Genetics of equine bleeding disorders

Genetic bleeding disorders can have a profound impact on a horse's health and athletic career. As such, it is important to understand the mechanisms of these diseases and how they are diagnosed. These diseases include haemophilia A, von Willebrand disease, prekallikrein deficiency, Glanzmann's Thrombasthenia and Atypical Equine Thrombasthenia. Exercise-induced pulmonary haemorrhage also has a proposed genetic component. Genetic mutations have been identified for haemophilia A and Glanzmann's Thrombasthenia in the horse. Mutations are known for von Willebrand disease and prekallikrein deficiency in other species. In the absence of genetic tests, bleeding disorders are typically diagnosed by measuring platelet function, von Willebrand factor, and other coagulation protein levels and activities. For autosomal recessive diseases, genetic testing can prevent the breeding of two carriers.     

A review of equine dental disorders

Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps") and vertical impaction of erupting CT that may lead to large eruption cysts and possibly then to apical infections. Disorders of wear, especially enamel overgrowths ("enamel points"), are the main equine dental disorder and are believed to be largely due to the dietary alterations associated with domestication. If untreated, such disorders will eventually lead to more severe CT disorders such as shearmouth and also to widespread periodontal disease. More focal dental overgrowths will develop opposite any CT not in full opposition to their counterpart, e.g., following maleruption of or loss of a CT. Because of the great length of reserve crown in young (hypsodont) CT, apical infections usually cause infection of the supporting bones and depending on the CT involved, cause facial swellings and fistulae and possibly sinusitis. Diagnosis of apical infection requires radiography, and possibly scintigraphy and other advanced imaging techniques in some early cases. When possible, oral extraction of affected CT is advocated, because it reduces the costs and risks of general anaesthesia and has much less post-extraction sequelae than CT repulsion or buccotomy.     

Tools for the diagnosis of equine respiratory disorders.

Respiratory disorders are among the most common problems leading horse owners to seek veterinary attention. Accurate diagnosis of these conditions allows for proper treatment to be instituted, much to the benefit of the patient and satisfaction of the client. As an introduction to this issue on equine respiratory disorders, we review some of the tools that are available to equine veterinarians for the diagnosis of respiratory disorders. Physical and endoscopic examination, radiology, diagnostic ultrasound, techniques for sampling the respiratory tract, hematology, blood gas analysis, respiratory mechanics, and some modern diagnostic tools are briefly covered.     

Histopathological findings in equine sinonasal disorders.

Biopsies collected from 79 referred cases of equine sinonasal disease, including 27 horses with primary sinusitis, 10 with secondary dental sinusitis, 19 with sinus cysts, 11 with progressive ethmoid haematomata (PEH), 4 with false nostril epidermal inclusion cysts, 4 with sinonasal polyps, 3 with sinonasal mycosis and from 2 control animals were examined histologically. Observations were made on epithelial type and integrity, cellular inflammatory response, fibroplasia and presence of potential pathogens. Chronic inflammatory changes including mucosal thickening, ulceration and significant fibroplasia, were found in the sinus mucosa with most sinus disorders, similar to those found in human chronic sinusitis. Bacteria were variably present on sinusitis mucosae but their aetiological significance was unclear. The presence of apparently irreversible changes including fibroplasia in some of these sinusitis cases may explain their poor or delayed response to treatment. Sinus cysts had histological similarities to human mucocoeles. Progressive ethmoid haematomata showed recent and older haemorrhage, as did sinus cysts (and occasionally some chronic sinusitis sections), but support for a common aetiology between sinus cysts and PEH was absent.     

Use of stem cells in equine musculoskeletal disorders

Stem cell therapies for musculoskeletal disorders are becoming commonplace in the horse. In order to decipher the many options available for stem cell therapy and interpret results of accumulating experimental and clinical data, practitioners should have a basic understanding of stem cells.     

