Effects of endotoxaemia and carbohydrate overload on glucose and insulin dynamics and the development of laminitis in horses

Reasons for performing study: Insulin resistance (IR) is a risk factor for pasture‐associated laminitis in equids and alimentary carbohydrate overload may trigger laminitis. Whether glucose metabolism responses to carbohydrate overload are more pronounced in insulin‐resistant horses requires further study. Hypothesis: Horses pretreated with endotoxin to alter insulin sensitivity differ significantly in their glucose and insulin responses to carbohydrate overload. Methods: Horses (n = 24) were divided into 3 groups. A lipopolysaccharide (LPS; n = 8) group that received endotoxin as an 8 h 7.5 ng/kg bwt/h i.v. continuous rate infusion, an oligofructose (OF; n = 8) group that received an infusion of saline followed by 5 g/kg bwt OF via nasogastric intubation, and a LPS/OF (n = 8) group that received LPS followed 16 h later by OF. Glucose and insulin dynamics were evaluated at ‐24 h and 48 h using the frequently sampled i.v. glucose tolerance test and minimal model analysis. Physical examinations and haematology were performed and the severity of laminitis assessed. Results: Horses receiving LPS developed leucopenia and both LPS and OF induced clinical signs consistent with systemic inflammation. Insulin sensitivity significantly decreased (P<0.001) over time, but responses did not differ significantly among groups. Time (P<0.001) and treatment × time (P = 0.038) effects were detected for the acute insulin response to glucose, with mean values significantly increasing in LPS and LPS/OF groups, but not the OF group. Five horses in the LPS/OF group developed clinical laminitis compared with 0 and 2 horses in the LPS and OF groups, respectively. Conclusions: Endotoxaemia and carbohydrate overload reduce insulin sensitivity in horses. Endotoxin pretreatment does not affect the alterations in glucose metabolism induced by carbohydrate overload. Potential relevance: Insulin sensitivity decreases after carbohydrate overload in horses, which may be relevant to the development of pasture‐associated laminitis.     

Renal Replacement Therapy in Healthy Adult Horses

Background

Renal replacement therapy (RRT) has been implemented extensively in people to facilitate recovery from acute renal failure (ARF). RRT has not been explored in horses, but might provide a further treatment option in horses with ARF.

Objective

To investigate efficacy and safety of RRT in horses.

Animals

Five healthy adult horses.

Methods

A prospective study was performed on horses restrained in stocks and intravenously connected to a commercial RRT machine to allow continuous venovenous hemodiafiltration to be performed for 6 hours. The RRT machine was set at the following flow rates: blood flow rate 250 mL/min; dialysate rate 3,000 mL/h; prefilter replacement pump 3,000 mL/h; and postfilter replacement pump rate 2,000 mL/h. Balanced electrolyte solution was used as dialysate and replacement fluid. Heart rate, respiratory rate, body temperature, direct arterial blood pressure, urine output, and various clinicopathologic parameters were measured over the study period.

Results

Renal replacement therapy was successfully performed in horses, resulting in a mean creatinine clearance of 0.127 mL/kg/min (68.9 mL/min) and urea reduction ratio of 24%. No adverse effects were detected although a significant decrease in rectal temperature was observed (P ≤ .007). A significant increase in serum phosphorus (P ≤ .001) and decrease in BUN (P < .001) were also noted. A significant prolongation of prothrombin (P < .01) and partial thromboplastin time (P < .0001) were observed along with a decrease in platelet count (P ≤ .04).

Conclusions and Clinical Importance

Renal replacement therapy can safely and effectively be used in adult horses.     

