Reproducibility and repeatability of M-mode echocardiographic measurements collected from 25 normal horses

Three different operators with varying levels of experience made repeated echocardiographic measurements of the aortic root diameter, interventricular septal thickness, left ventricular internal diameter, and left ventricular free wall thickness of 25 horses using a 3.5 MHz transducer. Each operator followed specific guidelines in order to determine the reproducibility (inter-operator variation) and repeatability (intra-operator variation) of their measurements. Variations due to horse differences, operator differences, and horse by operator interactions were determined. The largest variation was due to differences between horses. Inter-operator-based variability was only significant with respect to interventricular septal and aortic root measurements. All other measurements were reproducible and repeatable when obtained by well-trained operators. The experience of operators affects reproducibility and repeatability, however. It was concluded that different operators could apply equine M-mode echocardiography to obtain measurements of ventricular chamber and free wall dimensions that can be legitimately compared to measurements obtained by others if operators are adequately trained and landmarks are clearly standardized.     

Effects of mosapride citrate, metoclopramide hydrochloride, lidocaine hydrochloride, and cisapride citrate on equine gastric emptying, small intestinal and caecal motility

Objective

Although extensive work has been done to elucidate the beneficial and unfavorable effects of gastrointestinal prokinetic agents in humans, little is known on the effects of these agents in horses. In this study, we compared the effects of mosapride, metoclopramide, cisapride, and lidocaine on equine gastric emptying, jejunal and caecal motility and evaluated these agents’ adverse drug reactions (ADRs).

Animals

Seven healthy adult Thoroughbreds.

Procedure

Mosapride 1.0 mg/kg and 2.0 mg/kg, metoclopramide 0.2 mg/kg, and cisapride 1.0 mg/kg were dissolved in 100 mL distilled water for oral administration. Lidocaine 1.3 mg/kg was mixed with 500 mL saline for a 30-min intravenous infusion. Oral administration of 100 mL distilled water was used as control. Gastric emptying was evaluated using ¹³CO₂ breath test, and jejunal and caecal motility was assessed by electrointestinography.

Results

The present study demonstrates that mosapride at doses of 1.0 mg/kg and 2.0 mg/kg facilitates gastric emptying in horses. Improved jejunal motility was observed following administration of mosapride (1.0 mg/kg and 2.0 mg/kg), metoclopramide (0.2 mg/kg), and cisapride (1.0 mg/kg). Similarly, improved caecal motility was observed following administration of mosapride (2.0 mg/kg).

Conclusions and clinical relevance

This study shows that among the prokinetic agents studied here, only mosapride (2.0 mg/kg) promotes jejunal and caecal motility in horses. Considering mosapride ADRs profile, it is believed that this compound is useful in the treatment of diseases associated with decreased GI motility, including postoperative ileus.     

Comparison of a new laser beam wound camera and a digital photoplanimetry-based method for wound measurement in horses

The aim of this study was to compare the accuracy, precision, inter- and intra-operator reliability of a new laser beam (LB) wound camera and a digital photoplanimetry-based (DPB) method for measuring the dimensions of equine wounds. Forty-one wounds were created on equine cadavers. The area, circumference, maximum depth and volume of each wound were measured four times with both techniques by two operators. A silicone cast was made of each wound and served as the reference standard to measure the wound dimensions.The DPB method had a higher accuracy and precision in determining the wound volume compared with the LB camera, which had a higher accuracy in determining the wound area and maximum depth and better precision in determining the area and circumference. The LB camera also had a significantly higher overall inter-operator reliability for measuring the wound area, circumference and volume. In contrast, the DPB method had poor intra-operator reliability for the wound circumference. The LB camera was more user-friendly than the DPB method.The LB wound camera is recommended as the better objective method to assess the dimensions of wounds in horses, despite its poorer performance for the measurement of wound volume. However, if the wound measurements are performed by one operator on cadavers or animals under general anaesthesia, the DPB method is a less expensive and valid alternative.     

Omega‐3 Fatty Acid Supplementation Provides an Additional Benefit to a Low‐Dust Diet in the Management of Horses with Chronic Lower Airway Inflammatory Disease

Background

Omega‐3 polyunsaturated fatty acid (PUFA) may benefit humans and animals with chronic inflammatory diseases.

