Laparoscopic Closure of the Renosplenic Space in Standing Horses

OBJECTIVE: To report a technique for laparoscopic ablation of the renosplenic space in standing horses. STUDY DESIGN: Development of a technique to perform laparoscopic renosplenic space ablation in standing horses. ANIMALS: Five healthy horses, aged 3 to 13 years, weighing 380 to 520 kg. METHODS: Horses were restrained in standing stocks and sedated with detomidine (0.01 mg/kg intravenously [IV]) and butorphanol (0.01 mg/kg IV). Portal sites in the left paralumbar fossa were infiltrated with 2% mepivacaine. A laparoscopic portal was placed between the 17th and the 18th ribs. Two instrument portals were located caudal to the 18th rib. Closure of the renosplenic space was accomplished by apposing the dorsomedial splenic capsule to the dorsal portion of the renosplenic ligament with 1 polyglactin 910 in a continuous pattern. All horses had repeat laparoscopy 3 weeks after initial surgery. RESULTS: Laparoscopic closure of the renosplenic space required 35 minutes (range, 20-65 minutes) and was successful without intraoperative or postoperative complications. On laparoscopic re-examination at 3 weeks, there was smooth connecting fibrous-like tissue between the dorsal splenic capsule and the dorsal portion of the renosplenic ligament. CONCLUSIONS: Laparoscopic closure of the renosplenic space can be efficiently and safely performed in standing horses. CLINICAL RELEVANCE: Laparoscopic-assisted closure of the renosplenic space can be performed in standing horses and may be useful in preventing recurrent incarceration of viscera in this space.     

Laparoscopic Gonadectomy in Two Intersex Warmblood Horses

Two phenotypically female Warmblood horses were presented at the Clinic for Horses owing to stallion-like behavior. One mare had an enlarged clitoris, whereas the other one showed no signs of ambiguous external genitalia. In both cases, intra-abdominal testicles were removed by laparoscopy. Hormone status, cytogenetic evaluation, and histopathological examination of the gonads were performed. One animal was diagnosed as having XX disorder of sexual development; the other one, as male pseudohermaphrodite.     

Nephrosplenic Space Ablation in Horses After Homologous Pericardium Implant Using a Laparoscopic Stapler

This study aimed to describe and evaluate a laparoscopic technique to promote nephrosplenic space ablation in horses using a homologous pericardium implant, preserved in 98% glycerin and fixed using laparoscopic polydioxanone staples. In this experimental study, six Arabian horses without previous related abdominal diseases were used. The surgical procedures were performed in the standing position under sedation with alpha-2 agonists and opioids, associated with local infiltration of the local anesthetic in the portal sites. The horses were restrained in a stock, and the left flanks were clipped and aseptically prepared. Three portals were created on the left flank, and the homologous pericardium implant, measuring 10 × 5 cm, was introduced into the abdominal cavity covering the nephrosplenic space, positioned between the dorsal border of the spleen and perirenal fascia, fixed with polydioxanone staples using a laparoscopic stapler. Physical examination and blood and peritoneal fluid sample collection were performed on days 0, 1, 3, 7, 14, 30, and 60 of the postoperative period, and an exploratory laparoscopy was performed on day 60 to assess the effectiveness of the technique and eventual complications. There were no difficulties or significant complications during the surgical procedure, and the total average time to perform was 49.83 minutes (±10.19). In the postoperative period, there was a significant increase (P < .05) in the plasma fibrinogen concentration on days 7 and 14 compared with the preoperative moment. The total nucleated cell count in the peritoneal fluid increased (P < .05) on days 1, 3, 7, 14, and 30. After 60 days of the surgical procedure, the physical examination and laboratory data were within the normal range. Exploratory laparoscopy performed on day 60 revealed complete occlusion of the nephrosplenic space, and it was not possible to differentiate the pericardium implant from the scar tissue, not even in the histological evaluation performed on the collected samples. In two horses, omentum adhesion was observed in the region where the implant was fixed, and in two others, a synechia was observed between the implant area and mesocolon without association with clinical complications. The animals were followed up for 36 months at surgery, and no colic signs were observed along this period. It was concluded that the technique of ablation of the nephrosplenic space, using homologous pericardium preserved in 98% glycerin, fixed by polydioxanone staples by laparoscopy, was simple to perform, effective, and free of clinical complications during the period of evaluation, and its use may be indicated as a surgical option in clinical cases of horses with recurrent nephrosplenic entrapment.     

