Serum haptoglobin concentration and liver enzyme activity as indicators of systemic inflammatory response syndrome and survival of sick calves.

BACKGROUND: Increased concentration of haptoglobin (Hp) in serum is associated with survival of critically ill humans and horses. High serum activity of liver-derived enzyme is associated with sepsis in children and foals. HYPOTHESIS/OBJECTIVES: Investigate whether admission serum Hp and glutamic dehydrogenase (GLDH) are associated with systemic inflammatory response syndrome (SIRS) and survival of sick calves. ANIMALS: One hundred two calves. METHODS: Retrospective cross-sectional study. Electronic medical records from all calves <30 days of age admitted to a teaching hospital for 8 years were reviewed. The signalment, clinicopathological findings, the presence of SIRS, final diagnosis, hospitalization time and outcome were recorded. A Cox proportional hazard ratio (HzR) were calculated to assess the association between clinicopathological variables and survival to discharge. RESULTS: Serum Hp concentrations were similar between SIRS (0.29 g/L; range, 0.05-3.6) and non-SIRS calves (0.22 g/L; range, 0-4.2; P = .62). GLDH activity was similar between SIRS (12 U/L; range, 1-1025) and non-SIRS calves (9 U/L; range, 2-137; P = .2). Absent suckle reflex (HzR: 6.44, 95% CI: 1.44-28.86), heart rate (HR) < 100 beats per minute (bpm; HzR: 12.2; 95% CI: 2.54-58.62), HR > 140 bpm (HzR: 3.59, 95% CI: 1.05-12.33), neutrophil count <1.7 × 109 /L (HzR: 7.36; 95% CI: 2.03-26.66) and increased gamma-glutamyl transferase activity (every 50-unit, HzR: 1.12; 95% CI: 1.03-1.21) were predictive of nonsurvival. CONCLUSIONS AND CLINICAL IMPORTANCE: The use of Hp and GLDH for prediction of survival in sick calves cannot be recommended at this time.

Sabulous cystitis in the horse: 13 cases (2013-2020).

The objective of this study was to describe the clinical findings, medical management, and outcomes of horses with sabulous cystitis, and to describe a high flow bladder lavage procedure in horses that are standing or under general anesthesia. The medical records of 13 horses diagnosed with sabulous cystitis via cystoscopy between 2013 and 2020 were reviewed. Geldings (92%) and Warmbloods (46%) were overrepresented. The most common presenting complaint was urinary incontinence (69%). Complete blood cell count, serum biochemistry profile and urine cytology results were non-specific. Six (46%) horses had various degrees of erosion, ulceration, and hemorrhage of the bladder mucosa. All horses were treated with bladder lavage either with standing sedation (n = 12) or general anesthesia (n = 2), as well as antimicrobials (54%), anti-inflammatory drugs (62%), bethanechol (15%), and phenazopyridine (15%). Most horses (85%) were discharged from the hospital, but only a small percentage (23%) was reported as having no urinary abnormalities on follow-up communication. Key clinical message: Copious bladder lavage with a high flow rate system could mitigate the acute clinical signs and improve the quality of life of horses with sabulous cystitis, but the prognosis for return to previous level of athletic performance and long-term survival is guarded.

Cystite sableuse chez le cheval: 13 cas (2013­2020). L'objectif de cette étude était de décrire les résultats cliniques, la prise en charge médicale et les résultats des chevaux atteints de cystite sableuse, et de décrire une procédure de lavage de la vessie à haut débit chez les chevaux debout ou sous anesthésie générale. Les dossiers médicaux de 13 chevaux diagnostiqués avec une cystite sableuse par cystoscopie entre 2013 et 2020 ont été revus. Les hongres (92 %) et les Warmbloods (46 %) étaient surreprésentés. La plainte la plus fréquente était l'incontinence urinaire (69 %). Un hémogramme complet, le profil biochimique sérique et les résultats de cytologie urinaire n'étaient pas spécifiques. Six chevaux (46 %) présentaient divers degrés d'érosion, d'ulcération et d'hémorragie de la muqueuse de la vessie. Tous les chevaux ont été traités par lavage de la vessie soit avec sédation debout (n = 12) ou anesthésie générale (n = 2), ainsi que des antimicrobiens (54 %), des anti-inflammatoires (62 %), du béthanéchol (15 %) et de la phénazopyridine (15 %). La plupart des chevaux (85 %) sont sortis de l'hôpital, mais seul un petit pourcentage (23 %) a été signalé comme n'ayant aucune anomalie urinaire lors de la communication de suivi.Message clinique clé:Un lavage vésical abondant avec un système à débit élevé pourrait atténuer les signes cliniques aigus et améliorer la qualité de vie des chevaux atteints de cystite sableuse, mais le pronostic du retour au niveau antérieur de performance athlétique et de survie à long terme est réservé.(Traduit par Dr Serge Messier).

