Arterial blood gas parameters of normal foals born at 1500 metres elevation.

REASONS FOR PERFORMING STUDY: Arterial blood gas analysis is widely accepted as a diagnostic tool to assess respiratory function in neonates. To the authors' knowledge, there are no published reports of arterial blood gas parameters in normal neonatal foals at altitude. OBJECTIVE: To provide information on arterial blood gas parameters of normal foals born at 1500 m elevation (Fort Collins, Colorado) in the first 48 h post partum. HYPOTHESIS: Foals born at 1500 m will have lower PaO2 and PaCO2 than foals born at sea level due to low inspired oxygen and compensatory hyperventilation occurring at altitude. METHODS: Sixteen foals were studied. Arterial blood gas analysis was performed within 1 h of foaling and subsequent samples were evaluated at 3, 6, 12, 24 and 48 h post partum. Data were compared to those previously reported in healthy foals born near sea level. RESULTS: Mean PaO2 was 53.0 mmHg (7.06 kPa) within 1 h of foaling, rising to 67.5 mmHg (9.00 kPa) at 48 h post partum. PaCO2 was 44.1 mmHg (5.88 kPa) within one hour of foaling, falling to 38.3 mmHg (5.11 kPa) at 48 h. Both PaO2 and PaCO2 were significantly lower in foals born at 1500 m elevation than those near sea level at several time points during the first 48 h. CONCLUSIONS AND POTENTIAL RELEVANCE: Foals at 1500 m elevation undergo hypobaric hypoxia and compensatory hyperventilation in the first 48 h. Altitude specific normal arterial blood values are an important reference for veterinarians providing critical care to equine neonates.

Results of AlloDerm use in abdominal hernia repair.

BACKGROUND: AlloDerm (decellularized human cadaveric dermis) is increasingly being used for tissue reconstruction and hernia repairs. This article presents the results of AlloDerm use in treating abdominal wall hernias by analyzing all patients who underwent repair with AlloDerm at our institution. METHODS: A series of 70 consecutive patients starting in October 2003 with abdominal wall hernia repair using AlloDerm was studied. This study began as a retrospective chart review, which included subsequent postoperative follow-up. SPSS version 11.5 was used for statistical analysis, and parametric tests were conducted. Various technical variables (type of AlloDerm placement, mesh-suture technique, suture type) and nontechnical variables (steroids use, obesity, smoking status, diabetes, prior surgeries, number of comorbidities) were evaluated. RESULTS: Of 70 study patients, 31 were men and 39 were women, with a mean age of 58 (range 25-88) years. Fifty-six patients (80%) had no complications, whereas 14 (20%) suffered one or more complications. Of those patients with complications, there was one rejection, two infections, and 14 hernia recurrences. The overall complication rate was 24%. Of patients with hernia recurrences, one had the initial repair with AlloDerm implant of <1.8-mm thickness (thick) and 13 patients had their initial repair with AlloDerm implant of >1.8-mm thickness (ultrathick). The 14 patients with recurrences include three who had a prior AlloDerm repair with ultrathick implant. Two of these three patients reported abdominal wall protrusion, and one had a recurrence between two pieces of AlloDerm used in the initial repair. Of these 14 patients, nine had subsequent repair of their recurrence with synthetic mesh, and four had subsequent repair with AlloDerm with satisfactory outcomes; one patient was yet to have a repair at the time of this paper. Recurrence rates with ultrathick and thick AlloDerm were 23% and 6%, respectively. None of the patients who were on steroid therapy had complications. Mesh-suture technique had no effect on recurrence. Type of placement was positively correlated with infection (Pearson's R 0.575, p 0.05), showing that onlay mesh is better than underlay/interpositional mesh in having a lower infection rate. Diabetes was associated with mesh infection (Pearson's R 0.548, p 0.05), and redo hernia repair was associated with longer length of hospital stay (LOS). The average number of comorbidities was five for the series. LOS positively correlated with presence of comorbidities. CONCLUSIONS: Early results in repair of abdominal hernia with AlloDerm appear to have a complication rate of 24%. Recurrence is the most common complication. Thinner AlloDerm use has better outcomes with less recurrence. Careful analysis regarding the technical aspects and presence of comorbidities may be explored to improve the present outcomes to prevent recurrences.

Occurrence of infectious upper respiratory tract disease and response to vaccination in horses on six sentinel premises in northern Colorado.

