Chronic phalaris toxicity in macropods is widespread and peaks in July in Victoria, Australia.

Phalaris aquatica is pasture species introduced into Australia during early European settlement. Consumption of the plant can cause the neurological condition chronic phalaris toxicity (CPT) in sheep and cattle. In recent years, there has been an increase in reports of CPT in macropods, which has raised concerns regarding its impacts on their welfare. Currently, little is known about the distribution or seasonal patterns of this disease in wildlife, information pivotal in assessing its potential risks. Between 2021 and 2022, we conducted a survey targeting government bodies, veterinary businesses and wildlife organisations to investigate the locations and time of occurrence of CPT in macropods in the state of Victoria, Australia. We received 13 survey responses, 12 verbal reports, a full record of investigated cases from a university veterinary school and cases from a wildlife rescue organisation. Over the period of 11 years, Victoria had 918 cases of CPT recorded in macropods from 36 local government areas, with cases concentrated centrally just north of the state capital of Melbourne and July (midwinter) being the month with the highest case count (n = 220). There was a significant positive correlation between case count and both the abundance of kangaroos (Macropus giganteus and Macropus fuliginosus) (P < 0.01) and the abundance of P. aquatica (P = 0.009), and a significant negative correlation between annual case count and average rainfall of March (P = 0.016) and April (P = 0.02). Understanding these relationships will assist land and wildlife managers in predicting the risk and magnitude of disease outbreaks of CPT each in Victoria.

Investigation of breed differences in plasma adrenocorticotropic hormone concentrations among healthy horses and ponies.

Plasma adrenocorticotropic hormone (ACTH) concentration is commonly measured to diagnose pituitary pars intermedia dysfunction (PPID). Several intrinsic and extrinsic factors affect ACTH concentrations, including breed. The objective of this study was to prospectively compare plasma ACTH concentrations among different breeds of mature horses and ponies. Three breed groups comprised Thoroughbred horses (n = 127), Shetland ponies (n = 131) and ponies of non-Shetland breeds (n = 141). Enrolled animals did not show any signs of illness, lameness or clinical signs consistent with PPID. Blood samples were collected 6 months apart, around the autumn equinox and spring equinox, and plasma concentrations of ACTH were measured by chemiluminescent immunoassay. Pairwise breed comparisons within each season were performed on log transformed data using the Tukey test. Estimated mean differences in ACTH concentrations were expressed as fold difference with 95 % confidence intervals (CI). Reference intervals for each breed group per season were calculated using non-parametric methods. In autumn, higher ACTH concentrations were found among non-Shetland pony breeds compared with Thoroughbreds (1.55 fold higher; 95 % CI, 1.35-1.77; P < 0.001), and in Shetland ponies compared with Thoroughbreds (2.67 fold higher; 95 % CI, 2.33-3.08; P < 0.001) and non-Shetland pony breeds (1.73 fold higher; 95 % CI, 1.51-1.98; P < 0.001). In spring, no differences were identified among breed groups (all P > 0.05). Reference intervals were similar among breed groups in spring, but upper limits for ACTH concentrations were markedly different between Thoroughbred horses and pony breeds in autumn. These findings emphasise that breed should be accounted for when determining and interpreting reference intervals for ACTH concentrations among healthy horses and ponies in autumn.

A survey of veterinarians' practices, recommendations and perceptions associated with the prevention of tetanus in horses in Australia.

OBJECTIVE: Identify veterinarians' practices, recommendations and perceptions when preventing tetanus in horses in Australia. METHODS: Graduated members of Equine Veterinarians Australia participated in an online survey about the prevention of tetanus in horses in Australia. RESULTS: Of 77 respondents (response rate ~ 8%), 50 (65%) reported that they had attended collectively 145-152 cases of tetanus in horses in Australia (1.1 cases of tetanus observed/10 veterinarian-years since qualification). The estimated case fatality rate (CFR) was at least 79%. Puncture wounds were most frequently suspected as the entry point (32%; n = 47). Five respondents (7%) reported cases of localised tetanus. Three respondents reported generalised tetanus within 2 weeks of tetanus antitoxin (TAT) administration. Respondents did not report any cases of tetanus in horses which had been vaccinated according to manufacturer's recommendations. All respondents recommended vaccination, but over 50% (N = 45) stated 'lack of veterinary recommendation' as often or sometimes a reason why clients did not vaccinate horses. Opinions varied on the use of TAT for peri-exposure prophylaxis; 67% of respondents dosed TAT independent of body weight, with the rest dosing according to body weight. Cases of Theiler's disease related to the use of TAT were not reported in Australia by respondents. DISCUSSION: The caseload of equine tetanus appears relatively low among equine veterinarians in Australia. Consistent with the literature, estimated CFR was high. Respondents' recommendations and perceptions about tetanus vaccination were generally consistent but varied regarding TAT usage. Evidence for TAT usage is limited and we recommend studies of TAT efficacy in horses.

