Dynamic nasopharyngeal collapse in horses: What we know so far.

Dynamic nasopharyngeal collapse (NPC) is an obstructive upper airway disease that affects mainly the inspiratory phase of respiration in horses undergoing strenuous exercise. It occurs when the neuromuscular activity of the nasopharynx is overwhelmed by the intense negative pressures generated during exercise. This leads to collapse of at least one of the four components of the nasopharynx which is comprised of the two lateral walls, the dorsal roof and the ventral soft palate. As a result, the airway diameter and thus airflow become compromised. Even small changes in the airway diameter produces profound increases in negative inspiratory pressure, perpetuating the cycle of collapse. Compared to other dynamic upper respiratory tract disorders, the amount of literature on NPC as a disease entity is limited. The exact pathophysiology of NPC is unknown; however, it impacts up to one quarter of high-performance equine athletes presenting for poor performance. There is currently no definitive treatment for this severely performance-limiting condition. Thus, the prognosis for future athletic prognosis is guarded, with most horses being retired from racing or athletic use in general. Further research is warranted in this field to reduce the impact of disease and in turn, reduce the turnover rate and economic loss by enhancing the career longevity of elite equine athletes diagnosed with NPC.

Heat stress in horses: a literature review.

Healthy adult horses can balance accumulation and dissipation of body heat to maintain their body temperature between 37.5 and 38.5 °C, when they are in their thermoneutral zone (5 to 25 °C). However, under some circumstances, such as following strenuous exercise under hot, or hot and humid conditions, the accumulation of body heat exceeds dissipation and horses can suffer from heat stress. Prolonged or severe heat stress can lead to anhidrosis, heat stroke, or brain damage in the horse. To ameliorate the negative effects of high heat load in the body, early detection of heat stress and immediate human intervention is required to reduce the horse's elevated body temperature in a timely manner. Body temperature measurement and deviations from the normal range are used to detect heat stress. Rectal temperature is the most commonly used method to monitor body temperature in horses, but other body temperature monitoring technologies, percutaneous thermal sensing microchips or infrared thermometry, are currently being studied for routine monitoring of the body temperature of horses as a more practical alternative. When heat stress is detected, horses can be cooled down by cool water application, air movement over the horse (e.g., fans), or a combination of these. The early detection of heat stress and the use of the most effective cooling methods is important to improve the welfare of heat stressed horses.

Laryngeal tie-forward in standing sedated horses.

OBJECTIVES: To investigate the feasibility and describe the clinical experience of performing laryngeal tie-forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). STUDY DESIGN: Experimental study and case series. ANIMALS: Five normal experimental controls and five client owned horses affected by iDDSP. METHODS: Standing LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was performed under endoscopic guidance with horses sedated and the surgical site desensitized with local anesthetic solution. Short term outcome was assessed using radiography, resting and (in clinical cases) dynamic upper respiratory tract (URT) endoscopy. RESULTS: Standing LTF was well tolerated and completed in all horses. Radiographic assessment demonstrated that compared to preoperatively, the basihyoid bone and thyrohyoid-thyroid articulation were positioned dorsally (9.6 mm, p = .006 and 20.4 mm, p = .007, respectively) at 2 days postoperatively. During repeat dynamic URT endoscopy at 48 hours postoperatively, 3/5 horses showed resolution of iDDSP and 2/5 marked improvement. One horse experienced brief iDDSP associated with neck flexion which corrected after swallowing. The second achieved a greater speed and total distance prior to iDDSP. CONCLUSIONS: Standing LTF did not incur any major peri- or postoperative complications. The laryngohyoid apparatus was repositioned dorsally and in a small case series had a similar surgical effect on laryngeal position. CLINICAL SIGNIFICANCE: Standing LTF is feasible, mitigates the risk of general anesthesia related complications and reduces cost.

The Use of Percutaneous Thermal Sensing Microchips to Measure Body Temperature in Horses during and after Exercise Using Three Different Cool-Down Methods.

The frequent monitoring of a horse's body temperature post strenuous exercise is critical to prevent or alleviate exertional heat illness (EHI) from occurring. Percutaneous thermal sensing microchip (PTSM) technology has the potential to be used as a means of monitoring a horse's body temperature during and post-exercise. However, the accuracy of the temperature readings obtained, and their relationship to core body temperature are dependent on where they are implanted. This study aimed to document the relationship between core body temperature, and temperature readings obtained using PTSM implanted in different muscles, during exercise and post application of different cool-down methods. PTSMs were implanted into the right pectoral, right gluteal, right splenius muscles, and nuchal ligament. The temperatures were monitored during treadmill exercise, and post application of three different cool-down methods: no water application (Wno), water application only (Wonly), and water application following scraping (Wscraping). Central venous temperature (TCV) and PTSM temperatures from each region were obtained to investigate the optimal body site for microchip implantation. In this study, PTSM technology provided a practical, safe, and quick means of measuring body temperature in horses. However, its temperature readings varied depending on the implantation site. All muscle temperature readings exhibited strong relationships with TCV (r = 0.85~0.92, p < 0.05) after treadmill exercise without human intervention (water application), while the nuchal ligament temperature showed poor relationship with TCV. The relationships between TCV and PTSM temperatures became weaker with water application. Overall, however the pectoral muscle temperature measured by PTSM technology had the most constant relationships with TCV and showed the best potential to act as an alternate means of monitoring body temperature in horses for 50 min post-exercise, when there was no human intervention with cold water application.

Presence of Myeloperoxidase in Lamellar Tissue of Horses Induced by an Euglycemic Hyperinsulinemic Clamp.

