Paroxysmal atrial fibrillation and clinically reversible cor pulmonale in a horse with complicated recurrent airway obstruction.

Cor pulmonale is considered an uncommon complication in horses with recurrent airway obstruction (RAO). This case report describes the history, clinical and further examination findings, treatment, progression and outcome of a horse diagnosed with cor pulmonale and paroxysmal atrial fibrillation of 2 days duration due to a severe exacerbation of RAO. To our best knowledge, this is the first report of RAO induced pulmonary hypertension in a horse causing atrial fibrillation. However, even severe cardiac changes due to respiratory dysfunction seem to be largely reversible in horses.

Diagnostic and predictive capability of routine laboratory tests for the diagnosis and staging of equine inflammatory disease.

BACKGROUND: A wide spectrum of laboratory tests is available to aid diagnosis and classification of equine inflammatory disease. OBJECTIVES: To compare diagnostic efficacy and combined predictive capability of the myeloperoxidase index (MPXI), and plasma fibrinogen, iron and serum amyloid A (SAA) concentrations for the diagnosis of inflammation. ANIMALS: Twenty-six hospitalized horses with systemic inflammation (SI), 114 with local inflammation (LI) and 61 healthy horses or those with noninflammatory disease (NI) were included. METHODS: A retrospective study was performed; clinicopathologic data from horses were compared between groups. Receiver-operator characteristic (ROC) curves were used to evaluate diagnostic efficacy; classification and regression tree analysis (CART) and logistic regression analysis were used to generate diagnostic algorithms. RESULTS: Horses with SI had significantly higher SAA than horses with LI (P = .007) and NI (P < .001) and lower iron concentrations than horses with LI (P < .001) and NI (P < .001). Fibrinogen concentration was higher in horses with inflammation than in those without inflammation (P = .002). There was no difference between the SI and LI groups. White blood cell count, neutrophil count and MPXI were similar between groups. SAA had the highest accuracy for diagnosing inflammation (area under ROC curve [AUC], 0.83 ± 0.06) and iron and SAA concentration had the highest accuracy for differentiating SI from LI (AUC, 0.80 ± 0.09 and 0.73 ± 0.10 respectively). Predictive modeling failed to generate useful algorithms and classification of cases was moderate. CONCLUSIONS AND CLINICAL IMPORTANCE: Very high SAA and low iron concentrations may reflect SI, but diagnostic guidelines based on quantitative results of inflammatory markers could not be formulated.

Breathing pattern and thoracoabdominal asynchrony in horses with chronic obstructive and inflammatory lung disease.

The aim of the study was to show that changes in thoracoabdominal asynchrony (TAA) between quiet breathing and CO2-induced hyperpnoea can be used to differentiate between horses with healthy airways and those suffering from inflammatory airway disease (IAD) or recurrent airway obstruction (RAO). The level of TAA was displayed by the Pearson's correlation coefficient (PCC) of thoracic and abdominal signals, generated by respiratory ultrasonic plethysmography (RUP) during quiet breathing and hyperpnoea. Changes in TAA were expressed as the quotient of the PCCs (PCCQ) during normal breathing and hyperpnoea. Horses with RAO and IAD showed significant higher median PCCQ than healthy horses. Median PCCQ of horses with RAO and IAD was not significantly different. Horses affected by a pulmonary disorder showed lower TAA compared to the control group. This study suggests that TAA provides a useful parameter to differentiate horses with RAO and IAD from healthy horses.

Vectors and vector-borne diseases of horses.