Valvular endocarditis in the horse: 20 cases (1993-2020).

Medical records of 20 horses with a confirmed diagnosis of valvular endocarditis at the Ontario Veterinary College between January 1, 1993 and February 3, 2020 were reviewed. The diagnosis was based on physical examination findings, complete blood (cell) count (CBC), serum biochemistry, echocardiography, blood culture, and post-mortem findings. Common presenting signs included tachycardia, pyrexia, weight loss, lameness/joint distension, and a heart murmur. Clinicopathological findings included leukocytosis, anemia, hypoalbuminemia, hyperglobulinemia, and elevated inflammatory markers. Culture from 5 horses yielded Actinobacillus equuli in 2 cases and Actinobacillus suis in 1 case. Of the 20 horses included in this study, 17 were euthanized and 3 were treated. Only 1 case had follow-up more than 1 year after discharge.

Endocardite valvulaire chez le cheval : 20 cas (1993­2020). Les dossiers médicaux de 20 chevaux avec un diagnostic confirmé d'endocardite valvulaire au Ontario Veterinary College entre le 1er janvier 1993 et le 3 février 2020 furent revus. Le diagnostic était basé sur les trouvailles de l'examen physique, un comptage sanguin complet (CBC), une biochimie sérique, une échocardiographie, une hémoculture et les trouvailles post-mortem. Les signes fréquents de présentation incluaient tachycardie, pyrexie, perte de poids, boiterie/enflure articulaire et murmure cardiaque. Les trouvailles clinico-pathologiques incluaient leucocytose, anémie, hypoalbuminémie, hyperglobulinémie et augmentation des marqueurs inflammatoires. La culture provenant de cinq chevaux permis d'isoler Actinobacillus equuli dans deux cas et Actinobacillus suis d'un cas. Parmi les 20 chevaux inclus dans cette étude, 17 furent euthanasiés et trois furent traités. Seulement un cas avait un suivi de plus d'un an après le congé.(Traduit par Dr Serge Messier).

Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses.

The accuracy of using radiographs to diagnose cervical facet osteoarthritis (CFA) in horses is undetermined. Further investigation is required to determine the clinical significance of radiographic evidence of CFA, the prevalence of radiographic changes in horses without clinical signs, and the long-term efficacy of intra-articular CFA treatment. The objectives of this study is to compare degenerative changes of the cervical facet joints of the cervical vertebrae on radiographs of horses with clinical signs of CFA with healthy cohort-matched horses, to compare clinical findings between groups, and to obtain follow-up information on the long-term outcome in treated horses. This is a retrospective case-control cohort-matched comparison study of horses treated for cervical facet disease versus horses with no clinical signs of cervical facet disease. Horses diagnosed with CFA and treated with intra-articular injection of corticosteroids were included. Follow-up information on recovery from treatment was obtained via telephone survey of owners/trainers. Healthy horses with no clinical signs of CFA were matched to treated horses by breed, sex, age, and sport as the control group. Two blinded radiologists reviewed cervical spine radiographs for each horse and recorded CFA score and intravertebral/intervertebral measurements. Clinical and radiographic parameters were compared between treatment and control groups. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. However, interobserver agreement between radiologists for grading CFA was moderate and only 56% of values were identical for both observers. Atrophy of the neck was present on clinical examination in most cases in the treatment group. Dressage horses were overrepresented. Overall, 64% of horses returned to their previous level of performance after treatment. Clinical examination data collected for the treatment group were retrospective and were obtained by different clinicians. Eight owners/trainers were not able to be reached for the survey. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. Despite these statistical differences, the clinical diagnosis of CFA based on radiographic grading alone is questionable because of the lack of agreement between the radiologists. To strengthen the diagnosis, clinical signs of facet disease, in particular atrophy of the neck muscles, need to be present to make this diagnosis. Intra-articular corticosteroid injection was effective at allowing most treated horses to return to athletic use..

