The diagnostic and prognostic value of alkaline phosphatase activity in serum and peritoneal fluid from horses with acute colic

Alkaline phosphatase (ALP) is an enzyme present in intestinal mucosa, bile, bone, and renal tubule cells. We sought to assess the diagnostic and prognostic relationships of total ALP (ALPt) activity and that of intestine-derived ALP (ALPi) in serum and peritoneal fluid of 126 horses with colic. ALPt and ALPi activities were measured in both serum and peritoneal fluid by using both standard and L-phenylalanine-based buffers, respectively. Neither ALPt nor ALPi activity were useful in classifying type or severity of intestinal damage. ALPt and ALPi activities in peritoneal fluid were lowest in horses suffering from simple medical colic (39 international units [U]/L [19-60 U/L]; versus 31 U/L [16-44 U/L], median [interquartile range], P < .001) and nonstrangulated surgical lesions (45 U/L [30-62 U/L] versus 36 U/L [23-54 U/L], P < .001), and highest in surgical cases with suspected ulceration (109 U/L [60-1,113 U/L] versus 83 U/L [52-970 U/L], P < .001), strangulation (114 U/L [69-240 U/L] versus 94 U/L [56-191 U/L], P < .001), peritonitis (313 U/L [110-2,227 U/L] versus 283 U/L [91-1,800 U/L], P < .001) or intestinal rupture (687 U/L [205-852 U/L] versus 564 U/L [166-732 U/L], P < .001). Higher ALPt and ALPi activities in peritoneal fluid were associated with greater intestinal damage, increased probability of surgery, and a worse prognosis. The use of L-phenylalanine buffer in both serum and peritoneal fluid did not improve the sensitivity of the test. Based on these results, total ALP activity in peritoneal fluid may help in identifying ischemic or inflammatory bowel lesions in horses with acute colic.     

Detection of bovine papillomavirus DNA on the normal skin and in the habitual surroundings of horses with and without equine sarcoids

The purpose of the present study was to examine whether bovine papillomavirus (BPV) DNA can be detected on the normal skin and in the habitual surroundings of horses with and without equine sarcoids by means of superficially taken swabs. In affected horses, no significant difference in presence of BPV-DNA could be observed between samples obtained from the equine sarcoid surface, from normal skin close to the tumour and from a normal skin site in direct contact with the tumour. From the group of healthy horses living in contact with affected horses, 44% were BPV-DNA positive. The surroundings of affected and non-affected horses are probably not a major source of BPV-DNA contamination. It can be concluded that BPV-DNA is present on the normal skin of horses affected by equine sarcoid and to a lesser degree, on the normal skin of horses living in contact with affected horses.     

Maintenance of arytenoid abduction following carbon dioxide laser debridement of the articular cartilage and joint capsule of the cricoarytenoid joint combined with prosthetic laryngoplasty in horses: An in vivo and in vitro study

The objective was to evaluate CO₂ laser debridement of the cricoarytenoid joint (CAJ) combined with prosthetic laryngoplasty to prevent post-operative loss of arytenoid abduction in seven horses. Horses were assigned to either laser debridement of the left CAJ and laryngoplasty (laser treated, n = 5) or control laryngoplasty (sham, n = 2), and were evaluated with endoscopic examinations and measurement of right to left angle quotients (RLQ) to assess maintenance of arytenoid abduction. The animals were euthanased at intervals after surgery and larynges were harvested for post-mortem testing, including determination of translaryngeal flow, pressure, impedance and RLQ. Measurements were obtained under increasing vacuum-generated negative pressure with laryngoplasty sutures intact and with the knot/crimp of the laryngoplasty sutures removed. Following post-mortem testing the cricoarytenoid joints were examined histologically.Post-operative endoscopic examinations revealed no significant differences between RLQ measurements calculated for day 1 following surgery to the termination date of the study for the seven horses. Post-mortem RLQ at airflows of 10 and 60 L/s was significantly higher in sham than in laser treated horses both before and after knot/crimp removal. Translaryngeal impedance at 10 and 60 L/s was not statistically different between groups. Histopathology revealed necrosis and loss of articular cartilage in the laser treated horses. The lymphoid cell infiltration subsided but joint capsule and periarticular fibrosis increased over the course of the study. Post-operative loss of arytenoid abduction after laryngoplasty can be minimized with CO₂ laser debridement of the CAJ joint.     