Most diseases of horses with zoonotic importance are transmitted by arthropods. The vectors belong to two very distantly related groups, the chelicerate Ixodidae (Acari = ticks) and the hexapod Diptera (true flies). Almost all relevant species are predestined for transmitting pathogens by their blood-sucking habits. Especially species of Diptera, one of the megadiverse orders of holometabolan insects (ca. 150.000 spp.), affect the health status and performance of horses during the grazing period in summer. The severity of pathological effect depends on the pathogen, but also on the group of vectors and the intensity of the infection or infestation. Dipteran species but also blood-sucking representatives of Acari (Ixodidae) can damage their hosts by sucking blood, causing myiasis, allergy, paralysis and intoxication, and also transmit various bacterial, viral, parasitic, spirochetal and rickettsial diseases to animals and also humans. The aim of this review was to provide extensive information on the infectious diseases transmitted by members of the two arthropod lineages (Ixodidae, Diptera) and a systematic overview of the vectors. For each taxon, usually on the ordinal, family, and genus level a short characterisation is given, allowing non-entomologists easy identification. Additionally, the biology of the relevant species (or genera) is outlined briefly.

Outbreaks of equine grass sickness in Hungary.

Equine grass sickness (EGS) occurs mainly in Great Britain, but has once been reported in Hungary. The stud which was affected by EGS in 2001 had no new cases until 2009/10, when 11 of 60 and five of 12 one- to three-year-old colts died or were euthanased due to EGS. Following a few hours in the high-risk field during the winter of 2010/11 further four cases of acute EGS were noted among these horses. The affected horses showed somewhat different clinical signs compared with the cases reported in Great Britain. Histopathological findings in these horses were consistent with EGS. In most examined cases carbofuran, a carbamate was found in the liver by toxicological examination, and it is postulated that carbofuran may influence the immune system and therefore predispose the horses to develop EGS. Carbamates are thought to cause a delayed neurotoxicity in human beings. Further studies are needed to clarify the potential role of carbamates in EGS.

Safety and immunogenicity of BPV-1 L1 virus-like particles in a dose-escalation vaccination trial in horses.

REASONS FOR PERFORMING STUDY: Infection with bovine papillomaviruses types 1 and 2 (BPV-1, BPV-2) can lead to the development of therapy-resistant skin tumours termed sarcoids and possibly other skin diseases in equids. Although sarcoids seriously compromise the welfare of affected animals and cause considerable economic losses, no prophylactic vaccine is available to prevent this common disease. In several animal species and man, immunisation with papillomavirus-like particles (VLP) has been shown to protect efficiently from papillomaviral infection. HYPOTHESIS: BPV-1 L1 VLPs may constitute a safe and highly immunogenic vaccine candidate for protection of horses against BPV-1/-2-induced disease. METHODS: Three groups of 4 horses each received 50, 100 or 150 µg of BPV-1 L1 VLPs, respectively, on Days 0, 28 and 168. Three control horses received adjuvant only. Horses were monitored on a daily basis for one week after each immunisation and then in 2 week intervals. Sera were collected immediately before, 2 weeks after each vaccination and one and 2 years after the final boost and analysed by pseudovirion neutralisation assay. RESULTS: None of the horses showed adverse reactions upon vaccination apart from mild and transient swelling in 2 individuals. Irrespective of the VLP dose, all VLP-immunised horses had developed a BPV-1-neutralising antibody titre of ≥ 1600 plaque forming units (pfu)/ml 2 weeks after the third vaccination. Eight of 10 trial horses still available for follow-up had neutralising antibody titres ≥ 1600 pfu/ml one year and ≥ 800 pfu/ml 2 years after the last immunisation. CONCLUSION: Intramuscular BPV-1 L1 VLP vaccination in horses is safe and results in a long-lasting antibody response against BPV-1. Neutralisation titres were induced at levels that correlate with protection in experimental animals and man. POTENTIAL RELEVANCE: BPV-1 L1 VLPs constitute a promising vaccine candidate for prevention of BPV-1/-2-induced disease in equids.

A preliminary study on the changes in some potential markers of muscle-cell degradation in sub-maximally exercised horses supplemented with a protein and amino acid mixture.

