Principles and Practice of Therapeutic Exercise for Horses

Physical therapists are an integral component of the medical team in human health care. They are backed by a solid foundation of basic science and clinical research. Veterinarians have only recently begun to incorporate physical therapy into clinical practice, but without formal research that validates therapeutic interventions specific to equine patients. The purpose of this article is to present a series of therapeutic exercises adapted for horses based on knowledge and experience of human physical therapy, equine biomechanics, and the types of movement dysfunction commonly seen in the performance horse. Injuries, lameness and musculoskeletal pain syndromes, frequently encountered in equine practice, are disorders that may be successfully addressed with physical therapy. Incorporating standard therapeutic interventions based on clinical success in humans, basic science research, or expert opinion is possible with the understanding that these techniques will ultimately be accepted or refuted when their success or failure is formally documented. This review is designed to stimulate discussion and encourage research that will add to the knowledge base and lead to effective therapeutic protocols in the equine patient.     

Characterization of Horse Use in Therapeutic Horseback Riding Programs in the United States: A Pilot Survey

With increasing public scrutiny on animal welfare, it behooves those involved in the equine industry to revisit best management practices to ensure these support healthy horses. There is little published research on how horses are used in the equine industry, particularly in therapeutic horseback riding (THR) programs. Although there is a large amount of information on the benefits of THR programs to the participants, there is little published information available about the horses. Therefore, the objective of this survey was to gather data regarding horse use and care in Professional Association of Therapeutic Horsemanship International (PATH Intl.)–affiliated THR programs in the United States to help establish a foundation for a standard of care. A 20-question survey sent to 659 PATH Intl.–affiliated THR programs returned a 40% response rate. Demographics demonstrated that the median number of horses in each program was 10; geldings outnumbered mares; most horses were between 16 and 20 years of age; and Quarter Horse or stock-type breeds predominated. Median session length was 8 weeks and median lesson length was 45 minutes. Horses were typically ridden by clients 4 days/week and 2 hours/day. Most horses were donated to the programs, participated for approximately 7 years, and left because of aging. Limb lameness and back soreness were the top health issues noted, with only a small percentage of colic and ulcers reported. More horses received nonsteroidal anti-inflammatory drugs for a lameness issue, chiropractic adjustment, and massage than any other supplemental care or complementary therapy. Based on data gathered in this survey, THR horses were not worked excessively. Horses were ridden less than PATH Intl.’s maximum recommendation of 6 hours/day and 6 days/week and less than those used in university programs. Horses in THR programs also appeared to have fewer reported health issues as compared with data in other national reports.     

Optimal Testing for Thyroid Hormone Concentration after Treatment with Methimazole in Healthy and Hyperthyroid Cats

Background: Methimazole suppresses thyroid hormone synthesis and is commonly used to treat feline hyperthyroidism. The degree of variation in thyroid hormone concentrations 24 hours after administration of methimazole and optimal time for blood sampling to monitor therapeutic efficacy have not been determined.
Objective: To assess thyroid hormone concentration variation in serum of normal and hyperthyroid cats after administration of methimazole.
Animals: Four healthy cats and 889 retrospectively acquired feline thyroid hormone profiles.
Methods: Crossover and retrospective studies . In the crossover study, healthy cats were treated with increasing doses of oral methimazole until steady state of thyroid suppression was achieved. Thyroid hormones and thyroid stimulating hormone (TSH) were serially and randomly monitored after methimazole. Paired t -tests and a 3-factor analysis of variance were used to determine differences between thyroid hormone concentrations in treated and untreated cats in the crossover study. Thyroid profiles from methimazole-treated hyperthyroid cats were retrieved from the Diagnostic Center for Population and Animal Health database and reviewed. Linear regression analysis evaluated relationships of dosage (mg/kg), dosing interval (q24h versus q12h), and time after methimazole to all thyroid hormone concentrations.
Results: All serum concentrations of thyroid hormones were significantly suppressed and TSH was significantly increased for 24 hours after administration of oral methimazole in healthy cats ( P < .005). In hyperthyroid cats, there were no significant relationships between thyroid hormone concentrations and time postpill or dosing interval.
Conclusions: Timing of blood sampling after oral methimazole administration does not appear to be a significant factor when assessing response to methimazole treatment.     