Chlamydia psittaci: a suspected cause of reproductive loss in three Victorian horses.

Chlamydia psittaci was detected by PCR in the lung and equine foetal membranes of two aborted equine foetuses and one weak foal from two different studs in Victoria, Australia. The abortions occurred in September 2019 in two mares sharing a paddock northeast of Melbourne. The weak foal was born in October 2019 in a similar geographical region and died soon after birth despite receiving veterinary care. The detection of C. psittaci DNA in the lung and equine foetal membranes of the aborted or weak foals and the absence of any other factors that are commonly associated with abortion or neonatal death suggest that this pathogen may be the cause of the reproductive loss. The detection of C. psittaci in these cases is consistent with the recent detection of C. psittaci in association with equine abortion in New South Wales. These cases in Victoria show that C. psittaci, and the zoonotic risk it poses, should be considered in association with equine reproductive loss in other areas of Australia.

Construction and validation of the Lebanese Osteoporosis Knowledge Scale among a representative sample of Lebanese women.

Our study aimed at constructing and validating the Lebanese Osteoporosis Knowledge Scale adapted for use among Lebanese women and to assess factors associated with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. This scale showed adequate psychometric properties; higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. INTRODUCTION: The primary objective of this study was to describe the construction of the Lebanese Osteoporosis Knowledge Scale (LOKS) and assess its psychometric properties in a representative sample of Lebanese women aged 40 years and above. Secondary objectives were to explore factors associated with this knowledge score. METHODS: A cross-sectional study carried out between March and June 2018, enrolled 560 women over the age of 40 years living in the community. This proportionate sample was randomly selected from all Lebanese governorates to cover the entire Lebanese area. A survey was developed and adapted to the Lebanese population based on preexisting scales. Personal interviews were conducted to collect data. RESULTS: The items of the LOKS were distributed across seven factors with an Eigenvalue over 1 solution, outlining an overall value of 55.89% of the variance. A high Cronbach's alpha was found for the full scale (0.725). Individuals having a university level of education (beta = 1.62; compared to illiteracy), having heard of osteoporosis (beta = 2.62), taking supplements of calcium and vitamin D compared to none (beta = 0.77), and having had Crohn's disease (beta = 1.71) had significantly higher knowledge scores of osteoporosis; oppositely, having diabetes (beta = - 1.17), currently taking chemotherapy (beta = - 2.25), and ever having had a fracture (beta = - 0.74) were significantly correlated with lower awareness of osteoporosis. CONCLUSIONS: Our findings suggest that the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. A better knowledge seems to be associated with more preventive measures and less risk of fracture.

Serological responses of Australian horses using a commercial duplex indirect ELISA following vaccination against strangles.