In this preliminary study, time-dependent changes in plasma CK and AST activity, tyrosine (Tyr), 3-methyl-histidine (3mHis), glucose and lactate concentrations were analysed in nine horses under two different conditions. Furthermore, intramuscular concentrations of Tyr, 3mHis and activities of cathepsin B, acid phosphatase (ACP), glucose-6-phosphate dehydrogenase (G6PDH) and mRNA expression of ubiquitin were determined at the same time. After studying the effects of exercise alone, the effects of exercise and feeding of an experimental protein/amino acid (AA) supplement were analysed. Horses were submitted to a total of four standardised exercise tests (SETs) of high intensity. Potential markers of muscle break down were determined prior to, immediately after, 4 and 18 h after exercise. The experiment was subdivided into two consecutive periods of 3 weeks. In each period, two SETs were performed. In the second period, horses were fed with the protein/AA supplement within 1 h after exercise. Significant changes in plasma, intramuscular Tyr levels and mRNA expression of ubiquitin were caused both by time in relation to exercise and by treatment with the protein/AA supplement. The experimental supplement significantly decreased the 4-h post-exercise expression of ubiquitin mRNA in muscle. Only a borderline increase of markers of lysosomal involvement was seen and CK and AST activity generally showed their normal post-exercise patterns. A clear post-exercise reduction of this CK activity, however, was not observed after supplementation with the protein/AA mixture. The current findings indicate that horses might benefit from protein and AA supplementation directly after training by decreasing post-exercise proteolysis. The results support that further studies should be performed to characterize changes in equine protein metabolism caused by exercise including underlying molecular mechanisms.

Changes in intramuscular amino acid levels in submaximally exercised horses - a pilot study.

The time-dependent changes in intramuscular amino acid (AA) levels caused by exercise and by feeding a protein/AA supplement were analysed in nine horses. Horses were submitted to a total of four standardized exercise tests (SETs). Amino acid concentrations were determined prior to, immediately after, 4 and 18 h after exercise. The experiment was subdivided into two consecutive periods of 3 weeks. In each period two SETs were performed. In the second period, horses were given a protein/AA supplement within 1 h after exercise. Significant changes in mean plasma AA levels similar to previous studies were noted to be time-dependent and to be associated with feeding the supplement. The intramuscular concentrations of the free AA in relation to pre-exercise levels showed significant time-dependent changes for alanine, asparagine, aspartate, citrulline, glutamine, glycine, isoleucine, leucine, methionine, serine, taurine, threonine, tyrosine and valine. Feeding the supplement significantly increased the 4 h post-exercise intramuscular concentration of alanine, isoleucine, methionine and tyrosine. At 18 h after exercise, apart from isoleucine and methionine, levels were still increased and also those of asparagine, histidine and valine in relation to none treatment. Hence, it was concluded that AA mixtures administered orally to horses within 1 h after exercise increased intramuscular AA pool.

The effects of short intensive exercise on plasma free amino acids in standardbred trotters.

The aim of this study was to investigate the effect of short intense exercise on plasma amino acid concentrations in trotters and to test the repeatability of plasma amino acids concentration in samples obtained on two independent days under field conditions. Plasma amino acid concentrations were analysed in blood samples of 36 standardbred trotters before and after intense exercise over a distance of 2000 m. Sampling was repeated in 20 horses after 35 days. Exercise intensity was estimated from post-exercise lactate levels. Horses were divided in two groups according to a cut-off lactate concentration at 15 mmol/l. The plasma concentrations of alanine, aspartate, glutamate, isoleucine, leucine, lysine and taurine increased and arginine, asparagine, citrulline, glutamine, glycine, histidine, methionine, serine, tryptophan and 3-methylhistidine decreased after exercise. Ornithine, threonine, tyrosine, phenylalanine and valine concentrations remained constant. Higher intensity of exercise significantly decreased tryptophan and increased taurine concentrations. Sampling day had a significant effect on the absolute pre- and post-exercise amino acid concentrations. Exercise had a significant influence on the concentrations of most plasma amino acids in trotters. These changes could reflect shifts between the free amino acid compartments, but there were also some indications for muscle catabolism. The amino acid supply of sporting horses could be of specific significance for maintaining muscle integrity and for the improvement of post-exercise recovery of competition horses.

Clenbuterol affects the expression of messenger RNA for interleukin 10 in peripheral leukocytes from horses challenged intrabronchially with lipopolysaccharides.

