI) diseases. OBJECTIVES: To investigate the relationship between abdominal ultrasonographic findings and disease categories that cause abdominal pain requiring surgery. METHODS: Medical records were reviewed for horses undergoing surgery or post mortem examination for colic. The ultrasound examination was performed to assess free peritoneal fluid, the left kidney, stomach, appearance and motility of the duodenum, identification, appearance, motility and thickness of small intestine loops, and the appearance and motility of the colon. Logistic regression analysis was used to identify associations between disease categories and ultrasonographic findings; a Chi-squared test was used to test for associations between each variable and disease categories. RESULTS: The study included 158 horses. Distended and nonmotile SI loops were associated with strangulated obstruction (n = 45); increased free peritoneal fluid, completely distended SI loops with abnormal motility and thickened loops were associated with definitive diagnosis involving SI (n = 58). Failure to visualise the left kidney was associated with renosplenic entrapment (n = 16); thickened large colon (LC) was associated with LC strangulating volvulus (n = 9). CONCLUSION: The use of abdominal ultrasonography can be used for the accurate definitive diagnosis involving SI and LI diseases. POTENTIAL RELEVANCE: This retrospective study may be used as a basis for prospective studies to assess the ultrasonographic findings in horses with medical colic and to compare these with surgical findings.

Adsorption geometry variation of 1,4-benzenedimethanethiol self-assembled monolayers on Au(111) grown from the vapor phase.

1,4-benzenedimethanethiol was chemisorbed from the vapor phase onto Au(111). The chemisorption geometry, molecular orientation, and bonding properties were studied at different degrees of surface coverage by photoelectron spectroscopy, metastable deexcitation spectroscopy, and near-edge x-ray absorption fine structure spectroscopy at the carbon K edge. Two main chemisorption regimes were identified: at low coverage the molecules adopt a flat configuration, then, as the molecular density of the first layer increases, the reduction of the available chemisorption sites induces the newly bonded molecules to assume a vertical alignment, with only one of the sulphur head groups interacting with the substrate. Experimental results were interpreted on the basis of theoretical calculations that we performed on the free molecule concerning the molecular orbitals' density of states and simulated x-ray absorption.