Normograde nasolacrimal placement of an ocular-lavage system for treatment of equine eye diseases.

The standard placement of a subpalpebral lavage system may not be feasible in some horses with eyelid disease. We describe placement of a commercially available, indwelling nasolacrimal lavage system that circumvents eyelid perforation. This novel approach provided for effective delivery of drugs to 1 horse with periocular and corneal disease.

Placement nasolacrymal normograde d'un système de lavage oculaire pour le traitement des maladies de l'oeil des équidés. Le placement standard d'un système de lavage subpalpébral peut ne pas être réalisable chez certains chevaux atteints de maladies oculaires. Nous décrivons le placement d'un système de lavage nasolacrymal à demeure qui évite la perforation de la paupière. Cette approche innovatrice a permis d'administrer des médicaments à un cheval atteint de maladie périoculaire et cornéenne.(Traduit par Isabelle Vallières).

Klossiella equi Infecting Kidneys of Ontario Horses: Life Cycle Features and Multilocus Sequence-Based Genotyping Confirm the Genus Klossiella Belongs In the Adeleorina (Apicomplexa: Coccidia).

Species in the genus Klossiella Smith and Johnson, 1902 are unique among the suborder Adeleorina because they are monoxenous in mammals exclusively, whereas all other reported members of the Adeleorina use invertebrates as definitive hosts. Unlike other coccidia, all members of the Adeleorina undergo syzygy, the association of microgamonts and macrogamonts before maturation to gametes and syngamy. After fertilization, many members of the Adeleorina produce thin-walled polysporocystic oocysts. Despite being biologically similar to other members of the Adeleorina, the phylogenetic placement of the genus Klossiella has been questioned based on its unique host affinity. In the present study, 2 cases of Klossiella equi were reported from the kidneys of horses in Ontario. Details of the life cycle as well as mitochondrial and nuclear 18S ribosomal DNA ( 18S rDNA) sequences were analyzed to provide both morphological and molecular evidence for the phylogenetic placement of K. equi. Initially, various stages of the life cycle were identified in histological slides prepared from the kidney tissue, and DNA was isolated from the infected tissue. Polymerase chain reaction and Sanger sequencing were used to generate a complete mitochondrial genome sequence (6,569 bp) and a partial 18S rDNA sequence (1,443 bp). The K. equi 18S rDNA sequence was aligned with various publicly available apicomplexan 18S rDNA sequences. This alignment was used to generate a phylogenetic tree based on Bayesian inference. Multiple K. equi stages were identified including meronts, microgamonts, and macrogamonts associating in syzygy as well as thin-walled oocysts in various stages of sporogonic development. The 18S rDNA sequence of K. equi positioned within the monophyletic Adeleorina clade. The mitochondrial genome of K. equi contained 3 coding sequences for cytochrome c oxidase I, cytochrome c oxidase III, and cytochrome b as well as various fragmented ribosomal sequences. These components were arranged in a unique order that has not been observed in other apicomplexan mitochondrial genomes sequenced to date. Overall, it was concluded that there were sufficient morphological and molecular data to confirm the placement of K. equi and the genus Klossiella among the Adeleorina. The biological and molecular data obtained from these cases may assist with future studies evaluating the prevalence and life history of this seemingly underreported parasite and better define the impact of K. equi on the health of domestic and wild equids.

Acute Leukemia in Horses.