Hypothesis

Omega‐3 PUFA supplementation improves clinical signs, lung function, and airway inflammation in horses with recurrent airway obstruction (RAO) and inflammatory airway disease (IAD).

Animals

Eight research horses and 35 client‐owned horses.

Methods

A pilot study examined the dose of PUFA that can alter plasma PUFA composition. Then, a randomized, controlled clinical trial was performed in horses with RAO and IAD. Horses were fed a complete pelleted diet with no hay and randomly assigned to 1 of 3 daily treatments for 2 months: 30 or 60 g of the supplement or 30 g of placebo. Clinical signs, lung function, plasma PUFA composition, and bronchoalveolar lavage fluid (BALF) cytology were evaluated. Data were expressed as median (25–75th percentiles). P < .05 was considered significant.

Results

Polyunsaturated fatty acid supplementation resulted in increased plasma docosahexaenoic acid (DHA) that peaked at 4 weeks. Clinical improvement was noted in all horses involved in the clinical trial, but the group that received PUFA had greater improvement in clinical signs (cough score improved 60%), lung function (respiratory effort decreased 48%), and BALF (neutrophils decreased from 23 to 9%) when compared to placebo (cough score improved 33%, respiratory effort decreased 27%, BALF neutrophils increased from 11 to 17%; P < .05).

Conclusions and Clinical Importance

Feeding horses with RAO and IAD a PUFA supplement containing 1.5–3 g DHA for 2 months provides an additional benefit to low‐dust diet.     

Postnatal autonomic activity in the preterm lamb

Background

Early postnatal abnormalities of autonomic nervous system (ANS) activity, including at baseline and following cardiorespiratory challenge, are involved in apneas-bradycardias of prematurity, apparent life-threatening events of infancy and sudden infant death syndrome. Literature data suggest that baseline ANS activity does not mature normally after premature birth.

Objectives

This study performed in preterm lambs was aimed at assessing ANS maturation at baseline and following laryngeal chemoreflexes (LCR), a group of reflexes triggered by the contact of liquids with the laryngeal mucosa.

Methods

Heart rate variability (HRV) and baroreflex sensitivity (BRs) were measured at baseline and after LCR during polysomnographic recordings performed in five non-sedated lambs born 15 days prematurely. Laryngeal chemoreflexes were induced by distilled water or acid (pH 2) during sleep and wakefulness on postnatal days 7 (D7) and 14 (D14, full-term equivalence).

Results

While the life-threatening cardiorespiratory events of the LCR observed at D7 were no longer present at D14, baseline and post-LCR HRV and BRs indices were significantly lower at D14 compared to D7 (up to p < 0.001). These results suggest that an initial autonomic overactivity was present at D7 and normalized at D14.

Conclusion

The autonomic cardiac and baroreflex control appears to follow a specific evolution in the preterm compared to the full-term newborn lamb, with an important initial autonomic stress, which normalizes at an age equivalent to full-term. Potential relevance of these findings in relation to anomalies of cardiac control in the early postnatal period, such as apneas-bradycardias of prematurity, apparent life-threatening events of infancy and sudden infant death syndrome, awaits further studies.     

Autoantibodies to recombinant canine proinsulin in canine diabetic patients

Objective

To determine whether dogs with spontaneously-occurring diabetes mellitus demonstrate serological reactivity to proinsulin.

Sample population

Serum samples were collected from 15 newly-diagnosed diabetic, 15 insulin-treated diabetic and 15 non-diabetic control dogs.

Procedures

Canine proinsulin was cloned into a prokaryotic expression vector to generate recombinant poly-histidine-tagged protein in Escherichia coli. A Western blotting assay was developed for detection of proinsulin autoantibodies in canine sera.

Results

Reactivity to canine proinsulin was detected in 3 of 15 control dogs, 8 of 15 newly-diagnosed diabetic dogs and 6 of 15 insulin-treated diabetic patients. Of these reactors, only 1 control dog, 1 newly-diagnosed diabetic dog and 3 insulin-treated diabetic dogs recognised porcine insulin by ELISA, suggesting that the remaining proinsulin reactors might have been recognising proinsulin-specific epitopes.

Conclusions and clinical relevance

This study suggests that proinsulin autoantibodies are present in a proportion of diabetic dogs. Further work is required to refine the assay and clarify the significance of these autoantibodies.     