On four occasions, four horses with heaves and four horses with small airway inflammatory diseases inhaled 0.9% saline based aerosol mixtures with or without lipopolysaccharides (LPS). Prior to the first saline and LPS inhalation, horses were untreated, while three and a half days prior to the third and forth inhalation horses had received 0.8 microg/kg clenbuterol intravenously twice daily. The messenger RNA (mRNA) expression of tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-4, IL-6, IL-8, IL-10 and interferon- gamma (IFN- gamma) was investigated by RT-PCR, all of which were expressed in the white blood cells of samples collected. Inhalation of LPS only changed the cytokine expression profile of IL-10, IL-4 and TNF-alpha mRNA which were higher after challenge with LPS. However in those horses that were treated with clenbuterol the LPS-induced IL-10 mRNA expression was shown to be suppressed. Further changes in IL-4 and TNF-alpha were not significant. Thus the results of this study indicated that clenbuterol can modulate the expression of IL-10 mRNA in peripheral white blood cells in those horses with small airway diseases that have been exposed to LPS.

Individual differences and repeatability of post-prandial changes of plasma-free amino acids in young horses.

Few data are available on post-prandial changes of plasma amino acids (AAs) in horses and on the repeatability and the individual variance on different sampling days. The objective of the present study was to measure pre- and post-prandial concentrations of plasma AA in 10 yearling horses. Blood samples were taken on days 1 and 40 of the study before feeding of hay, oats and soya meal and over an 8 h post-prandial period in 2-h intervals. The plasma AAs were measured by high-pressure liquid chromatography after ortho-phthalaldehyde derivatization. Mean fasting concentrations of the AAs were not significantly influenced by the individuum and sampling day. Repeatability of the fasting AA levels in the individual horses on two different sampling days was only found for histidine, 3-methylhistidine, methionine, tryptophan and taurine. While the absolute post-prandial AA concentrations differed between sampling days, the relative changes were comparable. All AA concentrations except 3-methylhistidine increased after feeding by 13% to more than 200% of their fasting values if the combined data of both days were analysed. Four hours after feeding the concentrations of arginine, asparagine, lysine, leucine, isoleucine and threonine, decreased more than 20%. Histidine, methionine, phenylalanine, valine, tryptophan, glutamine, glycine, tyrosine and taurine concentrations decreased by less than 20%. Concentrations of aspartic acid, glutamic acid, ornithine, serine and citrulline remained elevated. Most AA approached the fasting concentrations at 8 h, only glycine increased between 6 and 8 h after meal and 3-methyl-histidine concentrations were constant throughout the entire period. In conclusion, the pre-prandial plasma AA in horses appeared less influenced by individuum or sampling day than post-prandial plasma AA concentrations. Therefore, plasma AA concentrations should be interpreted only under well-defined conditions, especially regarding the feeding regimen.

Improvement of the lung function of horses with heaves by treatment with a botanical preparation for 14 days.

The effects of an oral preparation containing a mixture of extracts from yellow gentian, garden sorrel, cowslip, verbena and common elder on the lung function of nine horses suffering from heaves were determined in a longitudinal crossover study. The horses were divided at random into a group of five (group 1) and a group of four (group 2). The horses in group 1 were each given 15 tablets of the preparation twice daily, while the horses in group 2 were left untreated. Fourteen days later, the horses in group 2 were given the same course of treatment while the horses in group 1 were left untreated. On being subjected to a histamine inhalation provocation test, five of eight horses tested appeared to be hyperresponsive to histamine. The treatment decreased the histamine sensitivity of three of them; it also caused a significant decrease in maximal intrapleural pressure difference of all the horses. The treatment had no significant effects on the clinical signs, the mucociliary activity or the cytology of the bronchoalveolar lavage fluid of the horses.

The effect of orally administered marbofloxacin on the pharmacokinetics of theophylline.