Laminitis is a pathology of the equine digit leading to a failure of the dermo-epidermal interface. Neutrophil activation is recognized as a major factor in SIRS-associated laminitis. Less is known about the role of neutrophil activation in laminitis associated with metabolic disorders. The aim of this descriptive study was to observe whether myeloperoxidase is increased in the laminae during early stage laminitis in three horses subjected to a prolonged euglycemic hyperinsulinemic clamp (pEHC). After 48 h of pEHC-treatment, horses were subjected to euthanasia. Two healthy horses are used as control. Histological sections of lamellar tissue from all horses were immunohistochemically stained for myeloperoxidase and counterstained with hematoxylin-eosin. Histopathological changes that characterize insulin-induced laminitis and increased presence of myeloperoxidase, especially in the dermal lamellae, were increased in histologic sections of pEHC-treated horses. Neutrophil myeloperoxidase release may contribute to the pathophysiology of endocrinopathic laminitis.

Bias Associated with Peripheral Non-Invasive Compared to Invasive Arterial Blood Pressure Monitoring in Healthy Anaesthetised and Standing Horses Using the Bionet BM7Vet.

To compare arterial blood pressure (ABP) measured invasively (IBP) to ABP measured non-invasively (NIBP) via oscillometry in healthy anaesthetised and standing horses using the Bionet BM7Vet. Fourteen horses were anaesthetised for elective procedures (anaesthetised group) and 10 horses were enrolled for standing blood pressure manipulation (standing group). In both groups, IBP and NIBP-corrected to heart level were measured every 3 min using the Bionet BM7Vet. The overall mean difference (bias), standard deviation and limits of agreement (LOA) were calculated for paired IBP and NIBP systolic (SAP), mean (MAP) and diastolic (DAP) blood pressure measurements. In anaesthetised horses, the NIBP cuff was placed at either the proximal tail base or the metacarpus. Invasive MAP was used to retrospectively characterise measurements into hypotensive (≤70 mm Hg), normotensive (71-110 mm Hg) or hypertensive (≥111 mm Hg) subgroups. In standing horses, the NIBP cuff was placed at the tail base only and invasive MAP was manipulated to achieve hypertension (≥126 mm Hg) and hypotension (≤90 mm Hg) using phenylephrine and acepromazine, respectively. When measuring NIBP at the tail in anaesthetised horses, the Bionet BM7Vet failed on 8/185 occasions and overestimated SAP, MAP and DAP during hypotension and normotension. The biases (lower, upper LOA) for MAP were -11.4 (-33.3, 10.5) and -6.0 (-25.8, 13.8) mm Hg, respectively. Hypertension could not be evaluated. When measuring NIBP at the metacarpus in anaesthetised horses, the Bionet BM7Vet failed on 24/65 occasions and underestimated SAP, MAP and DAP when all ABP subgroups were combined. The bias (lower, upper LOA) for pooled MAP was 3.6 (-44.3, 51.6) mm Hg. When measuring NIBP at the tail in standing horses, the Bionet BM7Vet failed on 64/268 occasions and underestimated SAP, MAP and DAP during hypotension, normotension and hypertension. The biases (lower, upper LOA) for MAP were 16.3 (-10.5, 43.1), 16.6 (-19.5, 52.7) and 30.0 (-8.1, 68.0) mm Hg, respectively. Monitoring NIBP on the Bionet BM7Vet in anaesthetised horses overestimated ABP at the tail and underestimated ABP at the metacarpus. The device inaccurately detected hypotension and should be used cautiously. In standing horses, the Bionet BM7Vet underestimated ABP at the tail, especially during pharmacologically induced hypertension.

Measurement of Tissue Oximetry in Standing Unsedated and Sedated Horses.

Near infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO2) and may be useful to detect early changes in StO2 in anaesthetized and critically ill horses. This study aimed to identify the muscle belly that provided the highest percentage of successful StO2 readings and the highest mean StO2 value. Fifty adult horses were enrolled in a prospective controlled study. StO2 was measured at six different muscles in each horse, for each intervention: hair overlying the muscle was clipped (post clipping: PC), clipped skin was cleaned with chlorhexidine (post-surgical prepping: PP) and medetomidine was administered intravenously (post medetomidine: PM). Mean StO2 values were calculated for each muscle, and a linear effects model was used to assess the effect of muscle group and intervention on StO2. The sartorius muscle gave the highest percentage of successful StO2 values (p < 0.001) and the highest mean (90% CI) StO2 values for the PC, PP and PM interventions. Surgical prepping of the skin increased the success for measurement of StO2 values. For all muscles, administration of medetomidine was associated with lower StO2 values (p < 0.001). In conclusion, of the muscles examined, the sartorius muscle may be the preferred muscle to measure StO2 in horses, and clipping and cleaning of the probe placement site is recommended.

The Use of Percutaneous Thermal Sensing Microchips for Body Temperature Measurements in Horses Prior to, during and after Treadmill Exercise.

Accurately measuring body temperature in horses will improve the management of horses suffering from or being at risk of developing postrace exertional heat illness. PTSM has the potential for measuring body temperature accurately, safely, rapidly, and noninvasively. This study was undertaken to investigate the relation between the core body temperature and PTSM temperatures prior to, during, and immediately after exercise. The microchips were implanted into the nuchal ligament, the right splenius, gluteal, and pectoral muscles, and these locations were then compared with the central venous temperature, which is considered to be the "gold standard" for assessing core body temperature. The changes in temperature of each implant in the horses were evaluated in each phase (prior to, during, and immediately postexercise) and combining all phases. There were strong positive correlations ranging from 0.82 to 0.94 (p < 0.001) of all the muscle sites with the central venous temperature when combining all the phases. Additionally, during the whole period, PTSM had narrow limits of agreement (LOA) with central venous temperature, which inferred that PTSM is essentially equivalent in measuring horse body temperature. Overall, the pectoral PTSM provided a valid estimation of the core body temperature.