Assessment of Resting Insulin and Leptin Concentrations and Their Association With Managerial and Innate Factors in Horses

The purpose of this study was to determine how insulin and leptin concentrations varied in a large population of privately owned horses. Further, the study was designed to examine the relationships between insulin and leptin with innate (sex, age, breed) and managerial (diet, exercise) factors in these horses. Resting blood samples (for determination of glucose, insulin, and leptin concentrations), body condition scores, feed information, and health history were collected from 366 privately owned horses. In this group of horses, 48% were considered overweight (Body Condition Score ≥6) and 8% were considered hyperinsulinemic (insulin concentrations >30 μU/mL). Confirming the findings of studies within research herds, both insulin and leptin concentrations were found to be correlated with body condition score (P < .001). It was also found that geldings had higher insulin concentrations than mares (P < .05). Ponies were found to have higher insulin and leptin concentrations as well as higher body condition scores, than several other breeds examined. While not a specific measure of insulin sensitivity, resting insulin concentrations have been associated with quantitative measurements of insulin sensitivity and may be useful in large-scale studies for estimating insulin and glucose dynamics. Because of the association between insulin resistance and obesity with diseases such as laminitis, the findings of the present study may help owners identify horses that may be at risk for the development of such conditions.     

Cardiac Troponin‐I Concentration,Myocardial Arteriosclerosis,and Fibrosis in Dogs with Congestive Heart Failure because of Myxomatous Mitral Valve Disease

Background

Few previous studies have investigated the association between biomarkers and cardiac disease findings in dogs with naturally occurring myxomatous mitral valve disease (MMVD).

Aim

To investigate if histopathological changes at necropsy could be reflected by in vivo circulating concentrations of cTnI and aldosterone, and renin activity, in dogs with naturally occurring congestive heart failure because of MMVD.

Animals

Fifty privately owned dogs with MMVD and heart failure.

Methods

Longitudinal Study. Dogs were prospectively recruited and examined by clinical and echocardiographical examination twice yearly until time of death. Blood was stored for batched analysis of concentrations of cTnI and aldosterone, and renin activity. All dogs underwent a standardized necropsy protocol.

Results

cTnI were associated with echocardiographic left ventricular end‐diastolic dimension (P < .0001) and proximal isovolumetric surface area radius (P < .004). Furthermore, in vivo cTnI concentrations reflected postmortem findings of global myocardial fibrosis (P < .001), fibrosis in the papillary muscles (P < .001), and degree of arterial luminal narrowing (P < .001) Aldosterone or renin activity did not reflect any of the cardiac disease variables investigated.

Conclusion and clinical importance

Cardiac fibrosis and arteriosclerosis in dogs with MMVD are reflected by circulating cTnI concentration, but not by aldosterone concentration or renin activity. Cardiac troponin I could be a valuable biomarker for myocardial fibrosis in dogs with chronic cardiac diseases.     

Plasma‐Free Metanephrine and Free Normetanephrine Measurement for the Diagnosis of Pheochromocytoma in Dogs

Background

Measurement of plasma‐free metanephrines is the test of choice to identify pheochromocytoma in human patients.

Objectives

To establish the sensitivity and specificity of plasma‐free metanephrine (fMN) and free normetanephrine (fNMN) concentrations to diagnose pheochromocytoma in dogs.

Animals

Forty‐five client‐owned dogs (8 dogs with pheochromocytoma, 11 dogs with adrenocortical tumors, 15 dogs with nonadrenal disease, and 11 healthy dogs.)

Methods

A prospective study. EDTA plasma was collected from diseased and healthy dogs and submitted for fMN and fNMN measurement by liquid chromatography‐tandem mass spectrometry (LC‐MS/MS).

Results

Free MN concentration (median [range]) was significantly higher in dogs with pheochromocytoma (8.15 [1.73–175.23] nmol/L) than in healthy dogs (0.95 [0.68–3.08] nmol/L; P < .01) and dogs with adrenocortical tumors (0.92 [0.25–2.51] nmol/L; P < .001), but was not different from dogs with nonadrenal disease (1.91 [0.41–6.57] nmol/L; P ≥ .05). Free NMN concentration was significantly higher in dogs with pheochromocytoma (63.89 [10.19–190.31] nmol/L) than in healthy dogs (2.54 [1.59–4.17] nmol/L; P < .001), dogs with nonadrenal disease (3.30 [1.30–10.10] nmol/L; P < .001), and dogs with adrenocortical tumors (2.96 [1.92–5.01] nmol/L); P < 0.01). When used to diagnose pheochromocytoma, a fMN concentration of 4.18 nmol/L had a sensitivity of 62.5% and specificity of 97.3%, and a fNMN concentration of 5.52 nmol/L had a sensitivity of 100% and specificity of 97.6%.