Leukemia is broadly divided into acute and chronic lymphocytic and myeloid types based on the proportion of blasts, morphology of cells, and expression of specific antigens on neoplastic cells. Classifying leukemia in horses can be challenging if blasts predominate and since few antibodies to identify cell types are available. The objective of this study was to describe in detail the clinical and pathologic features of acute leukemia in horses. Twelve horses ranging from 0.2 to 25.9 years of age were diagnosed with acute leukemia. Six cases were classified as acute lymphocytic leukemia (ALL) based on predominance of blasts, lack of granulocytic or monocytic differentiation, and detection of CD3, CD20, and/or CD79a antigens by immunohistochemistry. Six other cases were classified as acute myeloid leukemia (AML) with myelomonocytic ( n = 4), basophilic ( n = 1), and eosinophilic ( n = 1) differentiation based on > 20% bone marrow blasts and partial leukocytic differentiation. Reactivity with antibodies to Iba-1/AIF-1, CD172a, and CD163 was determined for all cases of AML. Eleven horses had thrombocytopenia, 10 had neutropenia, 8 had anemia, all had blasts on blood films, and none had leukocytosis. Ten horses had increased serum acute phase proteins. Bone marrow cellularity ranged from 30% to 100%, and the proportion of blasts ranged from 80% to 100% and 30% to 60% in ALL and AML, respectively. Horses were severely ill at diagnosis and euthanized within days or weeks. Unique features of acute leukemia in horses compared to other species were variable lymphocyte antigen expression (ALL) and frequent inflammation (ALL and AML).

Usefulness of repeat review of head magnetic resonance images during presurgical epilepsy conferences.

Surgical epilepsy conferences are an important part of the process of determining whether a patient is a candidate for resective epilepsy surgery. At these conferences, repeat review (re-review) of the magnetic resonance images (MRIs) of the patient's head often occurs. This study assessed how often radiologic re-review at a presurgical epilepsy conference resulted in a changed interpretation of the head MRI. Charts were reviewed for 239 patients who had been presented at presurgical epilepsy conferences between 2008 and 2012. Of the 233 patients whose MRIs were re-reviewed, resective surgery was performed in 94 patients (40.3%). Forty-one patients (17.6%) had a previously undiagnosed finding, and 18 of the 41 (43.9%) underwent resective surgery. For 4 of the 41 patients (9.8%) with a previously undiagnosed pertinent finding, re-review detected abnormalities that were not amenable to surgical resection (autoimmunity or significant bilateral pathology).

Patient Use of Complementary and Alternative Medicines in an Outpatient Pediatric Neurology Clinic.

BACKGROUND: This article describes the use of complementary and alternative medicines in an outpatient pediatric neurology clinic, and assesses family attitudes toward the efficacy of complementary and alternative medicines versus prescription medications. Complementary and alternative medicine is an important element of the modern health care landscape. There is limited information about whether, and to what extent, families perceive its utility in childhood neurological disorders. DESIGN/METHODS: Surveys were distributed to 500 consecutive patients at a child neurology clinic in Rochester, Minnesota. Questions pertained to the child's diagnoses, use of complementary and alternative medicines, and the specific complementary and alternative medicine modalities that were used. Opinions were also gathered on the perceived efficacy of complementary and alternative medicines and prescription medications. Data were compared using χ(2) or Fisher exact tests as indicated. RESULTS: A total of 484 surveys were returned, of which 327 were usable. Only 17.4% admitted to use of complementary and alternative medicine to treat neurological problems. However, in follow-up questioning, actually 41.6% of patients recognized that they were using one or more types of complementary and alternative medicines. Disorders associated with a statistically significant increased prevalence of complementary and alternative medicine use were headache (50.8% with headache used complementary and alternative medicine versus 35.7% without headache; P = 0.008, Fisher exact test), chronic fatigue (63.2% vs 38.8%; P = 0.005, Fisher exact test), and sleep disorders (77.1% vs 37.3%; P < 0.0001, Fisher exact test). CONCLUSIONS: A large proportion of pediatric neurology patients in our clinic are also using complementary and alternative medicine. Only 38.5% of these recognize themselves as using complementary and alternative medicine, underlining the need to inquire in-depth about its use. Patients who are less satisfied with their prescription medications are more likely to use complementary and alternative medicine, perhaps reflecting the less tractable nature of their disorders.

