Nasal high flow oxygen therapy in hospitalised neonatal foals.

BACKGROUND: Respiratory disease is common in critically ill neonatal foals. Traditional oxygen therapy (TOT) with nasal insufflation of oxygen is often used to provide first-line respiratory support. Mechanical ventilation is used in foals which require a greater level of support but requires specialist expertise and can be associated with significant complications. Non-invasive ventilation (NIV) enables a greater level of respiratory support without the need for intubation. High flow oxygen therapy (HFOT) is a mode of NIV commonly used in human intensive care. OBJECTIVES: To describe the use of HFOT in hospitalised neonatal foals. STUDY DESIGN: Retrospective case series. METHODS: Hospital records of neonatal foals admitted between 2018 and 2019 that received treatment with HFOT were reviewed. Clinical data and complications were recorded. RESULTS: Fourteen foals were identified and the median duration of use was 43 hours (range 2-93 hours) with a median flow rate of 0.7L/kg/min (range 0.42-1.67). Ten foals survived to discharge. No significant complications associated with the technique were recorded. MAIN LIMITATIONS: A small study population which was retrospectively reviewed. CONCLUSIONS: This study provides preliminary information about the clinical use of HFOT in neonatal foals. The technique was well tolerated and no significant adverse effects were noted. However, further study is required to evaluate efficacy.

New approaches to aquatic and terrestrial animal surveillance: The potential for people and technology to transform epidemiology.

Epidemiology provides insights about causes of diseases and how to control them, and is powered by surveillance information. Animal health surveillance systems typically have been designed to meet high-level government informational needs, and any incentives for those who generate data (such as animal owners and animal health workers) to report surveillance information are sometimes outweighed by the negative consequences of reporting; underreporting is a serious constraint. This problem can persist even when modern advances in information and communications technology (ICT) are incorporated into the structure and operation of surveillance systems, although some problems typical of paper-based systems (including timeliness of reporting and response, accuracy of data entry, and level of detail recorded) are reduced. On occasions, however, additional problems including sustainability arise. We describe two examples of a philosophical approach and ICT platform for the development of powerful and sustainable health information systems that are people-centred and do not exhibit these typical problems. iSIKHNAS is Indonesia's integrated animal health information system, and PIISAC is a sustainable secure research platform based on full production data from participating commercial Chilean aquaculture companies. Epidemiologists working with these systems are faced with interesting new challenges, including the need to develop skills in extracting appropriate surveillance outcomes from large volumes of continually-streaming data.

Episcleral cyclosporine A implants for the management of unilateral keratoconjunctivitis sicca in an 8-year-old mare.

An 8-year-old mare was presented for investigation of a 1-month history of blepharospasm, eyelid swelling, corneal edema, and ocular discharge of the right eye (OD). Ophthalmic examination confirmed mucopurulent ocular discharge, conjunctival hyperemia, and a dry, dull appearance to the cornea OD. Schirmer tear test results confirmed an absence of tear production OD (0 mm/min) consistent with keratoconjunctivitis sicca. Treatment with topical 0.2% cyclosporine A resulted in an improvement in clinical signs. An episcleral cyclosporine A implant was placed under standing sedation 5 days after initial presentation. Re-examination 9 days post-operatively confirmed that the mare's tear production in the right eye had improved and no further clinical signs had been observed. Topical medications were gradually discontinued. Re-examinations performed up to 12 months postsurgery showed no recurrence of clinical signs and no adverse effects of the implant. To our knowledge, this is the first report of the use of a cyclosporine A implant in the management of KCS in a horse and highlights its potential as an effective, alternative therapy in the management of KCS in horses.

Feminist bioethics and genetic termination.

A brief discussion of how relational autonomy, phenomenological theories of embodiment and narrative approaches to clinical ethics can open up the space for more subtle feminist ethical reflection about genetic termination.