Plasma homocysteine concentrations in healthy horses and horses with atrial fibrillation

Introduction

Homocysteine (HCY) is an amino acid produced from methionine metabolism. Plasma homocysteine concentrations ([HCY]_p) are elevated (>13 μmol/L) in people with atrial fibrillation (AF) and can predict the recurrence of AF after cardioversion. This study aimed to validate a commercially available human HCY assay for use in horses to develop reference intervals for [HCY]_p and compare [HCY]_p in healthy horses and horses with AF.

Pulmonary artery wedge pressure during treadmill exercise in warmblood horses with atrial fibrillation

The heart rate and the pulmonary artery wedge pressure (PWP) was measured in 10 healthy warmblood horses and in six warmblood horses with atrial fibrillation (AF) at rest and during standardised treadmill exercise. During treadmill exercise, the increase in heart rate was significantly higher in the horses with AF than in the healthy horses. Horses with AF showed a significantly higher increase in PWP at treadmill velocities of 5m/s and faster, than did the healthy horses. The differences in PWP between both groups increased with treadmill strain. The present study demonstrates that there is an influence on the haemodynamics in horses with AF during treadmill exercise, which could explain exercise intolerance in some horses with lone AF.     

Risk factors for salmonellosis in hospitalized horses

A case-control study to identify risk factors associated with isolation of Salmonella was accomplished, using data from records of horses hospitalized in the period July 1971 through June 1982. Horses in which nasogastric tubes were passed were at 2.9 times greater risk of having Salmonella isolated, compared with horses that did not undergo this procedure. Horses treated with antibiotics parenterally were at 6.4 times greater risk, and those treated with antibiotics orally and parenterally were at 40.4 times greater risk of developing salmonellosis, compared with horses not receiving such treatment. Horses admitted because of colic were 4.2 times as likely to have Salmonella isolated as those admitted for other reasons. Breed, age, and type of surgery did not appear to be risk factors. The risk factors identified and the magnitude of their association with Salmonella isolation were similar to those observed in a preceding study.     

Intravenous amiodarone treatment in horses with chronic atrial fibrillation

Six horses without underlying cardiac disease were presented because of atrial fibrillation of between 5 and 12 months duration. These horses received an intravenous amiodarone treatment of 5mg/kg/h for 1 h followed by 0.83mg/kg/h for 23h and subsequently 1.9mg/kg/h for 30h. During treatment, clinical signs were monitored and a surface ECG and an intra-atrial electrogram were recorded. Infusion was discontinued when sinus rhythm or side effects occurred. Four horses successfully cardioverted, of which one showed symptoms of hind limb weakness and weight shifting. Two horses did not cardiovert and showed similar side effects. In all horses, side effects disappeared within 6h after termination of treatment. Cardiac side effects, such as pro-arrhythmia, were not seen in any of the horses. Total bilirubin slightly increased in three horses and normalised within four days. It was concluded that amiodarone has the potential to treat naturally occurring chronic atrial fibrillation in horses, although further research is needed to refine the infusion protocol.     

Risk factors for enterolithiasis among horses in Texas

OBJECTIVE: To identify risk factors for enterolithiasis in horses. DESIGN: Matched case-control study. ANIMALS: 26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group). PROCEDURE: Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis. RESULTS: Horses that were fed alfalfa hay, spent < or = 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission. CONCLUSIONS AND CLINICAL RELEVANCE: Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic.     