Copy number variation in the horse genome.

We constructed a 400K WG tiling oligoarray for the horse and applied it for the discovery of copy number variations (CNVs) in 38 normal horses of 16 diverse breeds, and the Przewalski horse. Probes on the array represented 18,763 autosomal and X-linked genes, and intergenic, sub-telomeric and chrY sequences. We identified 258 CNV regions (CNVRs) across all autosomes, chrX and chrUn, but not in chrY. CNVs comprised 1.3% of the horse genome with chr12 being most enriched. American Miniature horses had the highest and American Quarter Horses the lowest number of CNVs in relation to Thoroughbred reference. The Przewalski horse was similar to native ponies and draft breeds. The majority of CNVRs involved genes, while 20% were located in intergenic regions. Similar to previous studies in horses and other mammals, molecular functions of CNV-associated genes were predominantly in sensory perception, immunity and reproduction. The findings were integrated with previous studies to generate a composite genome-wide dataset of 1476 CNVRs. Of these, 301 CNVRs were shared between studies, while 1174 were novel and require further validation. Integrated data revealed that to date, 41 out of over 400 breeds of the domestic horse have been analyzed for CNVs, of which 11 new breeds were added in this study. Finally, the composite CNV dataset was applied in a pilot study for the discovery of CNVs in 6 horses with XY disorders of sexual development. A homozygous deletion involving AKR1C gene cluster in chr29 in two affected horses was considered possibly causative because of the known role of AKR1C genes in testicular androgen synthesis and sexual development. While the findings improve and integrate the knowledge of CNVs in horses, they also show that for effective discovery of variants of biomedical importance, more breeds and individuals need to be analyzed using comparable methodological approaches.

Breed predisposition and heritability of atrial fibrillation in the Standardbred horse: a retrospective case-control study.

OBJECTIVES: To assess evidence for genetic contributions to atrial fibrillation (AF) in the Standardbred horse. ANIMALS: Equine referrals to the Ontario Veterinary College Health Sciences Centre (OVCHSC) for 1985-2009, and age and gait matched breed registry controls. METHODS: Breeds presenting ≥ 5 times annually were tabulated (admission year and diagnosis; total 40,039; AF 396; no AF 39,643), and breed and year effects examined. Heritability and inbreeding coefficients were determined for Standardbred AF cases and racing contemporaries, and odds ratios for AF were calculated for frequently occurring sires. RESULTS: Year and breed effects on diagnosis were highly significant (Chi-Square 212.85, p < 0.0001, and 304.25, p < 0.0001, respectively). Year effect on diagnosis by breed was significant from 1997, and due to Standardbred admissions each year. Quarterhorses were significantly less likely to present with AF (OR 0.0578-0.6048), Standardbreds were more likely (OR 4.3874-10.9006). Heritability of AF on the underlying scale (h²(u)) was estimated at 29.6 ± 3.9% and on the observed binomial scale (h²(o)), at 9.6%. For horses born in 1994 or later, h²(u) was 31.1 ± 4.3% and h²(o), 10.1%. Of 22 first generation sires appearing ≥ 10 times in the case/control file, seven pacing and one trotting sire produced affected horses more frequently than expected (OR 2.66-66.32). Inbreeding was not a factor. CONCLUSIONS: There is genetic liability to AF in Standardbred horses, likely due to more than single genes with simple Mendelian inheritance. Genomic studies are required.

Patient considerations in the management of focal seizures in children and adolescents.