Cytologic–histologic concordance in the diagnosis of neoplasia in canine and feline lymph nodes: a retrospective study of 367 cases

Lymph nodes are frequently sampled in dogs and cats for the diagnosis of primary and metastatic neoplasia. We determined the accuracy of cytologic diagnosis in lymph nodes using histology as the gold standard. Lymph node reports (2001–2011) were retrospectively evaluated and diagnoses were categorized as neoplastic or non‐neoplastic. Lymph nodes from 296 dogs and 71 cats included 157 (42.7%) non‐neoplastic lesions, 62 (16.9%) lymphomas and 148 (40.3%) metastatic neoplasms. Cytology had a sensitivity of 66.6% [95% confidence interval (CI) 60.0–72.8%], specificity of 91.5% (CI 86.3–95.2%), and accuracy of 77.2% (CI 72.6–81.3%) for neoplasia. Likelihood of malignancy with a positive cytologic diagnosis of neoplasia was 93.0%. High proportions of false‐negative results were found in mesenteric T‐cell lymphoma (22/35, 63%, mainly cats), metastatic sarcoma (8/14, 57%) and metastatic mast cell tumour (15/48, 31%, mainly dogs). Factors contributing to discrepancies included well‐differentiated lymphocyte morphology, focal distribution of metastases and poorly defined criteria for metastatic mast cell tumours.     

Penile and preputial squamous cell carcinoma in the horse: a retrospective study of treatment of 77 affected horses

Reasons for performing study: The most common penile and preputial neoplasm in the horse is the squamous cell carcinoma (SCC), but no large surveys of treatment and effects of the grade of the tumour, based on the degree of differentiation, on outcome of affected horses are available. Objectives: Analysis of treatment of male horses affected with SCC of the external genitalia and long‐term results of treatment. Methods: Seventy‐seven cases of SCC were evaluated. Data recorded included treatment, outcome, post operative histopathology and retrospective tumour grading. Results: Treatments included: cryosurgery, excision, partial phallectomy, partial phallectomy and sheath ablation, and en bloc penile and preputial resection with penile retroversion and removal of inguinal lymph nodes. The incidence of recurrence after partial phallectomy was 25.6% (10/39) and following incomplete removal was 17.9% (7/39). The incidence of recurrence after en bloc resection with retroversion was 12.5% (1/8). In horses with confirmed inguinal lymph node metastasis, the incidence of recurrence was 25.0% (1/4). Poorly differentiated SCCs were more likely to metastasise than well differentiated SCCs, and there was a greater chance that the treatment would be unsuccessful. The success of treatment, complete removal and in preventing recurrence of the tumour, of male horses with SCC of the external genitalia was 55.7%. Conclusions: Horses that receive only partial phallectomy for treatment for SCC of the external genitalia have a high incidence of recurrence in contrast to horses that receive an en bloc resection. Tumour grading of SCC can help predict prognosis and guide selection of treatment.     

Effect of freeze-drying on measurements of pH in biopsy samples of the middle gluteal muscle of the horse: comparison of muscle pH to the pyruvate and lactate content

Muscle biopsies taken after exercise, in comparison to those at rest, contain increased amounts of blood and this is a particular problem in studies of the horse. The inclusion of blood in muscle will introduce an upward bias in values of pH measured in muscle homogenates. In an attempt to control this, muscle biopsy samples of the middle gluteal from Thoroughbred horses were freeze-dried and dissected free of blood before determination of pH. Following exercise, muscle pH measured after freeze-drying was similar to that measured in homogenates prepared from frozen samples. In contrast, freeze-drying appeared to increase muscle pH in samples taken at rest. This was probably the result of loss of CO2 during freeze-drying. Muscle pH determined in freeze-dried samples taken at rest and after exercise was linearly related to pyruvate and lactate content (P less than 0.001). It is concluded that muscle samples taken after exercise can be freeze-dried and dissected free from blood before determination of pH, whereas this procedure will cause an alkaline shift in samples taken at rest.     

Quantification of surface EMG signals to monitor the effect of a Botox treatment in six healthy ponies and two horses with stringhalt: Preliminary study