安徽兔附红细胞体病流行情况调查与治疗试验

以血液涂片直接和染色镜检法为检查的主要手段,对安徽各地的兔附红细胞体病流行情况进行了调查,结果显示：各地普遍存在兔附红细胞体的感染与发病,调查的41家兔场均存在附红细胞体感染（感染率为83,33％-100％）。治疗试验结果表明,联合用药效果较好,贝尼尔＋强力霉素的治愈率为92,7％,贝尼尔＋土霉素的治愈率为85．4％。     

Plasma Peak and Trough Gentamicin Concentrations in Hospitalized Horses Receiving Intravenously Administered Gentamicin

Background

Gentamicin is an aminoglycoside antimicrobial commonly used in horses at 6.6 mg/kg IV once daily. Therapeutic drug monitoring (TDM) can confirm desired peak concentration is reached for common bacterial isolates, and detect toxicosis associated with high trough values.

Objectives

Determine the relationship between gentamicin dose and plasma concentration in hospitalized horses, and identify a starting dose range to achieve peaks > 32 μg/mL.

Animals

Sixty‐five horses (2002–2010) receiving once‐daily gentamicin with TDM performed (N = 99 sets).

Methods

Retrospective study. Data from hospitalized horses including weight, dose, plasma peak, and trough gentamicin concentration, creatinine concentrations and presence of focal or systemic disease were collected from medical records. Peak concentrations measured 25–35 minutes after administration were included (N = 77). Data were divided into low (<7.7 mg/kg), medium (7.7–9.7 mg/kg) and high (>9.7 mg/kg) dose groups, and were grouped by the horse having focal or systemic disease.

Results

Peak concentrations resulting from doses ≥7.7 mg/kg were 5.74 μg/mL (SE 2.1 μg/mL) greater than peaks from doses <7.7 mg/kg (P = .007). Peak concentrations was 3.6 times more likely to be >32 μg/mL if dose was ≥7.7 mg/kg (P = .04). There were no significant effects of dose on trough or creatinine concentration. At a given dose, horses with focal disease had higher peaks than those with systemic disease (P = .039).

Conclusions and Clinical Importance

These data suggest gentamicin dosage should be individually determined in horses using TDM, but support an initial once‐daily dose of 7.7–9.7 mg/kg IV to achieve peaks >32 μg/mL and trough concentrations <2 μg/mL. Further studies evaluating the safety of doses >6.6 mg/kg are required.     

Oral Cyclosporine Treatment in Dogs: A Review of the Literature

Cyclosporine is an immunomodulatory drug used to treat an increasing spectrum of diseases in dogs. Cyclosporine is a calcineurin inhibitor, ultimately exerting its inhibitory effects on T‐lymphocytes by decreasing production of cytokines, such as interleukin‐2. Although, in the United States, oral cyclosporine is approved in dogs only for treatment of atopic dermatitis, there are many other indications for its use. Cyclosporine is available in 2 oral formulations: the original oil‐based formulation and the more commonly used ultramicronized emulsion that facilitates oral absorption. Ultramicronized cyclosporine is available as an approved animal product, and human proprietary and generic preparations are also available. Bioavailability of the different formulations in dogs is likely to vary among the preparations. Cyclosporine is associated with a large number of drug interactions that can also influence blood cyclosporine concentrations. Therapeutic drug monitoring (TDM) can be used to assist in attaining consistent plasma cyclosporine concentrations despite the effects of varying bioavailability and drug interactions. TDM can facilitate therapeutic success by guiding dose adjustments on an individualized basis, and is recommended in cases that do not respond to initial oral dosing, or during treatment of severe, life‐threatening diseases for which a trial‐and‐error approach to dose adjustment is too risky. Pharmacodynamic assays that evaluate individual patient immune responses to cyclosporine can be used to augment information provided by TDM.     

Treatment With Therapeutic Bandages to Control Equine Postarthroscopic Tibio-Patellofemoral Swelling

The aim of this study was to evaluate the effect of therapeutic bandages, the Kinesio Taping Method (KTM), in controlling swelling following arthroscopic tibio-patellofemoral surgery in horses. In vivo experimental study was studied. Twelve horses undergoing experimental tibio-patellofemoral arthroscopy were divided into two groups: six animals in the control group (CG) (without tape) and six animals in the treatment group (TG) that received therapeutic bandages based on the KTM. All of the horses were evaluated by thermography of the lateral and cranial aspect of the joint as well as by a perimeter assessment of the tibio-patellofemoral joint. The TG showed greater control of postoperative swelling with a significant reduction in swelling after 24 hours of treatment compared to the CG staying up to 72 hours, but there were no significant differences in temperature based on the thermography. In this study, which was unprecedented in horses, the use of therapeutic bandages resulted in a significant reduction in postoperative swelling of tibio-patellofemoral arthroscopy in horses compared with CG. Although often employed in human rehabilitation, this therapy is potentially beneficial for veterinary rehabilitation, specifically in horses.