Use of intravenous flecainide in horses with naturally-occurring atrial fibrillation

REASONS FOR PERFORMING STUDY: It has been reported that i.v. flecainide has a high efficacy for the treatment of experimentally-induced acute atrial fibrillation (AF) in horses and that its use is associated with minimal toxic side effects. OBJECTIVES: The objectives were to study the efficacy of i.v. flecainide as a treatment for atrial fibrillation in horses with naturally-occurring AF. METHODS: Ten horses with naturally-occurring AF were treated with 2 mg/kg bwt flecainide i.v. at a rate of 0.2 mg/kg bwt/min. In 3 horses, the infusion was continued at 0.05-0.10 mg/kg bwt/min until a total dose of 3.0 mg/kg bwt had been administered. Heart rate, QRS duration and average interval between fibrillation waves were measured before, during and following flecainide infusion. If conversion to normal sinus rhythm was not achieved, horses were treated with quinidine sulphate per os at a dose of 22 mg/kg bwt given every 2 h. RESULTS: None of the horses with chronic AF (n = 9) converted to sinus rhythm with flecainide i.v. The only horse treated successfully had acute AF of 12 days' duration. The QRS duration and fibrillation cycle length increased significantly (P = 0.006 and 0.002, respectively) during and following flecainide infusion. Heart rate did not increase significantly over time however, 3 horses developed heart rates in excess of 100 beats/min. Two horses developed a potentially dangerous ventricular dysrhythmia during the first 15 mins of treatment. Quinidine sulphate given per os restored sinus rhythm in 8 out of 9 horses, with minimal adverse effects. CONCLUSIONS: Although flecainide might be efficacious in cases of acute AF, it was not possible to restore sinus rhythm in horses with naturally-occurring chronic AF at the dosages used in this study. In 2 horses, 2.0 mg/kg bwt flecainide was associated with potentially dangerous dysrhythmias. POTENTIAL CLINICAL RELEVANCE: Intravenous administration of 2 mg/kg bwt flecainide is unlikely to convert chronic AF in horses and could induce dangerous dysrhythmias.     

Case-control investigation of the factors affecting the risk of horses falling during steeplechase racing in the UK

A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.     

Surgical colic in racing endurance horses

A retrospective study was performed of horses that developed colic during endurance racing, and subsequently required surgery. Fifteen horses met the inclusion criteria, of which 13 (87%) had small intestinal volvulus. Nine of the 15 horses (60%) had a small intestinal resection and anastomosis performed. Post operative ileus, particularly in those horses that had a resection performed, was a common complication. Eleven of the 15 (73%) survived, and 4 (27%) have since raced.     

Risk factors for disease associated with influenza virus infections during three epidemics in horses

OBJECTIVE: To identify risk factors associated with respiratory tract disease in horses during 3 epidemics caused by influenza virus infections. DESIGN: Cross-sectional and prospective longitudinal observational studies. ANIMALS: 1,163 horses stabled at a Thoroughbred racetrack. PROCEDURES: Investigations were conducted during a 3-year period. An epidemic of respiratory tract disease caused by influenza virus infections was identified in each year. Routine observations and physical examinations were used to classify horses' disease status. Data were analyzed to identify factors associated with development of disease. RESULTS: Results were quite similar among the epidemics. Concentrations of serum antibodies against influenza virus and age were strongly associated with risk of disease; young horses and those with low antibody concentrations had the highest risk of disease. Calculation of population attributable fractions suggested that respiratory tract disease would have been prevented in 25% of affected horses of all horses had high serum antibody concentrations prior to exposure. However, recent history of vaccination was not associated with reduction in disease risk. Exercise ponies had greater risk of disease than racehorses, which was likely attributable to frequent horse-to-horse contact. CONCLUSIONS AND CLINICAL RELEVANCE: Particular attention should be paid to young horses, those with low serum antibody concentrations, and horses that have frequent contact with other horses when designing and implementing control programs for respiratory tract disease caused by influenza virus infections. It appears that control programs should not rely on the efficacy of commercial vaccines to substantially reduce the risk of disease caused by influenza virus infections.     