Diagnostic validity of electroencephalography in equine intracranial disorders

Electroencephalography (EEG) is a valuable diagnostic test to identify functional disturbances in brain activity. The purpose of this study was to assess the validity of EEG as a diagnostic indicator of intracranial diseases in horses. The validity of EEG was estimated by comparing clinical, clinicopathologic, and histopathologic findings to EEG findings in 20 horses examined for seizures. collapse, or abnormal behavior between 1984 and 1997. A bipolar left-to-right, back-to-front montage and a bipolar circular montage were recorded from sedated (4) and anesthetized (16) horses. Visual and semiquantitative masked analysis of EEG recording Ist was validated on 10 horses presented for problems other than intracranial diseases. EEG pattern was normal in 7 of the 20 clinically affected horses. Abnormal EEG patterns included high-voltage slow waves and discrete paroxysmal activity with or without generalized activity in 13 horses. Histopathologic diagnoses in 10 horses included meningoencephalitis, neuronal necrosis, congenital anomalies. cerebral edema. and abscess. All of these horses had abnormal EEG patterns (sensitivity, 100%) with a positive neuroanatomic correlation in 7 animals. Localization of histopathologic and EEG abnormalities did not correlate in 15% of the horses (3/20). The cause of neurologic signs could not be explained at postmortem examination in 10 animals and the EEG pattern was normal in 7 of these horses (specificity, 70%). In conclusion, equine EEG was a sensitive tool in the diagnosis of intracranial disorders.     

The effect of oxytocin on contractility of the equine oesophagus: a potential treatment for oesophageal obstruction

This study was performed to determine the effect of administration of i.v. oxytocin on the contractility of the musculature associated with the equine oesophagus. Nine clinically normal horses were fitted with a nasogastric tube modified with inflatable latex cuffs. These cuffs were connected to piezoelectric pressure recording devices. Oxytocin in 3 different doses or saline controls were administered i.v. in a randomised block pattern. Systolic blood pressure, ECG, heart rate and nasogastric tube cuff pressures were then measured for 60 min. Administration of oxytocin i.v. at 0.11 and 0.22 iu/kg bwt, resulted in a short-term statistically significant relaxation of the musculature of the equine oesophagus. When oxytocin was administered at 0.11, 0.22 and 0.44 iu/kg bwt, no clinically significant cardiovascular changes were seen. In approximately 5% of the oxytocin administrations, signs of mild short-term abdominal discomfort were observed. In clinical cases of noncomplicated oesophageal obstruction, it is suggested that reduction in tone of oesophageal musculature may result in passage of oesophageal obstructions with reduced risk of oesophageal injury when compared to other traditional treatments.     

Diagnosis of equine stifle joint disorders: three cases

The clinical, radiographic, arthrographic, arthroscopic, and pathological findings of three horses with femorotibial joint injuries are presented. Overall diagnostic accuracy is improved when clinical signs, arthrography, and arthroscopy are combined. Treatment of these injuries remains limited. One horse was euthanized, and two were treated by stall rest after diagnosis. Of the two surviving horses, one became a successful breeding animal, and the other was unable to perform as a pleasure horse.     

Use of scintigraphy for diagnosis of equine paranasal sinus disorders

OBJECTIVES: To describe and analyze subjective and objective scintigraphic findings in horses with paranasal sinus disorders. ANIMALS: Horses with suspected disorders of the paranasal sinuses or cheek teeth (n = 48) and control horses (n = 30). METHODS: 99Technetium-methylenediphosphate (99Tc-MDP; 7500 MBq) was administered for scintigraphic examination of the skull. Abnormal patterns of increased radionuclide uptake (IRU) were identified and subjectively described. Scintigrams and radiographs were blindly assessed by 2 clinicians and the accuracy of the imaging modalities was compared. Objective analysis was performed by comparing regions of interest (ROI) drawn over areas of abnormal IRU to the equivalent area on the unaffected side using the Mann-Whitney test. An ROI ratio (affected:non-affected sides) was also calculated for each lesion. RESULTS: Twenty-eight horses were diagnosed with primary (15) or secondary (13) sinusitis. Nine primary sinusitis cases had focal area(s) of moderate or marked IRU in addition to a more diffuse uptake in the affected sinus(es). kappa was marginally higher for scintigraphic assessment of paranasal sinus disorders than for radiographic assessment. There were significant differences in mean counts/pixel in ROI drawn on the affected side compared with the non-affected side. There was considerable overlap between the magnitudes of ROI ratios found with many different disorders. CONCLUSIONS: Scintigraphy can be useful for differentiation of sinusitis of dental origin from other causes of sinusitis. Quantitative analysis of scintigrams is not reliable for identification of particular disorders. CLINICAL RELEVANCE: Focal areas of moderate or marked IRU may be observed with primary sinusitis. Careful 3-dimensional localization of the lesion, along with consideration of other clinical and diagnostic findings should be performed to prevent false-positive diagnoses of periapical infection in such instances.     