OBJECTIVE: To determine the nature of serological responses in Australian horses using a commercial duplex indirect ELISA (iELISA) following vaccination against strangles. DESIGN: A group (n = 19) of client-owned horses from five properties were recruited to receive a primary course of a Streptococcus equi subsp. equi (S. equi) extract vaccine. Serological responses were determined by duplex iELISA incorporating S. equi-specific fragments of two cell wall proteins, SEQ2190 and SeM (antigens (Ag) A and C, respectively). METHODS: The horses were administered a primary strangles vaccination course. Blood was collected immediately prior to each of the three vaccinations at 2-week intervals and additionally at 28 and 56 days following the 3rd vaccination (V3). RESULTS: Significant increases in mean antibody levels of horses following vaccination were limited only to AgC, which was significantly increased at T2/V3, 14 days following V2 (ratio of geometric means = 3.7; 95% confidence interval (CI): 1.6, 8.4; P = 0.003). There was no increase in mean antibody to Ag A (ratio of geometric means = 1.4; 95% CI: 0.6, 3.2; P = 0.39). Four horses (22%) exceeded the test cut-off for AgC following vaccination. CONCLUSION: Vaccination of Australian horses is unlikely to interfere greatly with detection of strangles using the duplex iELISA. No responses would be anticipated to AgA following vaccination with Equivac© S/Equivac© 2in1 and only a minority are likely to respond to AgC. We conclude that the results of this study validate the usefulness of the duplex iELISA to assist control measures for strangles outbreaks in Australian horse populations.

Osteoporosis awareness and health beliefs among Lebanese women aged 40 years and above.

Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures in order to identify categories that should be targeted in future campaigns and educational programs. Higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, osteoporosis awareness campaigns and educational programs are mostly needed in populations with lower educational levels. INTRODUCTION: Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. METHODS: A cross-sectional study, conducted between March and June 2018, enrolled 560 community dwelling women aged 40 years and above. A questionnaire was used to collect data. A proportionate random sample from all Lebanese Mohafazat was used. Data collection was performed through personal interviews. The median was used as a cutoff point for both the Knowledge and Health Belief scales. RESULTS: The study results showed that 47.3% of participants had a poor knowledge score. Women who received no education, compared to a higher education and have not previously heard about the disease, had lower knowledge scores. In addition, women not taking calcium and vitamin D supplements and not exercising or exercising less than 20 min per day compared to those having these characteristics had lower osteoporosis knowledge levels. A lower knowledge score was associated with less recognized benefits of adequate calcium intake and regular physical activity, more perceived barriers towards their practice, and a less important health motivation. A lower level of education correlated to the same results. CONCLUSION: Lower knowledge scores were reached in women who have never heard of osteoporosis and had a lower level of education. As a result, osteoporosis awareness campaigns and educational programs need to target population categories with lower educational levels.

Chronic phalaris toxicity in eastern grey kangaroos (Macropus giganteus).

CASE REPORT: Seven eastern grey kangaroos (Macropus giganteus) grazing pastures including Phalaris spp. in Victoria showed neurological deficits characterised by ataxia, head tremors and collapse. Gross examination of the brains and spinal cords of affected kangaroos showed a greenish discolouration in several regions of the grey matter. Histologically, intracytoplasmic accumulation of pigment granules was detected in the neurons, most prominently in the thalamus, brainstem and ventral horns of the spinal cord. Pigment granules were positive to stains used for identification of melanin, including Fontana-Masson stain and Schmorl's reaction. CONCLUSION: The combination of clinical signs and obvious neuronal pigmentation is consistent with chronic Phalaris spp. toxicity, a condition well documented in domestic ruminants.

Accelerated vaccination schedule provides protective levels of antibody and complete herd immunity to equine influenza.

REASONS FOR PERFORMING STUDY: During the 2007 Australian equine influenza (EI) outbreak, an accelerated primary course 14 day intervaccination schedule was proposed, but not widely implemented. Expert opinion was divided as to the efficacy of such a schedule given the lack of published data. This study determined the level and duration of humoral immunity following administration of a recombinant canarypox-vectored vaccine (ALVAC-EIV) with a primary intervaccination interval of 14 days and booster at 105 days. OBJECTIVES: To examine whether protective levels of immunity of adequate duration were achieved following a primary course reduced from a minimum interval of 28 to 14 days. Antibody responses to 2 H3N8 American lineage virus strains (including A/equine/Sydney/6085/2007) were assessed and compared to previous challenge studies using ALVAC-EIV at conventional intervaccination intervals. METHODS: Fourteen Thoroughbred horses and 2 ponies from a rural racehorse training property in Victoria, Australia, were vaccinated with ALVAC-EIV on Days 0, 14 and 105. Serial blood samples were collected over the next 32 weeks and tested with haemagglutination inhibition and single radial haemolysis (SRH) in full assays to evaluate the serological response. RESULTS: All horses and ponies responded to the accelerated ALVAC-EIV vaccination schedule. Mean SRH antibodies remained above those consistent with clinical protection for the duration of the study period. All vaccinates demonstrated high SRH antibodies 14 days following V2, thereby achieving 100% herd immunity to homologous viral challenge. CONCLUSIONS: An accelerated vaccination schedule conferred long-lasting protective antibody levels despite a >50% reduction in the recommended V1-V2 interval. POTENTIAL RELEVANCE: High levels of rapidly acquired herd immunity are critical in containing an outbreak of such a highly contagious pathogen as EIV. In a strategic vaccination programme, it is important that horses remain protected for sufficient time to allow control programmes to succeed. An accelerated 14 day primary course intervaccination interval and booster at 105 days achieves both of these objectives.