Treatment of atrial fibrillation in horses by intravenous administration of quinidine

Intravenous administration of quinidine gluconate converted atrial fibrillation (AF) to sinus rhythm in 9 of 12 horses. Twelve horses that were diagnosed by ECG to have AF were administered up to 11 mg of quinidine gluconate/kg of body weight in 1.0- to 1.5-mg/kg bolus injections every 10 to 15 minutes. The total dose of quinidine administered IV ranged from 1.8 to 5.8 g. Increased ventricular rate, apprehension, and mild depression were observed during treatment. Other signs of toxicosis were not observed. One horse was successfully treated with IV administered quinidine gluconate on 3 occasions. Intravenous administration of quinidine is a safe and effective alternative for treatment of AF in some horses.     

Risk factors for faecal sand excretion in Icelandic horses

REASONS FOR PERFORMING STUDY: Sandy soil is often mentioned as a risk factor in the development of sand-related gastrointestinal disease (SGID) in the horse. There are other variables, but few studies confirm any of these. OBJECTIVE: To investigate soil type, pasture quality, feeding practice in the paddock, age, sex and body condition score as risk factors for sand intake in the horse. METHODS: Faeces were collected from 211 Icelandic horses on 19 different studs in Denmark together with soil samples and other potential risk factors. Sand content in faeces determined by a sand sedimentation test was interpreted as evidence of sand intake. Soil types were identified by soil analysis and significance of the data was tested using logistic analysis. RESULTS: Of horses included in the study, 56.4% showed sand in the faeces and 5.7% had more than 5 mm sand as quantified by the rectal sleeve sedimentation test. Soil type had no significant effect when tested as main effect, but there was interaction between soil type and pasture quality. Significant interactions were also found between paddock feeding practice and pasture quality. CONCLUSION: To evaluate the risk of sand intake it is important to consider 3 variables: soil type, pasture quality and feeding practice. Pasture quality was identified as a risk factor of both short and long grass in combination with sandy soil, while clay soil had the lowest risk in these combinations. Feeding practice in the paddock revealed feeding directly on the ground to be a risk factor when there was short (1-5 cm) or no grass. Also, no feeding outdoors increased the risk on pastures with short grass, while this had no effect in paddocks with no grass. More than 50% of all horses investigated in this study had sand in the faeces. POTENTIAL RELEVANCE: The identification of risk factors is an important step towards prevention of SGID. Further research is necessary to determine why some horses exhibit more than 5 mm sand in the sedimentation test and whether this is correlated with geophagic behaviour.     

How to perform transvenous electrical cardioversion in horses with atrial fibrillation

Electrical cardioversion of atrial fibrillation is a well-established technique for restoration of sinus rhythm in humans. While transthoracic cardioversion is more commonly used, transvenous electrical cardioversion (TVEC) has been reported as having higher efficacy at substantially lower energy levels. In horses, treatment of atrial fibrillation has essentially been limited to the administration of quinidine salts either orally or intravenously. TVEC provides an alternative to quinidine salts, especially for those animals in which quinidine is neither effective nor tolerated. The present report details this technique in horses, discusses possible complications of the procedure, and provides guidance for successful outcome. Still and video images are used to illustrate details with regard to TVEC techniques in horses. Please view supplemental material for the videos.     

Use of biphasic electrical cardioversion for treatment of idiopathic atrial fibrillation in two horses

Rectilinear biphasic cardioversion was used in 2 horses with idiopathic sustained atrial fibrillation; 1 horse converted to sustained sinus rhythm. Variables that potentially affected outcome of the electrical cardioversion procedures in these horses included duration of arrhythmia, placement of cardioverter pads and paddles, serum electrolyte concentrations, and treatment with quinidine. Serum cardiac troponin I concentration, measured to determine whether the myocardium was damaged from the electrical shocks, was within the reference range in both horses after the procedure. Biphasic electrical cardioversion may provide an alternative to pharmacologic cardioversion with quinidine in horses. The rectilinear biphasic defibrillator-cardioverter uses a unique biphasic waveform to deliver constant current to the myocardium during cardioversion, regardless of transthoracic impedance. Biphasic cardioversion is safer and more effective than traditional monophasic cardioversion in humans and animals.