Use of antiviral medications against equine herpes virus associated disorders

Numerous types of equine herpesviruses (EHV) continue to afflict horses resulting in a variety of clinical manifestations. While many of the clinical manifestations of EHV are self‐limiting or require only supportive care, some clinical expressions of EHV infections cause severe risk to the horse's overall health and can result in abortion, long‐term deficits or death. Antiviral medications are infrequently utilised therapeutics in equine medicine and their exact efficacy is largely unknown. However, the use of antiviral medications may potentially decrease convalescent time and improve outcome in horses with EHV‐related diseases. Thus, equine practitioners should consider the potential use of antiviral medications in the future. The purpose of this article is to familiarise the equine practitioner with current information in regard to antiviral medications and their potential uses in equine medicine.     

The effect of drugs commonly used in the treatment of equine articular disorders on the activity of equine matrix metalloproteinase-2 and 9

Loss of articular cartilage, which is the most important pathological lesion occurring in osteoarthritis, has been shown to be enzymatically mediated. The matrix metalloproteinases (MMPs) are a group of enzymes which have been implicated in this degradation of articular cartilage matrix. The use of pharmacological agents to inhibit this catabolic process in the joint is a potential route for therapeutic intervention.
  The gelatinase MMPs, MMPs-2 and 9, were purified by affinity chromatography from equine cell cultures. The ability of phenylbutazone, flunixin, betamethasone, dexamethasone, methylprednisolone acetate (MPA), hyaluronan, pentosan polysulphate and polysulphated glycosaminoglycan (PSGAG) to inhibit equine MMPs-2 and 9 were assessed by two degradation assays. Whilst some agents did have direct effects on MMP activity, these effects were only obtained at concentrations which were unlikely to be achieved for any length of time in vivo . It is improbable that any pharmacological agent, currently used in the horse, has a significant effect on gelatinase MMP activity.     

Owner-reported equine health disorders: results of an Australia-wide postal survey

OBJECTIVE: To establish the prevalence of health disorders reported by horse owners registered with veterinary practices in Australia. DESIGN AND METHOD: Mailed questionnaire-based study of horse owners in Australia conducted in 2001. RESULTS: Data were obtained for 3901 horses belonging to 621 owners. The most prevalent health disorders were non-laminitic lameness (13.0%), skin disorders (6.1%) and behavioural disorders (4.5%). Prevalence of health disorders varied among different age, breed and sex categories within the study population, and disorders were more prevalent in male and older horses. CONCLUSION: The most frequent disorders reported by owners were lameness, skin disorders and behavioural disorders. The disease profile was similar to that described in other owner reported studies conducted in the UK and USA.     

Structure of the canine oesophagus

The hardjo component of a bivalent pomona/hardjo vaccine was evaluated, using sheep. Nine sheep were vaccinated and 10 remained unvaccinated. All sheep were challenged with an intraperitoneal and intramuscular injection of a hardjo culture. After 13 weeks, the sheep were slaughtered and their kidneys cultured for leptospires.

There was a highly significant difference between the culture results from the two groups (p<0.001); 10/10 (100%) of the unvaccinated animals gave positive cultures compared with 2/9 (22%)of the vaccinates.     

Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 2: the bony disorders

The metacarpophangeal/metatarsophalangeal (fetlock) joint in the horse is commonly associated with equine lameness and diagnostic imaging is routinely used to investigate disorders of the joint and its surrounding tissues. This review describes the osseous disorders of the fetlock as well as the technical aspects of taking radiographic and ultrasonographic images of the different lesions. In current clinical practice, a combination of radiography and ultrasonography is still the most frequently used approach to arrive at a diagnosis.