Laminitis in Horses: Through the Lens of Systems Theory

Systems theory is a way of describing complex and dynamic relationships. We applied systems theory to the structure and function of the equine foot in an effort to better understand laminitis and, in so doing, reconcile the various theories of its etiopathogenesis and find more universally effective preventive and therapeutic strategies. The foot is described as an open system, and its inherent vulnerabilities are explored. Cascade failure is discussed as a potentially unifying theory of laminitis. The fundamental failure in laminitis is failure of the lamellar dermal−epidermal bond, but that endpoint can be reached via vascular, enzymatic, inflammatory, or mechanical mechanisms, or any combination thereof. Inflammation is discussed as a common denominator, making anti-inflammatory therapy of greater importance than just pain management. Multimodal anti-inflammatory therapy is discussed, including selective COX-2 inhibitors, heparin, nutraceuticals, and inhibitors of matrix metalloproteinases (MMPs). Multimodal analgesic therapy also is important and may include nonsteroidal anti-inflammatory drugs (NSAIDs), opiates, epidural analgesics, physical therapy, relief of weight bearing, diligent nursing care, deep digital flexor tenotomy, and case-appropriate trimming and shoeing. Preventing laminitis still comes down to risk management: knowing the risk factors applicable to an individual horse and adjusting the management accordingly. Examples include weight management and control of carbohydrate intake in overweight horses and ponies, the use of pergolide in patients with pituitary pars intermedia dysfunction (PPID), and distal limb cryotherapy in high-risk patients. It is anticipated that application of molecular biologic techniques will further advance treatment and prevention of laminitis.     

Morphology and Morphometry of Seminiferous Tubules in Crioulo Horses

This study aimed to assess the biometrics of the testes and the morphology of the seminiferous tubules of Crioulo horses. We studied 10 sexually mature stallions (3–6 years of age). After orchiectomy, testes were perfused with Karnovsky's solution and then embedded in glycol methacrylate. Testis sections (4 μm) were cut and stained with toluidine blue and a solution of 1% sodium borate. The histological images were digitized, and the morphometric analysis was performed using ImageJ software. The average weight of the stallions was 377.5 kg, and the average weight of both testicles was 162.9 g. The percentage of testicular parenchyma occupied by the seminiferous tubules and the intertubular tissue was 77.97% ± 6.34% and 22.03% ± 6.34%, respectively. The average tubular diameter was 205.00 ± 36.91 μm, whereas the average height of the seminiferous epithelium was 70.56 ± 2.82 μm. Average tubular length per testicle and average tubular length per gram of testicle were 4,085.10 ± 1,170.68 m and 26.09 ± 10.63 m/g, respectively. The characteristics of the eight stages of the seminiferous epithelium cycle were similar to those reported in other horse breeds. We conclude that the morphometry of the seminiferous tubules of Crioulo horse resembles what has been reported in other horse breeds. The volumetric proportion of the seminiferous tubules and the Leydig cells of the Crioulo horse is one of the highest ever reported for stallions.     

Variation of Insulin Sensitivity Estimates in Horses

In the horse, resting insulin concentration (INS), the glucose-to-insulin ratio (G:I), and the reciprocal of the square root of insulin (RISQI = 1/√INS) are commonly used to estimate insulin sensitivity, whereas the modified insulin-to-glucose ratio (MIRG = [800 – 0.30 × (INS -50)²]/(GLU – 30) is used to estimate pancreatic beta-cell responsiveness. Because no estimates of their within-horse variability and repeatability have been reported, the objective of this study was to evaluate the within-horse variation of these estimates. Resting blood samples were obtained from six healthy equids (three geldings, two mares; mean ± SD body weight, 525.0 ± 43.36 kg; mean age, 9.8 ± 8.2 years; and one pony gelding: 293 kg; 12 years) on three consecutive days in week 1 and again in week 2. Samples were collected at 12:00 noon, approximately 6 hours postprandially. Serum insulin and plasma glucose (GLU) concentrations were analyzed and used to calculate G:I, RISQI, and MIRG, as well as the insulin to glucose ratio (I:G). The coefficient of variation was used to determine within-horse variation, and repeatability was determined using the repeatability coefficient (RC; measurements from a single horse should differ less than the RC for 95% of the pairs). The mean coefficients of variation (CVs) for resting GLU, INS, G:I, I:G, MIRG, and RISQI were 5.5%, 33.7%, 36.0%, 31.6%, 22.3%, and 18.6%, respectively. All variables had values that differed more than the RC in at least one horse. These data suggest that care should be taken when interpreting insulin sensitivity estimates from a single blood sample.     