Conclusions and Clinical Importance

Plasma fNMN concentration has excellent sensitivity and specificity for the diagnosis of pheochromocytoma in dogs, whereas fMN concentration has moderate sensitivity and excellent specificity. Measurement of plasma‐free metanephrines provides an effective, noninvasive, means of identifying dogs with pheochromocytoma.     

Association of Season and Pasture Grazing with Blood Hormone and Metabolite Concentrations in Horses with Presumed Pituitary Pars Intermedia Dysfunction

Background: Pituitary pars intermedia dysfunction (PPID) is a risk factor for pasture‐associated laminitis, which follows a seasonal pattern. Hypothesis: Hormonal responses to season differ between PPID and unaffected horses. Animals: Seventeen horses aged 8–30 years (14 horses ≥ 20 years of age). Methods: Longitudinal observational study. Blood was collected monthly from August 2007 until July 2008 after pasture grazing and again after overnight stall confinement. Blood hormone and metabolite concentrations were measured and pasture grass samples were analyzed to determine carbohydrate content. Analysis of variance analysis for repeated measures was performed. Results: Mean ACTH concentrations varied significantly over time (P < .001), with higher concentrations detected in August, September, and October compared with November–April. Pasture × time effects were detected for glucose and insulin concentrations, with peaks observed in September. Horses were retrospectively allocated to PPID (n = 8) and control (n = 9) groups on the basis of plasma ACTH concentrations. Changes in insulin concentrations over time differed in the PPID group when compared with the control group. Insulin concentrations were positively correlated with grass carbohydrate composition. Conclusions and Clinical Importance: PPID did not affect the timing or duration of the seasonal increase in ACTH concentrations, but higher values were detected in affected horses. Insulin concentrations differed between groups, but hyperinsulinemia was rarely detected. Glucose and insulin concentrations peaked in September when horses were grazing on pasture, which could be relevant to the seasonal pattern of laminitis.     

Prediction of incipient pasture‐associated laminitis from hyperinsulinaemia,hyperleptinaemia and generalised and localised obesity in a cohort of ponies

Reasons for performing study: The ability to predict ponies at increased risk of laminitic episodes, when exposed to nutrient dense pasture, would facilitate management to avoid disease. Objectives: To identify variables and clinically useful cut‐off values with reproducible diagnostic accuracy for the prediction of ponies that subsequently developed laminitis when exposed to nutrient dense pasture. Methods: A cohort of predominantly Welsh and Dartmoor ponies from a closed herd was evaluated in March 2006 (n = 74) and March 2007 (n = 57). Ponies were categorised as never laminitic or previously laminitic according to reported laminitic history and as clinically laminitic (CL) if laminitis was observed within 3 months following evaluation. Body condition score (BCS), cresty neck score (CNS), girth and neck circumferences (NC), withers height, blood pressure and hoof surface temperature, and plasma insulin, glucose, triglyceride, leptin, cortisol, ACTH, uric acid and TNF‐α concentrations were measured. Analysis of sensitivity, specificity and receiver operating characteristic curves was used to evaluate the diagnostic accuracy for a variable to predict CL ponies. Results: Variables with diagnostic accuracy for the prediction of CL ponies included insulin, leptin, BCS, CNS, and NC:height ratio. Specific cut‐off values of insulin (>32 mu/l), leptin (>7.3 ng/ml), BCS (≥7), CNS (≥4) and NC:height ratio (>0.71) had reproducible diagnostic accuracy for the prediction of laminitis. Combining tests did not result in higher diagnostic accuracy than individual tests of insulin or leptin during either evaluation. Conclusions: Tests of insulin and leptin concentrations and measures of generalised (BCS) and localised (CNS or NC:height ratio) obesity were beneficial in the prediction of laminitic episodes. Potential relevance: These results highlight the importance of monitoring and reducing insulin concentration, and generalised and regional obesity in ponies to reduce risk of laminitis.     