Reasons for performing the study: Therapeutic options for stringhalt in horses are limited, whereas medical experiences with botulinum toxin type A (Botox) have been positive. To evaluate its effectiveness in horses, surface electromyography (sEMG) signals before and after injection need to be quantified. Hypothesis: Treatment of healthy ponies and cases with Botox should reduce muscle activity in injected muscles and reduce spastic movements without adverse side effects. Methods: Unilaterally, the extensor digitorum longus, extensor digitorum lateralis and lateral vastus muscles of 6 healthy mature Shetland ponies and 2 talented Dutch Warmblood dressage horses with stringhalt were injected (maximum of 400 iu per pony and 700 iu per case; 100 iu in 5 ml NaCl divided into 5 injections) with Botox under needle EMG guidance. Surface EMG data were evaluated using customised software, and in the individuals gait was analysed using Proreflex. Statistical analysis was performed using mixed models and independent sample t test (P<0.05). Results: Surface EMG signals were quantified using customised software. The area under the curve (integrated EMG) in time was used as variable. It became significantly reduced in injected muscles after injection of Botox in normal ponies (P<0.05). This effect was present from Day 1 until Day 84 after injection. In the 2 cases, after injection of 3 muscles, the integrated EMG in time became significantly reduced in all 3 muscles. Kinematic measurements confirmed reduction of frequency and amplitude of hyperflexing or hyperabducting strides of the affected hindlimbs. The duration of effect was also seen in the cases until around 12 weeks after injection. Conclusions and potential relevance: After EMG guided injections of Botox, sEMG signals recorded from injected muscle were reduced, which proves this to be a useful tool in statistically evaluating a treatment effect. The positive results of this pilot study encourage further research with a larger group of clinical cases.     

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

Spontaneous pneumothorax induced by grass awns accounts for 5% of spontaneous pneumothorax and 22.5% of thoracic grass awn cases. Previous studies report limited interest of CT for spontaneous pneumothorax. Aims of this retrospective case series were to describe CT features of this condition and determine if CT features can efficiently localize the perforation site. Dogs that had a spontaneous pneumothorax, CT examination, thoracic surgery, and confirmed lung perforation due to a grass awn were included. Computed tomography studies were reviewed and compared to the surgical findings.  In 19 of 22 (86.4%) dogs, the pneumothorax or its recurrence were ipsilateral to the perforation site. The perforation site was identified in 21 of 22 (95.5%) dogs and involved the caudal lobes in 20 of 22 (90.9%) cases. The lateralization and the involved lung lobe corresponded to surgical findings in 21 of 22(95.5%) dogs. The perforation site was characterized as a soft tissue attenuating focus lying against an extensive pleural thickening in 21 of 22(95.5%) dogs. An adjacent defect in the visceral pleura was seen in 13 of 22(59.1%) dogs. A grass awn was seen in 11 of 22(50%) dogs.  The pneumothorax distribution and grass awn position consistently indicated the perforation side in this sample of dogs. The comparison with surgical findings suggests CT might be helpful for future presurgical planning of this etiology for pneumothorax.     

Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006)

Objective   Describe the use of a phalangeal cast as treatment for wounds in the pastern and foot region of horses. Secondly, to evaluate the healing and soundness of horses treated with phalangeal casts.
Design   Retrospective study of 49 horses.
Procedures   Medical records of 49 horses that were treated with a phalangeal cast for 50 cases of wounds in the pastern and foot region at equine referral hospitals from 1995 to 2006 were reviewed and follow-up information was obtained.
Results   Treatment consisted of wound debridement, lavage, wound closure (28 wounds), cast application and antibiotics (84%). At follow-up, the majority of horses were sound (42 of 47 wounds, 89.4%), three horses were still lame and one horse was euthanased because of persistent lameness. Three horses were lost to follow-up. There was no statistical difference between the outcomes of horses treated acutely (<24 h) or after a 24-h delay. Similarly, the involvement of synovial structures in the wound did not significantly influence outcome.
Conclusions   In this study, wounds involving the pastern and foot that were treated with a phalangeal cast carried a good prognosis for soundness (89.4%) and cosmetic healing (89.5%). The phalangeal casts were well-tolerated and effective.     

Diagnostic accuracy of electrocardiography and thoracic radiography in the assessment of left atrial size in cats: comparison with transthoracic 2-dimensional echocardiography

BACKGROUND: Left atrial (LA) enlargement (LAE) is a morphologic expression of the severity and chronicity of left ventricular (LV) diastolic dysfunction, volume overload, and increased atrial pressure and has diagnostic, therapeutic, and prognostic importance in cats. The noninvasive gold standard for assessing LA size is 2-dimensional echocardiography (2DE). HYPOTHESIS: ECG and thoracic radiography may be used to predict LAE in cats. ANIMALS: Twenty-one healthy control cats and 31 cats with cardiomyopathy were prospectively studied. METHODS: 2DE studies, including determination of the maximum LA dimension (LAD) and area (LAA), were performed prospectively in all cats and compared to the assessment of LA size based on thoracic radiography and indices obtained from a 6-lead ECG. Results obtained from healthy cats were used to generate discrimination limits suggestive of LAE as defined by LAD > 1.57 cm and LAA > 2.75 cm2. RESULTS: In cats with LAE, P wave duration and PR interval were prolonged and radiographic LA vertebral heart size (LA-VHS) was increased (P < .05). P wave-related indices had low sensitivity (Se; range, 0.12 to 0.60) but high specificity (Sp; range, 0.81 to 1.00) for the prediction of LAE. Radiographic indices had low Se (range, 0.28 to 0.72) and high Sp (range, 0.74 to 0.95) for the prediction of LAE. Correlation analyses identified correlations between LAA and P wave duration (r = 0.47, P = .003) and LAD and LA-VHS (r = 0.70, P < .001). CONCLUSION AND CLINICAL IMPORTANCE: ECG and thoracic radiography are reasonably specific but less sensitive predictors of LAE in cats.     