No evidence of horizontal infection in horses kept in close contact with dogs experimentally infected with canine influenza A virus (H3N8)

Background

Since equine influenza A virus (H3N8) was transmitted to dogs in the United States in 2004, the causative virus, which is called canine influenza A virus (CIV), has become widespread in dogs. To date, it has remained unclear whether or not CIV-infected dogs could transmit CIV to horses. To address this, we tested whether or not close contact between horses and dogs experimentally infected with CIV would result in its interspecies transmission.

Methods

Three pairs of animals consisting of a dog inoculated with CIV (10^8.3 egg infectious dose₅₀/dog) and a healthy horse were kept together in individual stalls for 15 consecutive days. During the study, all the dogs and horses were clinically observed. Virus titres in nasal swab extracts and serological responses were also evaluated. In addition, all the animals were subjected to a gross pathological examination after euthanasia.

Results

All three dogs inoculated with CIV exhibited clinical signs including, pyrexia, cough, nasal discharge, virus shedding and seroconversion. Gross pathology revealed lung consolidations in all the dogs, and Streptococcus equi subsp. zooepidemicus was isolated from the lesions. Meanwhile, none of the paired horses showed any clinical signs, virus shedding or seroconversion. Moreover, gross pathology revealed no lesions in the respiratory tracts including the lungs of the horses.

Conclusions

These findings may indicate that a single dog infected with CIV is not sufficient to constitute a source of CIV infection in horses.     

Comparison of the effects of an intravenous lidocaine infusion combined with 1% isoflurane versus 2% isoflurane alone on selected cardiovascular variables and recovery characteristics during equine general anaesthesia

Objectives

To compare the effects of a lidocaine constant rate infusion (CRI) combined with 1% isoflurane versus those of 2% isoflurane alone on cardiovascular variables in anaesthetized horses, and to estimate the sample size required to detect a difference in recovery quality.

The T wave in the V10 precordial electrocardiographic lead is negative in healthy Chihuahua dogs

Objectives

The T wave polarity in the V10 precordial electrocardiographic (ECG) lead in Chihuahuas is described as positive in the veterinary literature. The aim of this study was to investigate the polarity of the T wave in the V10 precordial ECG lead in clinically healthy Chihuahuas. Our null hypothesis was that healthy Chihuahuas have a negative T wave in V10.

Animals, materials and methods

In this prospective study, 67 healthy breeder-owned Chihuahuas were used. A physical examination, 10-lead ECG and an echocardiogram were performed on each dog.

Results

No cardio-respiratory abnormalities were revealed in any of the otherwise healthy dogs. Three out of 67 ECGs were of insufficient quality because of baseline artifacts due to movement of the animal. Two other ECGs showed a nearly iso-electric T wave in the V10 lead. The remaining 62 ECGs showed negative T waves in the V10 lead. Right ventricular hypertrophy was excluded with echocardiography in all dogs.

Conclusion

In contrast to previous reports, we found that healthy Chihuahuas have negative T wave in the V10 precordial ECG lead.     

Quantification of pulmonary to systemic flow ratio by a Doppler echocardiographic method in the normal dog: Repeatability, reproducibility, and reference ranges

Objective

To determine if the pulmonary to systemic flow ratio (Qp/Qs) could be assessed in healthy awake dogs using Doppler echocardiography.

Background

Qp/Qs could provide reliable information in assessing the severity of intracardiac shunts (ICS) by quantifying pulmonary overcirculation. Qp/Qs has been validated against electromagnetic flowmeter methods in experimental canine models. However, its clinical applicability in awake dogs has never been assessed.

Animals, materials and methods

Six healthy dogs were used to determine the repeatability and reproducibility of the technique (Study 1); Qp/Qs was then prospectively assessed in 50 healthy dogs (Study 2). In both studies Qp/Qs was calculated in awake animals using a standardized Doppler echocardiographic method.

Results

Within- and between-day coefficients of variation for Qp/Qs were <10% (Study 1). For Study 2, a relatively wide range of Qp/Qs was found (reference range = 0.71-1.29; mean ± SD = 1.00 ± 0.15).

Conclusions

Qp/Qs can be assessed with good repeatability and reproducibility in healthy dogs. However, the wide range of Qp/Qs obtained in the healthy population may suggest a limited usefulness of this variable for accurately assessing ICS severity in diseased animals. This needs to be assessed in further prospective and longitudinal studies including a large number of animals with ICS of various grades.     