Inflammatory Cytokine Gene Expression in Blood During the Development of Oligofructose-Induced Laminitis in Horses

Systemic inflammation is a risk factor for laminitis in horses and precedes the onset of lameness in experimental models. We therefore hypothesized that whole-blood inflammatory cytokine expression would increase during the development of laminitis in a carbohydrate overload model. Blood samples were obtained from 14 horses undergoing laminitis induction with 10 g/kg oligofructose as part of another study. Samples were collected at 0, 8, 12, 16, 20, and 24 hours, and lameness evaluations were performed every 4 hours. Expression levels of interleukin-1β (IL-1β), IL-6, IL-8, IL-10, and tumor necrosis factor-α were measured in whole blood by using real-time PCR. IL-1β, IL-8, and IL-10 expression increased above baseline from 8 to 24 hours (P < .001), and IL-6 expression increased at 16 and 20 hours (P = .005). Expression of tumor necrosis factor-α did not change over time. All horses developed clinical laminitis between 12 and 24 hours. Increased mean IL-1β, IL-8, and IL-10 expression detected at 8 hours therefore preceded the onset of lameness. We conclude that peripheral leukocyte cytokine expression increases as systemic inflammation develops in an alimentary carbohydrate overload model of laminitis, and this precedes detection of lameness. Results support current recommendations to control the systemic inflammatory response in order to lower the risk of laminitis in horses.     

Effect of Sward Height on Pasture Nonstructural Carbohydrate Concentrations and Blood Glucose/Insulin Profiles in Grazing Horses

Six mature stock-type geldings with maintenance only requirements were used in a randomized cross-over design to determine the effect of sward height on pasture plant nonstructural carbohydrate (NSC) concentrations and blood glucose and insulin concentrations. Horses were randomly assigned to one of two tall fescue (Lolium arundinaceum Schreb cv Max-Q, Pennington Seed, Madison, GA) grazing cells (0.37 ha) having two different sward heights for a period of 7 days: (1) short (approximately 15 cm; n = 3) or tall (between 30 and 40 cm; n = 3). After the first 7-day period, treatment groups were reversed by moving horses to ungrazed cells having similar characteristics to those used in the first 7 days, so that all horses receive all treatments resulting in six observations per treatment. Both short and tall grazing cells were mowed to a height of approximately 15 cm 32 days before the experiment starts. The short grazing cells were removed to approximately 15 cm at 11 days before the start of the first 7-day period and again 1 day before the start of each 7-day period. All horses had access to pasture for 10 h/d beginning at 8 AM and ending at 6 PM. Although not at pasture, all horses were individually housed in 3.7 × 12.2 m partially covered pens containing automatic water troughs and a crushed stone surface. Herbage mass (kg DM/ha) was determined by use of a falling plate meter for each pasture to ensure that both groups of horses had adequate dry matter to provide grazing for at least 7 days. On day 7 of each period, jugular venous blood samples were collected from each horse before being turned out to pasture, and then at 2, 4, 6, and 8 hours after turn-out. Pasture samples were also collected from each grazing cell at the same time blood samples were taken. Serum and plasma from blood samples were harvested and analyzed for insulin and glucose concentrations, respectively. Pasture samples were analyzed for water soluble carbohydrate (WSC), ethanol soluble carbohydrate (ESC), and starch. The sum of WSC and starch were used as an estimate of NSC. Area under the curve (AUC) and peak concentration were calculated for both plasma glucose (PPG) and serum insulin (PSI) concentration and were analyzed using analysis of variance for randomized cross-over designs. Pasture WSC, ESC, starch, and NSC concentrations were analyzed using analysis of variance for randomized complete block design. A P value of < .05 was considered significant. Mean pasture plant NSC, WSC, and ESC concentrations were lower (P < .001) in short as compared with tall. Pasture plant starch concentration was not different between treatments. Mean pregrazing plasma glucose concentrations, PPG concentrations, and plasma glucose AUC were not affected by treatment. Mean pregrazing serum insulin concentrations were not affected by treatment. Mean PSI and insulin AUC were greater (P < .01) when horses grazed tall, as compared with short. In conclusion, decreasing the sward height by mowing pasture decreased NSC, WSC, and ESC concentrations and subsequently decreased the postprandial insulin response of horses grazing the pasture. These findings may be important in developing strategies aimed at preventing insulin resistance in grazing horses.     