Murray Valley encephalomyelitis in a horse.

A 5-year-old Thoroughbred mare presented with signs of severe pain and was taken to exploratory laparotomy based on suspicion of an acute abdominal lesion. A mild gastrointestinal lesion was discovered, but was considered disproportional to the severity of signs displayed. The mare was later euthanased because of intractable pain. Comprehensive postmortem examination, including polymerase chain reaction testing of central nervous system tissue samples, allowed a definitive diagnosis of Murray Valley encephalomyelitis to be made. This case demonstrates the variability of clinical presentations in horses infected with Murray Valley encephalitis virus.

Evaluation of the response to an accelerated immunisation schedule using a canarypox-vectored equine influenza vaccine, shortened interdose intervals and vaccination of young foals.

The results of an accelerated immunisation schedule for horses used as part of the emergency response plan to contain and eradicate equine influenza in Australia in 2007 is described. The horses studied were vaccinated with a recombinant canarypox-vectored vaccine (ProteqFlu®, Merial) with a shorter interdose interval. Vaccinated horses included foals aged less than 4 months.

Circulating angiotensin converting enzyme in endurance horses: effect of exercise on blood levels and its value in predicting performance.

REASONS FOR PERFORMING STUDY: Investigate angiotensin converting enzyme (ACE) activity in equine plasma as a predictor of performance in endurance competitions and the effect of endurance exercise on ACE activity. HYPOTHESIS: Precompetition values of ACE activity in equine blood are correlated with performance results and with heart rates pre- and post competition used as indicators of fitness. Endurance exercise increases ACE activity. METHODS: Nineteen horses participating in an 80 km endurance competition had venous blood samples collected before and after the ride. ACE activity and total protein were measured in the blood samples and heart rates and finishing positions were recorded. Statistical analysis included paired t tests and Spearman's rank correlation coefficient. RESULTS: Of the 19 horses enlisted, only 16 horses completed the ride. Of these 16, another 2 were disqualified at the last veterinary check. When the 16 horses were considered, precompetition heart rate, but not ACE, was correlated with finishing position. When only the 14 horses that were classified were considered, the association disappeared. ACE activity was similar before and after competition. CONCLUSIONS: Precompetition ACE activity in endurance horses competing in an 80 km event was not associated with either finishing position or heart rates before or after competition, indicating that the enzyme is not a good predictor of performance in this form of equestrian competition. Endurance competition did not significantly alter ACE activity in this group of horses.

[Audit on preoperative cardiac evaluation before non-cardiac surgery: the importance of a pocket guide to improve the anaesthesist's adhesion to ACC/AHA guidelines]. / Audit sur l'évaluation cardiaque préopératoire avant une chirurgie non cardiaque : utilité d'un aide-mémoire pour améliorer l'adhésion des anesthésistes aux recommandations de l'American College of Cardiology/American Heart Association (ACC/AHA).