Analysis of weight uniformity, content uniformity and 30-day stability in halves and quarters of routinely prescribed cardiovascular medications

Objectives

Congenital and acquired cardiac disorders are frequently diagnosed in small breed dogs and cats. In order to appropriately dose cardiovascular drugs for small patients, fractions of commercially available tablets must be prescribed. The aims of this study were to evaluate weight and content uniformity and 30-day chemical stability in halves and quarters of 11 drug formulations commonly prescribed to treat cardiovascular disorders in small breed dogs and cats.

Animals, materials and methods

Fifteen tablets from 11 drug formulations were obtained within the same lot. Tablets were split by a single operator using a commercially available pill splitter. Whole tablets, halves and quarters were weighed and stored in plastic containers. High-pressure liquid chromatography or liquid chromatography with mass spectrometry were utilized to determine drug content and repeated 30 days later to estimate chemical stability.

Results

Statistically significant weight variability, content non-uniformity and chemical degradation were found for some formulations. Digoxin showed a significant degradation that should be considered in clinical practice.

Conclusions

It appears that pill splitting is overall a relatively reliable practice; however tablets should not be split ahead of time but only immediately prior to intended usage.     

Twenty-four hour Holter monitoring of unsedated healthy cats in the home environment

Objective

To determine the heart rate, rhythm, number of ventricular premature complexes (VPCs) and atrial premature complexes (APCs) in unsedated cats using Holter monitoring.

Animals, materials and methods

Twenty-three healthy client owned cats were used. Clinical examination, blood pressure measurements, echocardiographic examination and serum biochemical analysis were performed. A lightweight Holter was used in the home environment.

Results

Three-lead electrocardiographic registrations of good quality were obtained from all cats. Normal sinus rhythm was present in all cats. The median heart rate was 165 beats per minute (bpm), range 70-303 bpm. Mean heart rate varied significantly with age and gender. Sinus arrhythmia occurred intermittently in 18 cats (78%). Uncommon ventricular premature complexes occurred in 18 (78%) of the cats. The median number of VPCs per cat was 3 complexes/24 h period, range 0-146. Cats 7-15 years of age had significantly more VPCs than cats 1-6 years of age (median 6 versus 1 per 24 h period, p = 0.04). A single APC occurred in one cat (4%).

Conclusions

Cats commonly have intermittent sinus arrhythmia. Many healthy cats have rare single VPCs per 24 h period. Old cats have significantly more VPCs than young cats. The heart rate varies significantly with age and gender.     

A systematic review-meta-analysis of chilling interventions and a meta-regression of various processing interventions for Salmonella contamination of chicken

Context

The results of individual studies investigating the efficacy of chilling and other processing interventions on Salmonella prevalence or concentration in broiler chicken carcasses are inconsistent or contradictory.

Objective

Determine efficacy of chilling on reducing Salmonella prevalence or concentration on broiler carcasses using systematic review-meta-analysis, and explore sources of heterogeneity among studies investigating various processing interventions through meta-regression.

Data sources

A comprehensive search included electronic search in six databases, manual search of reference lists of topic-related articles, and consultation with five topic experts to assure that all relevant intervention research was identified.

Study inclusion

Primary intervention research, published in English, encompassing control, challenge, cohort, or before-and-after study designs investigating the efficacy of any chilling or other processing interventions on Salmonella prevalence or concentration in broiler chicken carcasses.

Risk of bias assessment and data extraction

Data pertaining to study methodology and reported results, chilling or other processing intervention parameters, populations sampled and outcomes measured were assessed for methodological soundness and extracted by two independent reviewers using pretested checklists.

Results

Random-effects meta-analyses of immersion chilling with chlorine (n = 9 trials), acetic acid (n = 16) and potable water (n = 13) trended towards reductions in the odds or log₁₀ CFU/ml of Salmonella. Significant heterogeneity (P-value ≤ 0.1 and I² > 25%) precluded the reporting of pooled summary effect estimates. Meta-regression of all processing interventions indicated that serotype, disinfectant type and treatment time and pH were significantly associated with studies reporting reductions in concentration while study design, population sampled, study setting, publication date, intervention and disinfectant type, and treatment pH were significantly associated with studies reporting reductions in prevalence. Methodological and reporting flaws were consistently observed in relevant intervention research as well as a lack of studies conducted under commercial conditions and using Salmonella concentration outcomes.