Feline Temporal Lobe Epilepsy: Review of the Experimental Literature

Accumulating evidence suggests that epileptic seizures originating from the temporal lobe (TL) occur in cats. Typically, affected animals have clinically focal seizures with orofacial automatisms including salivation, facial twitching, lip smacking, chewing, licking, and swallowing. Motor arrest and autonomic and behavioral signs also may occur. Many affected cats have magnetic resonance imaging (MRI) changes within the hippocampus or histopathologically confirmed hippocampal sclerosis or necrosis. From the 1950s to the 1980s, cats frequently were used as animal models for neurophysiological experiments and electrophysiological studies, from which important basic knowledge about epilepsy originated, but which has been rarely cited in clinical veterinary studies. These studies were reviewed. Experimental research on cats showed the widespread anatomical connections among TL structures. The ictal clinical signs originating from the hippocampus, amygdala, or lateral temporal cortex are similar, because of their dense interconnections. The ictal signs can be divided into autonomic, somatic, and behavioral. For research purposes, a 6‐stage system was established, reflecting the usual sequential progression from focal to generalized seizure: attention response (1), arrest (2), salivation, licking (3), facial twitching (4), head turning or nodding (5), and generalized clonic convulsions (6). Knowledge of this data may help in recognizing low‐stage (stage 1 or stage 2) epileptic seizures in clinical practice. Early experimental research data are in accordance with recent clinical observations regarding ictal clinical signs of TL epileptic seizures in cats. Furthermore, the research data supports the idea that TL epilepsy represents a unique clinical entity with a specific seizure type and origin in cats.     

Magnetic Resonance Imaging Findings in the Proximal Metacarpal Region of 359 Horses and Proximal Metatarsal Region of 64 Horses Acquired Under Standing Sedation

Standing magnetic resonance (MR) images of proximal metacarpal/metatarsal regions are increasingly being acquired. This study aimed at describing ranges of abnormalities detected in sport/racehorses, using retrospective evaluation of magnetic resonance imaging (MRI) reports from horses with lameness isolated to proximal metacarpal/metatarsal regions with images acquired standing. It was hypothesized that MRI features are different between metacarpal and metatarsal regions and between horses doing different sports. Reports from 359 forelimbs and 64 hindlimbs were included. Palmar/plantar metacarpal/metatarsal bone injury and suspensory desmopathy, which often occurred concurrently, were most frequently reported. Third metacarpal abnormalities were more likely at palmar/medial locations, including cortical (86.4%) and trabecular (38.2%) pathology with frequent thickening, irregularity, and periosteal/endosteal abnormalities. Fluid signal was reported in cortical (38.7%) and trabecular (22.6%) bone. Medial intermetacarpal articulation abnormalities were more frequently reported (52.5%) than lateral. Suspensory ligament pathology was reported in 83.8% forelimbs, frequently with cortical (74.1%) or trabecular (32.9%) pathology. Tarsal-joint abnormalities were significantly more likely than carpal-joint abnormalities. Third metatarsal cortical (57.8%) and trabecular (20.3%) pathology was most frequently plantar, but significantly more likely to be dorsal than forelimbs. Metatarsal fluid signal was significantly less likely than metacarpal. Lateral intermetatarsal articulation pathology (23.4%) was more frequent than medial; medial was significantly more likely in forelimbs. Suspensory ligament abnormalities were reported in 64.1% hindlimbs, 39.1% having concurrent cortical pathology. Metacarpal fluid signal was significantly more likely in endurance/racehorses than dressage/show jumping horses. Dressage was overrepresented in hindlimb suspensory origin pathology. These findings indicate different pathology patterns between forelimb/hindlimb and between different sports and may be useful for MRI interpretation.     