As certain quinolones can interfere with the metabolism of theophylline by competitive inhibition of the hepatic microsomal cytochrome P450 system, concomitant use of these drugs with theophylline could result in theophylline toxicity. This study investigated the effect of orally administered marbofloxacin (2 and 5 mg/kg each once daily) on steady-state plasma pharmacokinetics of theophylline after concomitant oral administration of a sustained release theophylline preparation in dogs. Marbofloxacin caused some alteration in theophylline metabolism. A 2 mg/kg dose of marbofloxacin did not clearly result in an increased area under the concentration--time curve (AUC) or decreased clearance of theophylline, but at a dose of 5 mg/kg, a statistically significant increase in AUC and a decrease in the total clearance of theophylline was found. The 26% reduction in theophylline clearance is probably not clinically significant in healthy dogs, but for dogs with renal impairment, there might be a chance of theophylline accumulation when dosed concomitantly with marbofloxacin.

Efficacy of montelukast in the treatment of chronic obstructive pulmonary disease in five horses.

Five horses with moderate to severe chronic obstructive pulmonary disease (COPD) were treated with 0.11 (0.01) mg/kg bodyweight of montelukast, a cysteinyl leukotriene receptor antagonist, once a day for 26 days. The horses were evaluated clinically and endoscopically and subjected to arterial blood gas analysis and lung function tests before and after the period of treatment, and the plasma concentrations of montelukast were determined by high-performance liquid chromatography with fluorescence detection. The treatment did not result in statistically significant differences in the total scores of clinical and endoscopical signs, or in the difference in the arterioalveolar partial pressure of oxygen, maximal changes in pleural pressure, pulmonary resistance or dynamic compliance. The mean (sd) peak plasma concentration (C(max0) of montelukast was 12 (4) ng/ml and was reached 66 (13) minutes (t(max)) after its oral administration. The dose of montelukast per kg bodyweight was approximately the same as that for human beings, but the C(max) in the horses was 28 times lower and the t(max) was reached in one-fifth of the time, suggesting that its oral bioavailability may be lower.

Study of the effect of Bronchipret on the lung function of five Austrian saddle horses suffering recurrent airway obstruction (heaves).

The effects of an oral preparation containing an extract of thyme and primula (Bronchipret; Bionorica) on the lung function of five horses suffering heaves were determined in a longitudinal study. The horses accepted the product well. The plasma concentrations of the marker substance, thymol, indicated that at least one of the substances in the extract had been absorbed from the gastrointestinal tract. The compliance, pulmonary pressure and airway resistance of the horses' lungs were all significantly improved after one month of treatment However, the severity of their clinical signs and their arterial oxygen partial pressure had not improved significantly.

Intramuscular dosing strategy for ampicillin sodium in horses, based on its distribution into tissue chambers before and after induction of inflammation.

The Pharmacokinetics (PK) and distribution into tissue chamber fluid (TCF) of intramuscularly (i.m.) administered ampicillin sodium were examined in horses in order to design adequate dosing strategies. Concentration-time curves of ampicillin in plasma and TCF were determined in six horses following administration of 15 mg/kg ampicillin sodium, before and after the induction of local inflammation with 0.5% carrageenan. The calculated parameters were used to simulate various dosage-dosing interval combinations. Ampicillin was absorbed very rapidly following i.m. administration. Plasma concentrations were maximual between 18 and 21 min after administration. None of the plasma PK parameters were affected significantly by local (TC) inflammation. Penetration of ampicillin into and elimination from the TCF were affected significantly by inflammation and the half-life of elimination from the tissue fluid t1/2(d) was significantly shorter in inflammation. In the simulated dosage-dosing interval scenarios, only a dosage of 15 mg ampicillin/kg four times daily would successfully treat all ampicillin-susceptible bacterial isolates in well vascularized tissues. However a dosage as low as 10 mg/kg twice daily, would, in theory, treat all ampicillin-susceptible isolates in the inflamed poorly vascularized tissues. Decreasing the dosage results in loss of efficacy that cannot be completely compensated for by increasing the frequency of dosing.

Area under the curve calculations as a tool to compare the efficacy of equine influenza vaccines--a retrospective analysis of three independent field trials.

