Eosinophils Play a Surprising Leading Role in Recurrent Urticaria in Horses.

Urticaria, independent of or associated with allergies, is commonly seen in horses and often shows a high reoccurrence rate. Managing these horses is discouraging, and efficient treatment options are lacking. Due to an incidental finding in a study on horses affected by insect bite hypersensitivity using the eosinophil-targeting eIL-5-CuMV-TT vaccine, we observed the prevention of reoccurring seasonal urticaria in four subsequent years with re-vaccination. In an exploratory case series of horses affected with non-seasonal urticaria, we aimed to investigate the role of eosinophils in urticaria. Skin punch biopsies for histology and qPCR of eosinophil associated genes were performed. Further, two severe, non-seasonal, recurrent urticaria-affected horses were vaccinated using eIL-5-CuMV-TT, and urticaria flare-up was followed up with re-vaccination for several years. Eotaxin-2, eotaxin-3, IL-5, CCR5, and CXCL10 showed high sensitivity and specificity for urticarial lesions, while eosinophils were present in 50% of histological tissue sections. The eIL-5-CuMV-TT vaccine reduced eosinophil counts in blood, cleared clinical signs of urticaria, and even prevented new episodes of urticaria in horses with non-seasonal recurrent urticaria. This indicates that eosinophils play a leading role in urticaria in horses, and targeting eosinophils offers an attractive new treatment option, replacing the use of corticosteroids.

Clinical signs, treatment, and outcome in 15 cattle with sinonasal cysts.

OBJECTIVE: To evaluate clinical signs, diagnosis, treatment and outcome of cattle with sinonasal cysts. STUDY DESIGN: Case series. ANIMALS: Cattle (n = 15). METHODS: Medical records (2004-2011) of cattle with a fluid-filled mass in the nasal cavity, conchae, and/or paranasal sinuses were evaluated. Data retrieved and analyzed were reason of presentation, clinical signs, diagnostic techniques, surgical treatment, complications, and outcome. RESULTS: Common presenting clinical signs were abnormal respiratory noise, nasal discharge, and abnormal respiratory effort. Mean age of affected cattle was 21.7 months. In 9 animals, cysts were identified by endoscopy. Radiographic signs included a mass in the paranasal sinuses or conchae (13), nasal septum deviation (12), fluid lines (10), and bone atrophy (5). Ten cattle were treated surgically with osteoplastic flap techniques to gain access to the frontal or maxillary sinus (5), nasal extraction of the cyst under endoscopic control (3) or a combination of both techniques (2). Nine cattle returned to be productive members of their herd and had no recurrence (mean follow-up, 20.7 months). CONCLUSIONS: Sinonasal cysts should be considered as a primary differential diagnosis in cattle with abnormal respiratory noise, particularly in younger animals. Multiple cysts were common, which underlines the importance of a thorough preoperative examination using appropriate imaging modalities. Despite the often expansive nature of sinonasal cysts, the prognosis with surgical treatment was good.

Evaluation of a continuous glucose monitoring system compared with an in-house standard laboratory assay and a handheld point-of-care glucometer in critically ill neonatal foals.

OBJECTIVE: To evaluate the applicability and accuracy of a continuous glucose monitoring system (CGMS) in critically ill foals by comparing the performance of the CGMS, a point-of-care (POC) glucometer, and an in-house standard laboratory assay (SLA). DESIGN: Prospective study. SETTING: University teaching hospital. ANIMALS: Seven critically ill neonatal foals requiring intensive care. INTERVENTIONS: Foals were instrumented with a CGMS that measured interstitial glucose concentration every 5 minutes for the duration of 15-79 hours. Capillary and venous blood samples were taken every 4-6 hours for POC and SLA measurements, respectively. MEASUREMENTS AND MAIN RESULTS: Bland-Altman analysis showed a mean bias (95% limits of agreement) of -0.1 (-3.9 to 3.5) mmol/L for comparison of CGMS versus SLA, 0.06 (-3.9 to 4.0) mmol/L for comparison of CGMS versus POC glucometer, and -0.16 (-1.8 to 1.5) mmol/L for comparison of POC glucometer versus SLA. Percent agreement and weighted kappa for classification in hypoglycemia, normoglycemia, and hyperglycemia were 68.4% and 0.296 for CGMS versus SLA, 72.4% and 0.442 for CGMS versus POC glucometer, and 80.7% and 0.568 for POC glucometer versus SLA. CONCLUSIONS: The CGMS may be helpful for monitoring a trend in interstitial glucose concentration in critically ill neonatal foals. However, considering the wide limits of agreement between methods, the CGMS should only be used as an adjunctive device to other, more accurate and readily available methods that are able to detect acute changes in glucose concentration. Its use is further limited by the relatively high costs of the sensors, the mandatory 2-hour initialization period, and the difficulties of keeping the transducer in place in an active foal. The POC glucometer used in this study is easy to use and proved to be sufficiently accurate for repeated, stall-sided glucose monitoring in neonatal foals.