Morphometric analyses of the body and the branches of the normal third interosseous muscle (suspensory ligament) in Standardbreds

The third interosseous muscle (suspensory ligament, TIOM) is composed of connective tissue (CT) with a variable proportion of muscle (MT) and adipose tissue (AT). The aim of our study is to quantify the CT, MT and AT within the body and the branches of right thoracic and pelvic limbs TIOM in sound horses to determine whether there are differences in CT, MT and AT between age, sex, limbs and levels. Right limbs from 11 sound horses were collected. Samples from 6 levels of the TIOM were embedded in paraffin or in Tissue‐Tek^®. Most of the paraffin sections were shredded. Using the cryosection, some artefacts appeared. Cryoprotection was carried out, which produced the best results. Hematoxylin–phloxine–saffron and Hematoxylin–eosin gave a good contrast of colours between the tissues observed allowing the use of an image analysis programme to calculate percentage of each tissue within the TIOM. The percentage of MT and AT decreased significantly (P < 0.0001), whereas the percentage of CT increased significantly (P < 0.0001) with age and when descending from the proximal to the distal level of the TIOM. The percentage of MT was significantly higher (P < 0.0001) in females than males, while the percentage of CT was significantly higher (P < 0.0001) in males than females. The percentage of AT was significantly higher (P = 0.0278) in pelvic limbs than in thoracic limbs. These results confirm the variation in tissue composition within the TIOM of sound horses.     

Glucose and insulin responses to different dietary energy sources in Thoroughbred broodmares grazing cool season pasture

The objectives of this study were to characterize the glycemic and insulinemic responses of Thoroughbred broodmares fed late spring pasture only or a mixture of pasture and a high starch or low starch feed and to test hypotheses about differences in the glycemic and insulinemic effects of these dietary regimes. A group of 15 mares were divided into three treatment groups; pasture and high starch feed (PHS), pasture and low starch feed (PLS), and pasture only (PO) and maintained in these groups for 4.5 months prior to this study. These groups were maintained on a single pasture that was temporarily divided into three sections. The study protocol was conducted over two days. On day 1 the mares were fed their respective treatments and on day 2 all mares were allowed access to pasture only. On both days plasma glucose and insulin were measured in samples taken over a 7.5 h period. Baseline measurements for glucose and insulin were not different between any of the treatment groups on either day (P > 0.05). The baseline insulin concentrations of these pasture-kept mares (26.7 ± 8.3 mIU/L) were high compared to those reported from stall-kept horses. Plasma glucose and insulin on day 1 were influenced by treatment group, sample time, and an interaction between treatment and time (P < 0.05). On day 2 there was no significant influence of treatment group (P > 0.05). Glucose and insulin rose to higher (P < 0.01) peak concentrations in the PHS group on day 1 when compared to the PLS and PO groups, with no difference (P > 0.05) detected between the PLS and PO groups. These results are reflected in greater areas under the concentration-time curves for glucose and insulin in the PHS group on day 1 (P < 0.05). On day 2 there were no differences in any of the glucose and insulin characteristics for any of the treatment groups (P > 0.05). These results indicate a clear difference in the glycemic and insulinemic effect of the PHS feed compared to the PLS and PO groups. Of further interest are the glucose and insulin characteristics of these pasture-kept mares that indicate a low insulin sensitivity and high insulin secretory response. This study provides further information on factors influencing glycemic and insulinemic responses in horses.     