Conclusions

Chilling may be effective at reducing Salmonella concentration and prevalence, but significant heterogeneity precluded reporting of pooled summary effect estimates for many chilling interventions. Investigations into potential sources of heterogeneity among all processing interventions found that the use of other chemical disinfectants, such as organic acids and surfactants might result in larger reductions in Salmonella contamination than more commonly utilized oxidizing agents like chlorine.     

Plasma N-terminal pro-B-type natriuretic peptide concentration helps to predict survival in dogs with symptomatic degenerative mitral valve disease regardless of and in combination with the initial clinical status at admission

Objectives

Although mitral valve disease (MVD) is the most common canine heart disease, readily available prognostic markers of the disease are still lacking. The aim of this study was to evaluate the comparative ability of N-terminal pro-B-type natriuretic peptide plasma concentration (NT-proBNP) and various echocardiographic variables to predict outcome in dogs with MVD.

Animals, materials and methods

Seventy-four dogs with ISACHC classes 2 and 3 MVD (Groups A and B, respectively) were prospectively recruited. NT-proBNP and several echo-Doppler variables at inclusion were compared as predictors of outcome at 6 months in 54/74 dogs.

Results

NT-proBNP was significantly higher in Group B than in Group A (P < 0.0001), and was the only tested variable significantly different between survivor and non-survivor dogs in both groups (P < 0.05). In the whole canine population, a threshold of 1500 pmol/L could discriminate survivor from non-survivor dogs with a sensitivity and specificity of 80% and 73%, respectively. When combining ISACHC class with NT-proBNP levels, a cut-off of 1265 pmol/L was predictive of survival in Group A, whereas the cut-off was 2700 pmol/L for Group B.

Conclusions

NT-proBNP is correlated with MVD severity and could be used in combination with clinical status to predict cardiac outcome.     

Cardiac troponin I and C-reactive protein concentrations in dogs with severe pulmonic stenosis before and after balloon valvuloplasty

Objective

To report cardiac troponin I (cTnI) and C-reactive protein (CRP) concentrations in dogs with severe pulmonic stenosis (PS) before and after balloon valvuloplasty (BV).

Background

Increased morbidity and mortality have been reported with severe PS and histopathologic evidence of myocardial damage is demonstrated with BV. Severity of myocardial injury and inflammation associated with severe PS and BV, as assessed by cTnI and CRP, is unknown.

Animals, materials and methods

Serum cTnI and CRP concentrations were measured in dogs with severe PS (n = 23) and following BV (n = 16).

Results

Baseline cTnI and CRP were elevated in 7/23 (30.4%) and 8/23 (34.8%) dogs. Median cTnI at baseline and post-BV were 0.20 ng/mL (range, 0.20-1.29 ng/mL) and 2.85 ng/mL (range, 0.21-55.40 ng/mL), respectively. Median CRP at baseline and post-BV were 3.40 μg/mL (range, 0-14.70 μg/mL) and 11.70 μg/mL (range, 4.20-120 μg/mL), respectively. Post-BV concentrations were significantly increased compared to baseline for cTnI (p < 0.001) and CRP (p = 0.001).

Conclusions

Serum cTnI and CRP are increased in dogs with severe PS and following BV. Future studies should evaluate whether biomarkers correlate with severity and prognosis of PS or can be used to guide therapy.     

Comparison of arterial blood pressure measurements obtained invasively or oscillometrically using a Datex S/5 Compact monitor in anaesthetised adult horses

Objective

To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery.

Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions

Objective

To determine agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses undergoing elective surgery.

Clinical comparison of dexmedetomidine and medetomidine for isoflurane balanced anaesthesia in horses

Objective

To compare the effects of two balanced anaesthetic protocols (isoflurane–dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses.

Repeatability and Intra‐ and Inter‐observer Agreement of Cervical Vertebral Sagittal Diameter Ratios in Horses with Neurological Disease

Background

Sagittal ratio values (SRVs) of cervical vertebrae are used for ante‐mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease.

Objectives

To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age.

Animals

Forty‐two horses (>1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained.

Methods

Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and >3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined.

Results

Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were >0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites.

Conclusions and Clinical Importance

Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.