Functional and morphological changes in the adenohypophysis of dogs with induced primary hypothyroidism: loss of TSH hypersecretion, hypersomatotropism, hypoprolactinemia, and pituitary enlargement with transdifferentiation

From case studies in humans it is known that primary hypothyroidism (PH) may be associated with morphological and functional changes of the pituitary. There is no insight into the time scale of these changes. In this study, seven beagle dogs were followed up for 3 years after the induction of primary hypothyroidism. Three of these dogs were followed up for another 1.5 years while receiving l-thyroxine. Adenohypophyseal function was investigated at 2-month intervals with the combined intravenous injection of CRH, GHRH, GnRH, and TRH, and measurement of the plasma concentrations of ACTH, GH, LH, PRL, and TSH. In addition, after 2 years of hypothyroidism a single TRH-stimulation test and a somatostatin test were performed, with measurements of the same pituitary hormones. Every 6 months the pituitary gland was visualized by computed tomography (CT). Induction of PH led to high plasma TSH concentrations for a few months, where after concentrations gradually declined to values no longer significantly different from pre-PH values. A blunted response to stimulation of TSH release preceded this decline. Basal plasma GH concentrations increased during PH and there was a paradoxical hyperresponsiveness to TRH stimulation. Basal GH concentrations remained elevated and returned only to low values during l-thyroxine treatment. Basal PRL concentrations decreased significantly during PH and normalized after several months of l-thyroxine treatment. The pituitary gland became enlarged in all dogs. Histomorphology and immunohistochemical studies in 4 dogs, after 3 years of PH, revealed thyrotroph hyperplasia, large vacuolated thyroid deficiency cells, and decreased numbers of mammotrophs. Several cells stained for both GH and TSH. In conclusion, with time PH led to a loss of the TSH response to low T4 concentrations, hypersecretion of GH, and hyposecretion of PRL. The enlarged pituitaries were characterized by thyrotroph hyperplasia, large vacuolated thyroid deficiency cells, and double-staining cells, which are indicative of transdifferentiation.     

Cross-sectional serological survey on gastrointestinal and lung nematode infections in first and second-year replacement stock in the netherlands: relation with management practices and use of anthelmintics

A cross-sectional survey was carried out on 86 farms randomly distributed in The Netherlands. After housing following the first and the second grazing season (FGS and SGS) serum samples were collected to determine IgG levels against Cooperia oncophora and Dictyocaulus viviparus, and the pepsinogen content. A questionnaire was used to inquire on grazing management practices and the use of anthelmintic drugs. On 80.7 and 60.2% of the farms FGS and SGS animals, respectively, were treated at least once with an anthelmintic drug. The percentage for the SGS animals indicates that the use of anthelmintic drugs in those animals has increased enormously over the last 10–15 years. Generally, parasitic nematode control in the FGS is good on most farms, but it can be characterised as being overprotective. There is a tendency that if anthelmintic drugs are used in the FGS they also are used more often in the SGS. On 12 farms (14%), no anthelmintic drugs were given in the FGS and the SGS. These farms did not differ from the others with respect to management practices in any obvious way. The serological results were in general very low, indicating low levels of exposure to gastrointestinal nematode infection in both FGS and SGS animals. This was not surprising in view of the good to high level of nematode control practices reported by the farmers. Although not statistically significant, a consistent result was that serological results for the SGS animals were more often positive or on average higher on those farms where FGS parasite control tended to be excessive. For D. viviparus, a prevalence rate of 41% positive farms was found. Following comparison with previous data, it is speculated that lungworm (sero-)prevalence in replacement stock may be declining as a result of continuing high levels of parasite control in replacement stock. It is concluded that the results confirm previous surveys, lending support to the conclusion that parasitic nematode control on Dutch dairy farms, certainly in FGS calves, is good but tends to be overprotective.