Effect of body weight on the pharmacokinetics of flunixin meglumine in miniature horses and quarter horses

In most species, large variations in body size necessitate dose adjustments based on an allometric function of body weight. Despite the substantial disparity in body size between miniature horses and light‐breed horses, there are no studies investigating appropriate dosing of any veterinary drug in miniature horses. The purpose of this study was to determine whether miniature horses should receive a different dosage of flunixin meglumine than that used typically in light‐breed horses. A standard dose of flunixin meglumine was administered intravenously to eight horses of each breed, and three‐compartmental analysis was used to compare pharmacokinetic parameters between breed groups. The total body clearance of flunixin was 0.97 ± 0.30 mL/min/kg in miniature horses and 1.04 ± 0.27 mL/min/kg in quarter horses. There were no significant differences between miniature horses and quarter horses in total body clearance, the terminal elimination rate, area under the plasma concentration versus time curve, apparent volume of distribution at steady‐state or the volume of the central compartment for flunixin (P > 0.05). Therefore, flunixin meglumine may be administered to miniature horses at the same dosage as is used in light‐breed horses.     

Influence of riders’ skill on plasma cortisol levels of horses walking on forest and field trekking courses

The aim of this study was to evaluate the influence of rider's skill on the plasma cortisol levels of trekking horses on two courses, walking on field and forest courses (about 4.5 to 5.1 km each). Three riders of different skills did horse trekking (HT) in a tandem line under a fixed order: advanced‐leading, beginner‐second and intermediate‐last. A total of six horses were used and they experienced all positions in both courses; a total of 12 experiments were done. Blood samples were obtained before HT, immediately after and 2 h after HT. As a control, additional blood samples were obtained from the same horses on non‐riding days. Irrespective of the course and the rider's skill, the cortisol level before HT was higher than that of control (P < 0.05). In both courses, the cortisol levels immediately after HT ridden by the advanced rider were higher than that of control (P < 0.05). However, in every case, the cortisol level 2 h after HT was closely similar to the level of the control. Thus, we concluded the stress of trekking horse was not sufficient to disturb the circadian rhythm of the cortisol level, irrespective of the course and the rider's skill.     

Factors Affecting the Glucose Response to Insulin Injection in Mares: Epinephrine, Short- and Long-Term Prior Feed Intake, Cinnamon Extract, and Omega-3 Fatty Acid Supplementation

Five experiments were conducted with mares to better define factors that might affect the assessment of insulin sensitivity via direct insulin injection, and to then apply this method of assessing insulin sensitivity to trials which tested two potential supplements for improving poor insulin sensitivity in horses. The experiments assessed the effects of the following: (1) previous administration of epinephrine, (2) overnight feed deprivation versus hay or pasture consumption, (3) 10-day acclimatization to hay in a dry lot versus pasture grazing, (4) cinnamon extract supplementation, and (5) fish oil supplementation on insulin sensitivity. Mares of known high and low insulin sensitivities were used in the first three experiments, whereas mares with low insulin sensitivities were used in the supplement trials. Epinephrine administration increased blood glucose concentrations (P < .05) and prevented the insulin-induced decrease in blood glucose concentrations in both sensitive and insensitive mares. Overnight feed deprivation decreased (P < .06) insulin sensitivity relative to overnight ad libitum access to hay, and both regimens resulted in reduced insulin sensitivity relative to overnight pasture availability; sensitive and insensitive mares responded similarly except when kept on pasture (P = .0854). Ten days of hay consumption in a dry lot reduced (P < .05) insulin sensitivity in insensitive mares, but not in sensitive mares, relative to pasture grazing. Supplementation with cinnamon extract or fish oil had no effect on insulin sensitivity of mares with known low insulin sensitivity under the conditions of these experiments.     

Comparison of three rebound tonometers in normal and glaucomatous dogs

Objective

The objectives of the study were to compare intraocular pressure (IOP) readings across a wide range and obtained via three rebound tonometers in ADAMTS10-mutant Beagle-derived dogs with different stages of open-angle glaucoma (OAG) and normal control dogs and to investigate the effect of central corneal thickness (CCT).