REASONS FOR PERFORMING STUDY: Horses vaccinated against common agents of infectious upper respiratory disease (IURD) may not have detectable serum antibody and may not be protected from clinical disease. OBJECTIVES: The objectives of this study were to 1) investigate the serological response of horses to vaccination against influenza virus (H3N8 and H7N7) and equine herpesviruses (EHV) in a field setting and 2) evaluate associations among vaccination status, serum antibody concentrations, and occurrences of IURD in monitored horses. METHODS: In this study, horses on 6 Colorado premises were vaccinated parenterally against influenza virus and EHV, and serological response evaluated. Horses were monitored, and biological samples collected from individuals with clinical IURD and control horses. RESULTS: Of 173 horses, 61 (35.3%), 21 (12.1%) and 4 (2.3%) seroconverted in response to vaccination against EHV, influenza virus H7N7 and influenza virus H3N8, respectively. CONCLUSIONS: Outbreaks of IURD in study horses were associated with influenza virus H3N8 and Streptococcus equi infection, and serological response to vaccination with conventional products was poor. POTENTIAL RELEVANCE: These results confirm that horses may not respond with detectable serological responses to conventional vaccination against common respiratory viruses and, therefore, suggest that alternate methods of protecting horses against common respiratory viruses should be sought.

The value of creep feeding during the last 84, 56, or 28 days prior to weaning on growth performance of nursing calves grazing endophyte-infected tall fescue.

To evaluate limiting the number of days that calves are creep fed, 84 crossbred cows (frame score 4) nursing steer calves were randomly assigned to three replicates over 2 yr to receive one of four lengths of creep feeding (0, 28, 56, or 84 d) for cows and calves grazing endophyte-infected tall fescue. There were no differences in cow performance due to treatments. Calf daily gain increased (P < .001) as the length of time exposed to creep increased. In yr 1, creep intake increased (P < .05) as the length to time exposed to creep increased. In yr 2, there was no difference in intake by period among 28-, 56-, and 84-d treatments. Supplemental feed efficiency was best for 56 and 84 d, and the 28-d treatment was extremely poor. During the feedlot phase, there were differences in performance between the 2 yr and there were no differences in carcass composition due to length of time receiving creep feed. Overall, creep feeding calves for 56 or 84 d improved performance, and the 56-d calves had the most efficient gain. Creep feeding calves for 28 d showed no advantage during the creep feeding period or in the feedlot. Four ruminally fistulated nursing steer calves were used in a 4 x 4 Latin square design to receive treatments of forage alone or .68 kg, 1.13 kg, or 2.27 kg/d of creep plus high-quality, freshly harvested forage available on an ad libitum basis. Forage OM intake and NDF digestibility tended (P = .11) to decrease as intake of creep feed increased. The pH decreased (P < .001), molar proportion of propionate tended to increase (P = .06), and acetate tended to decrease (P = .07) as the level of creep feed intake increased. Higher levels of creep feed tended to cause a decrease in ruminal fiber digestibility and forage intake. Creep feeding calves for 56 or 84 d improved gain; 56 d had the most efficient supplemental gain. Creep feeding calves for 28 d showed no advantage during the creep feeding period or in the feedlot.

Respiratory stridor associated with polymyopathy suspected to be hyperkalemic periodic paralysis in four quarter horse foals.

Four Quarter Horse foals ranging in age from 6 days to 2 months were determined to have upper airway stridor secondary to polymyopathy suspected to be hyperkalemic periodic paralysis. Electromyography revealed spontaneous muscle activity in all muscles examined. Electromyographic findings were similar in the dams of 3 foals (No. 1, 3 and 4). Hyperkalemia was found in foals 1 and 4. Endoscopically, the upper airway stridor in foals 1 and 3 was confirmed to be attributable to laryngeal and pharyngeal collapse or spasm. Foals 1, 2, and 3 were treated with acetazolamide. Foal 4 was not treated, at the owner's request. Foals 2 and 3 improved with treatment, foal 4's condition was static, and foal 1 required a tracheostomy and laryngeal surgery to manage its upper airway stridor.

Alprazolam in the treatment of cardiology patients with atypical chest pain and panic disorder.

Ten cardiology chest pain patients without clinical evidence of coronary artery disease and with panic disorder were enrolled in an open label trial of alprazolam. Two dropped out at week 3 because of excessive side effects. The eight study completers showed significant decreases in both Hamilton Anxiety and Hamilton Depression scales by week 2 that remained significant by week 8. On the physician's global impression of change since baseline, all completers were rated at least "much improved." Seven experienced a 50% or greater reduction in panic frequency at week 8 compared to baseline. These results suggest that alprazolam is likely to be of benefit to this patient population.