Efficacy of Hyperimmunized Plasma in the Treatment of Horses with Acute Colitis

Colitis in the adult horse is a life-threatening clinical condition that can be caused by any of several enteric pathogens. This study was conducted to determine whether treating horses with plasma obtained from donors that were hyperimmunized against the common equine diarrheal pathogens Clostridium difficile, Clostridium perfringens, and Salmonella sp shortens the duration of diarrhea in acute colitis. To evaluate the efficacy of plasma treatment, 42 horses with acute onset of diarrhea were studied. Horses were enrolled if they were of age >1 year, duration of diarrhea at presentation was <72 hours, and they had not received equine plasma within the last 3 months. In addition, the serum cortisol concentrations of horses with acute diarrhea were studied.Horses were randomized to receive hyperimmunized plasma, control plasma (collected from nonimmunized horses), or no plasma therapy. Clinical parameters and fecal consistency were observed until resolution, discharge, or death, and complete blood counts (CBCs) and biochemical profiles were collected throughout the study. A total of 38 horses completed the study. The mean duration of diarrhea was 40.7 ± 9.8 (mean ± SEM) hours, 119.2 ± 56.1 hours, and 72.0 ± 24.5 hours for the hyperimmunized plasma, normal plasma (NP), and control groups, respectively. Using survival analysis techniques, this difference did not achieve statistical significance (P = .374). Serum cortisol was found to be increased in all horses at presentation and to decrease with time in all treatment groups. There was no difference in cortisol concentrations between the three treatment groups studied (P = .237).     

A Preliminary Investigation Into the Mineral Intake of Horses in the UK

The diet of the domesticated horse is influenced by both internal and external variables, such as age, breed, discipline, and workload, as well as the feed brand preference of the owner. With a range of products and feeds available to the horse owner, this has the potential to lead to inappropriate feeding management. The aim of this study was to evaluate the current mineral intakes of horses in the UK. An online questionnaire was used to collect data on horse and owner demographics and feed rations. Total daily intakes of phosphorus, calcium, sodium, and potassium were calculated based on forage, concentrate, and supplement information given in the questionnaire. Estimated mineral intakes were compared to recommended levels using a Wilcoxon signed-rank test. Intakes of phosphorus, calcium, sodium, and potassium were found to be significantly (P < .001) higher than NRC recommendations, with most estimated mineral intakes originating from the forage component of the diet. However, the calcium to phosphorus ratio was calculated at 2.07:1, which is close to the recommended ratio limits. Excess intakes of calcium, phosphorus, sodium, and potassium have the potential to influence the metabolism of additional macro and micro minerals and, therefore, further research into this area is recommended.     

Electrocution as a Cause of Sudden Death in Horses

Four previously-well horses experienced electrical exposure due to unsuspected buried electrical wiring on entering a wet indoor barn arena surface. Two horses died. Electrocution was determined to have resulted from deterioration in the wiring and conductance through the wet arena. Horses shod on all four hooves were more severely affected than horses shod on front hooves only. An affected horse owner and two surviving horses recovered uneventfully. Inadvertent electrical exposure from buried wires in a wet (arena) surface may be an important consideration for sudden unexplained deaths, convulsions, or avoidance of an area in horses. Guidelines for electrical placement in areas used by horses are reviewed.     

Epigenetic Regulation of Gene Expression: Emerging Applications for Horses

Epigenetic modifications play a central role in the cellular and developmental programming of gene expression, serving as a molecular code for regulating the spatial and temporal patterns of gene expression. Epigenetic modifications are unique as they are cell-specific, heritable, and dynamic. They provide a framework for regulating gene expression, a map of functional noncoding elements in the genome, a biological sensor of environmental conditions, and a window of opportunity for the potential development of therapeutic strategies. Here we provide a brief overview of our current understanding of the epigenetic mechanisms regulating gene expression, focusing on DNA methylation and posttranslational modifications of histone proteins. Furthermore, we explore the emerging field of epigenetics in the horse, including the identification of functional elements in the horse genome and the potential development of epigenetic therapies in horses.