Animals Studied

Measurements were performed on 99 eyes from 50 Beagle-derived dogs with variable genetics—16 non-glaucomatous and 34 with ADAMTS10-OAG. Seventeen OAG eyes were measured twice—with and without the use of IOP-lowering medications.

Procedures

IOP was measured in each eye using three tonometers with their “dog” setting—ICare® Tonovet (TV), ICare® Tonovet Plus® (TVP), and the novel Reichert® Tono-Vera® Vet (TVA)—in randomized order. CCT was measured with the Accutome® PachPen. Statistical analyses included one-way ANOVA, Tukey pairwise comparisons, and regression analyses of tonometer readings and pairwise IOP-CCT Pearson correlations (MiniTab®).

Results

A total of 116 IOP measurements were taken with each of the three tonometers. When comparing readings over a range of ~7–77 mmHg, mean IOPs from the TV were significantly lower compared with TVP (−4.6 mmHg, p < .001) and TVA (−3.7 mmHg, p = .001). We found no significant differences between TVA and TVP measurements (p = .695). There was a moderate positive correlation between CCT and IOP for TVA (r = 0.53, p < .001), TVP (r = 0.48, p < .001), and TV (r = 0.47, p < .001).

Conclusions

Our data demonstrate strong agreement between TVP and TVA, suggesting that the TVA may similarly reflect true IOP values in canines. CCT influenced IOP measurements of all three tonometers.     

Physicochemical Interpretation of Acid‐Base Abnormalities in 54 Adult Horses with Acute Severe Colitis and Diarrhea

Background

The quantitative effect of strong electrolytes, pCO₂, and plasma protein concentration in determining plasma pH and bicarbonate concentrations can be demonstrated with the physicochemical approach. Plasma anion gap (AG) and strong ion gap (SIG) are used to assess the presence or absence of unmeasured anions.

Hypotheses

The physicochemical approach is useful for detection and explanation of acid‐base disorders in horses with colitis. AG and SIG accurately predict hyperlactatemia in horses with colitis.

Animals

Fifty‐four horses with acute colitis and diarrhea.

Methods

Retrospective study . Physicochemical variables were calculated for each patient. ROC curves were generated to analyze sensitivity and specificity of AG and SIG for predicting hyperlactatemia.

Results

Physicochemical interpretation of acid‐base events indicated that strong ion metabolic acidosis was present in 39 (72%) horses. Mixed strong ion acidosis and decreased weak acid (hypoproteinemia) alkalosis was concomitantly present in 17 (30%) patients. The sensitivity and specificity of AG and SIG to predict hyperlactatemia (L‐lactate > 5 mEq/L) were 100% (95% CI, 66.4–100; P < .0001) and 84.4% (95% CI, 70.5–93.5 P < .0001). Area under the ROC curve for AG and SIG for predicting hyperlactatemia was 0.95 (95% CI, 0.86–0.99) and 0.93 (95% CI, 0.83–0.99), respectively.

Conclusion and Clinical relevance

These results emphasize the importance of strong ions and proteins in the maintenance of the acid‐base equilibria. AG and SIG were considered good predictors of clinically relevant hyperlactatemia.     