Using the area under the curve (AUC) concept as is commonly used in pharmaceutical bioequivalence studies, the bioequivalence of three equine influenza vaccines was demonstrated. A retrospective analysis was performed using this technique on data generated in three trials in which each of the three vaccines had been used. In total, data from 63 pony and horse foals were used. The AUC of the single radial hemolysis (SRH) titres against Influenza A/equi-1/Prague/56 (Pr/56), A/equi-2/Newmarket-1/93, and A/equi-2/Suffolk/89 (Suf/89) were calculated for each horse. It was concluded that calculation of the AUC from four time-points permitted a suitable estimate for vaccine potency. Using pooled data, it appeared that the AUC permitted better evaluation of vaccine potency than simply considering the highest post vaccinal titre (Titremax). In two studies, a minimal value for the AUC was associated with protection against Influenza (H3N8) challenge 50-153 days later.

Clinical and virological evaluation of the efficacy of an inactivated EHV1 and EHV4 whole virus vaccine (Duvaxyn EHV1,4). Vaccination/challenge experiments in foals and pregnant mares.

Pregnant mares and young foals were vaccinated with Duvaxyn EHV1,4, an inactivated and adjuvanted vaccine containing both the EHV-1 and 4 antigens. SN and CF antibody titres were induced two weeks after first vaccination. Antibody levels were boosted after second vaccination, however they never reached the levels induced after virus challenge. Young foals were challenged with virulent EHV-1 and EHV-4 field viruses. Pregnant mares were challenged with the highly abortigenic EHV-1 strain Ab4. Vaccinated animals showed a clear reduction in clinical signs and virus excretion compared to unvaccinated control animals. Log transformed antibody levels could be correlated to duration of virus excretion. The incidence of EHV-1 induced abortions was drastically reduced in vaccinated mares. Therefore, although vaccinated animals are not fully protected against disease, Duvaxyn EHV1,4 clearly reduces clinical symptoms, the duration of virus shedding and the quantity of virus shed. It can be concluded that vaccination of foals and pregnant mares with Duvaxyn EHV1,4 significantly reduces the risk of abortions and outbreaks of respiratory disease caused by circulating field viruses.

Duration of immunity induced by an adjuvanted and inactivated equine influenza, tetanus and equine herpesvirus 1 and 4 combination vaccine.

An adjuvanted vaccine containing inactivated equine influenza, herpesvirus antigens, and tetanus toxoid was administered to young seronegative foals of 8 months of age by deep intramuscular injection in the neck (Group A). The first two vaccinations were given 4 weeks apart. The third was administered 6 months later. Another group of foals (Group B) was vaccinated according to the same scheme at the same time with monovalent equine herpes virus (EHV) vaccine (EHV1.4) vaccine. Antibody responses to the equine influenza (single radial haemolysis; SRH) and tetanus (ToBi ELISA) components of the vaccines were examined from first vaccination until 1 year after the third vaccination. The influenza components of the combination vaccine induced high antibody titres at two weeks after the second vaccination whereafter titres declined until the time of the third vaccination. After the third vaccination, the titres rose rapidly again to remain high for at least 1 year. Antibody titres against tetanus peaked only after the third vaccination but remained high enough to offer protective immunity for at least 1 year. Foals vaccinated with monovalent EHV1.4 remained seronegative for influenza and tetanus throughout the study. Four and a half months after the third vaccination of groups A and B, a third group of animals was vaccinated twice with monovalent EHV1.4 vaccine 4 weeks apart (Group C). Two weeks after the administration of the second dose in the later group, all groups (A, B, C and an unvaccinated control group D) were challenged with EHV-4. Vaccinated foals (Group A, B, C) showed a clear reduction of clinical symptoms and virus excretion after EHV-4 challenge compared with the unvaccinated control foals. No difference could be demonstrated among the vaccinated groups, suggesting that the combination vaccine protects as well as the monovalent vaccine. In EHV1.4-vaccinated foals both antigenic fractions induced clear protection up to 6 months after vaccination (9). It can therefore be anticipated that the efficacy of the combination vaccine against EHV-1 challenge is similar to the efficacy against EHV-1 induced by EHV1.4 vaccination.