INTRODUCTION: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines stratify perioperative cardiac risk according to clinical markers, functional capacity, and type of surgery. They help determining which patients are candidates for preoperative cardiac testing and optimizing the cost-effectiveness of the evaluation strategy. Auditing our preoperative anaesthetic screening practice revealed an exceedingly high rate of referrals to the cardiologists. A small pocket-size reminder was created in order to improve the adhesion of the anaesthesiologists to the recommendations of the ACC/AHA, and confirm or obviate the need for a formal preoperative specialized cardiology consultation. Another audit was conducted 1 year later in order to evaluate the effectiveness of this reminder. METHODS: The second audit was conducted over a period of 1 month. Recorded data included demographic characteristics, clinical predictors of cardiovascular risk, surgical risk, and the reasons for the cardiac evaluation by a cardiologist (as reported by the senior or junior anaesthesiologist). Results of this second audit were compared to those of the audit conducted a year earlier. RESULTS: During the first audit, a total of 654 patients were seen in the preoperative unit. Fifty-two patients were referred to a cardiologist during the study period (7.9%). Guidelines for cardiac assessment were respected in 7/52 patients (13.5%). During the second audit, 30 out of 787 patients (3.8%) screened in preoperative anaesthetic consultation unit were referred to the cardiologist. According to the ACC/AHA guidelines, 27/30 patients (90%) objectively needed a cardiology consultation due to the existence of a known previous heart disease. DISCUSSION: The use of the pocket reminder concerning the ACC/AHA recommendations significantly reduced both the total number of cardiology referrals, and the number of unjustified referrals. The use of a pocket guide may help in reducing both the cost and the postponement of scheduled surgery.

Disease suspected to be caused by Ross River virus infection of horses.

Ross River Virus (RRV) was believed to be the cause of acute illness in four horses around the Bellarine peninsula in south-west Victoria, Australia. The horses presented with clinical signs including petechial haemorrhages, lymphadenopathy, distal limb swelling and reluctance to move. Fibrinogen was also elevated in three of the four horses. Whilst no virus was isolated, serological testing revealed elevated RRV IgM titres in all horses indicating acute infection. The outbreak occurred at a time when a known RRV vector, the mosquito Aedes camptorhynchus was recorded at very high levels in the region. This report is one of very few to attribute specific signs of disease to RRV in horses in conjunction with serological evidence of infection.

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.

Mivacurium in an obese patient with myotonic dystrophy--a case report.

Mivacurium is a short-acting non-deplolarizing neuromuscular blocking agent. Its use in an obese patient with myotonic dystrophy undergoing laparoscopic cholecystectomy is reported. Mivacurium was used as a bolus dose of 0.07 mg. kg-1, followed by a continuous infusion at the rate of 0.003 mg. kg-1. min-1. Muscle relaxation, monitored by a train of four count, was adequate throughout the surgery. Spontaneous recovery of the neuromuscular function was obtained fifteen minutes after the end of mivacurium infusion. Neostigmine was not given. Postoperative mechanical ventilation and respiratory complications were avoided.

Does adult liver transplantation without venovenous bypass result in renal failure?

Thirty-eight adult orthotopic liver transplant recipients were studied to compare renal hemodynamics and renal function with (17 patients) and without (21 patients) venovenous bypass. Bypass was used when mean arterial blood pressure decreased by greater than 30% or cardiac index decreased by greater than 50%, or both, during a 5-min trial of clamping of the suprahepatic and infrahepatic vena cava and portal vein. Intraoperative measurements were performed 2 h after induction of anesthesia, 10 min before the end of the anhepatic phase, and 2 h after cava unclamping. During the anhepatic stage, renal perfusion pressure decreased significantly in the group with no bypass (79 +/- 20 vs 60 +/- 17 mm Hg, P less than 0.05) (mean +/- SD), whereas it remained unchanged in the group with bypass (77 +/- 14 vs 74 +/- 16 mm Hg, NS); urinary output was not modified in the bypass group, whereas it decreased significantly in the group with no bypass compared with the dissection phase (0.7 +/- 0.6 vs 1.7 +/- 2.0 mL.kg-1.h-1, P less than 0.05). However, during the postreperfusion phase, urinary output was similar in both groups and was more when compared with the dissection phase (P less than 0.05). Serum creatinine level was increased in both groups on the third postoperative day, but no difference occurred between the groups (bypass group 107 +/- 49 mmol/L; nonbypass group 126 +/- 95 mmol/L). No patient required dialysis in either group in the postoperative period. This study suggests that in patients without preoperative renal failure and who tolerate the trial of clamping well, venovenous bypass is not required to maintain postoperative renal function after liver transplantation.