Glucose transport in the equine hoof

Reasons for performing study: Several conditions associated with laminitis in horses are also associated with insulin resistance, which represents the failure of glucose uptake via the insulin‐responsive glucose transport proteins in certain tissues. Glucose starvation is a possible mechanism of laminitis, but glucose uptake mechanisms in the hoof are not well understood. Objectives: To determine whether glucose uptake in equine lamellae is dependent on insulin, to characterise the glucose transport mechanism in lamellae from healthy horses and ponies, and to compare this with ponies with laminitis. Methods: Study 1 investigated the effects of insulin (300 µU/ml; acute and 24 h) and various concentrations of glucose up to 24 mmol/l, on 2‐deoxy‐D‐[2,6‐³H]glucose uptake in hoof lamellar explants in vitro. Study 2 measured the mRNA expression of GLUT1 and GLUT4 transport proteins by PCR analysis in coronary band and lamellar tissue from healthy horses and ponies, ponies with insulin‐induced laminitis, and ponies suffering from chronic laminitis as a result of equine Cushing's syndrome. Results: Glucose uptake was not affected by insulin. Furthermore, the relationship between glucose concentration and glucose uptake was consistent with an insulin‐independent glucose transport system. GLUT1 mRNA expression was strong in brain, coronary band and lamellar tissue, but was weak in skeletal muscle. Expression of GLUT4 mRNA was strong in skeletal muscle, but was either absent or barely detectable in coronary band and lamellar tissue. Conclusions: The results do not support a glucose deprivation model for laminitis, in which glucose uptake in the hoof is impaired by reduced insulin sensitivity. Hoof lamellae rely on a GLUT1‐mediated glucose transport system, and it is unlikely that GLUT4 proteins play a substantial role in this tissue. Potential relevance: Laminitis associated with insulin resistance is unlikely to be due to impaired glucose uptake and subsequent glucose deprivation in lamellae.     

Equine pectinate ligament descemetization is associated with age

Purpose

To evaluate the correlation between equine pectinate ligament descemetization and ocular disease.

Methods

The pathology database of the North Carolina State University Veterinary Medical Center was searched from 2010–2021 for all equine globes. Disease status was then assigned as affected by glaucoma, uveitis, or “other” based upon clinical records. The iridocorneal angles (ICA) of each globe were evaluated for the presence of pectinate ligament descemetization, the length of descemetization, as well as for the degree of angle collapse and the extent of cellular infiltrate or proteinaceous debris. One slide from each eye was evaluated by two separate, blinded investigators (HW & TS).

Results

A total of 66 eyes from 61 horses were identified, with a total of 124 sections of ICA of sufficient quality to review. 16 horses were affected by uveitis, 8 by glaucoma, 7 by both glaucoma and uveitis, and 30 horses by other ocular disease, most commonly ocular surface disease or neoplasia, which served as controls. Pectinate ligament descemetization was most prevalent in the control group compared to the glaucoma and uveitis groups. Pectinate ligament descemetization length was positively correlated with age, with an increase of 13.5 μm per year of age (p = .016). Infiltrate scores and angle closure scores were higher in both the glaucoma and uveitis group compared to the control group (p < .001).

Conclusions

Equine pectinate ligament descemetization appears to be correlated with increased age and should not be used as a histologic marker for the presence of glaucoma.     

Efficacy of Mass Antimicrobial Treatment of Foals with Subclinical Pulmonary Abscesses Associated with Rhodococcus equi

Background

Mass antimicrobial treatment of foals with small subclinical ultrasonographic pulmonary lesions is empirical practice on many farms with endemic disease caused by Rhodococcus equi.

Hypothesis

Mass antimicrobial treatment of foals with subclinical ultrasonographic pulmonary lesions is unnecessary.

Animals

One hundred and eight foals on a farm endemic for infections caused by R. equi.

Methods

Controlled, randomized, and double‐blinded prospective study. Foals with ultrasonographic evidence of pulmonary abscesses 5.0–10 cm in diameter (n = 108) were randomly allocated in 5 treatment groups: (1) tulathromycin IM; (2) doxycycline monotherapy PO; (3) doxycycline with rifampin PO; (4) azithromycin with rifampin PO, and (5) saline IM as a placebo. Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals with evidence of disease progression were removed from the study and treated with azithromycin‐rifampin.

Results

Overall, 22/25 (88%) foals in the placebo group recovered without the need for treatment. The proportion of foals that had evidence of disease progression did not differ significantly between the treatment groups (P > .05). Although the median duration of treatment was significantly (P < .05) shorter in foals treated with azithromycin‐rifampin (46 days) compared with foals treated with the placebo (73 days), the time frame of ultrasonographic lesion resolution did not differ significantly between the treatment groups.

Conclusions and Clinical Importance

The majority of foals with subclinical pulmonary abscesses <10 cm in diameter recover without antimicrobial treatment and treatment of affected foals does not provide a clear benefit over administration of a placebo.