Focal epilepsy accounts for approximately one-half to two-thirds of new-onset epilepsy in children. Etiologies are diverse, and range from benign epilepsy syndromes with normal neuroimaging and almost certain remission to focal malformations of cortical development or hippocampal sclerosis with intractable seizures persisting lifelong. Other important etiologies in children include pre-, peri-, or postnatal brain injury, low-grade neoplasms, vascular lesions, and neuroimmunological disorders. Cognitive, behavioral, and psychiatric comorbidities are commonly seen and must be addressed in addition to seizure control. Given the diverse nature of focal epilepsies in children and adolescents, investigations and treatments must be individualized. First-line therapy consists of prophylactic antiepileptic drugs; however, prognosis is poor after failure of two to three drugs for lack of efficacy. Refractory cases should be referred for an epilepsy surgery workup. Dietary treatments and neurostimulation may be considered in refractory cases who are not good candidates for surgery.

Methicillin-resistant Staphylococcus aureus in a neonatal alpaca.

A 6-hour-old alpaca was presented for evaluation of respiratory difficulty. As part of routine surveillance, methicillin-resistant Staphylococcus aureus (MRSA) was identified from a nasal swab taken upon admission to the hospital. No signs of MRSA infection were noted. The MRSA strain recovered was a human epidemic clone that has been associated with horses. Methicillin-resistant S. aureus colonization can occur in camelids, and the potential animal and public health risks require consideration.

Removal of a nasogastric tube fragment from the stomach of a standing horse.

An 82-cm fragment of nasogastric tube was removed from the stomach of an adult horse under standing sedation by use of an endoscope and electrocautery snare. This is the first report of successful non-surgical removal of a nasogastric tube fragment from the stomach of a horse.

Influence of electrode position on cardioversion energy requirements during transvenous electrical cardioversion in horses.

OBJECTIVE: To evaluate influence of electrode position on cardioversion energy (CE; energy delivered in the shock at which cardioversion was achieved) during transvenous electrical cardioversion (TVEC) in horses with atrial fibrillation. ANIMALS: 37 horses with atrial fibrillation (41 cardioversion events). PROCEDURES: Records were reviewed to identify horses that underwent TVEC for treatment of atrial fibrillation. Signalment and CE were recorded. Electrode positions in the right atrium and pulmonary artery were identified on intraoperative radiographs. An orthogonal coordinate space was created, and electrode y- and z-axis coordinates and shadow lengths were determined. Trigonometric modeling was used to estimate x-axis electrode positions that resulted in observed shadows. Postmortem casts of catheterized horses were used to assess electrode paths and anatomic relationships. Model assumptions were tested by use of these and a theoretical data set. Relationships between signalment, electrode position, and CE were assessed via multivariate analysis. RESULTS: Sex and y-axis differences between electrode positions were significant predictors of CE. Population stratification based on examination of residuals improved model strength; populations differed in z-axis variables and in CE. Decreasing distance between electrodes and pulmonary artery electrode positions ventral to the right atrium were associated with increased CE. Agreement between estimated and actual x-axis coordinates was poor. CONCLUSIONS AND CLINICAL RELEVANCE: Optimal electrode positioning can reduce the energy requirement for successful TVEC and may eventually support application of TVEC under short-term IV anesthesia and potentially increase chances of treatment response. Further investigation into these relationships is warranted.

Multi-site analytical evaluation of a chemiluminescent magnetic microparticle immunoassay (CMIA) for sirolimus on the Abbott ARCHITECT analyzer.

OBJECTIVE: This study evaluated a new chemiluminescent magnetic microparticle immunoassay (CMIA) for sirolimus on the ARCHITECT analyzer. DESIGN AND METHODS: Patient and laboratory proficiency samples were tested at three European sites and one site in the United States. RESULTS: The CMIA total %CV's were all <8% and the Limit of Quantification (LOQ) was <1.52 ng/mL across the four sites. It cross-reacts to sirolimus metabolites F4 and F5 and showed no hematocrit interference over a range of 25% to 55%. Patient specimen correlations to three LC/MS/MS methods gave R>or=0.91 at three sites and mean biases of 14%, 25% and 39%. CMIA patient specimen correlations to the Abbott IMx gave R>or=0.94 at 2 sites and mean biases of 5.4% and 6.9%. CONCLUSIONS: CMIA is a precise and sensitive immunoassay method without hematocrit interference. It correlates well to both LC/MS/MS and immunoassay results, but shows an expected positive bias to LC/MS/MS.