Update on Metabolic Diseases Associated With Laminitis in Horses and Ponies

Several recent scientific publications describe some important findings that may further improve our ability to diagnose and manage both equine Cushing's disease (ECD) and equine metabolic disease (EMD). This abstract provides a brief summary of recent findings in ECD and EMD that have immediate application for clinical practice.     

Lactate Dehydrogenase Activity in Abdominal Fluid From Horses With Colic

The purpose of this study was to determine whether lactate dehydrogenase (LDH) activity in abdominal fluid could be used as a prognostic indicator in horses with colic. Lactate dehydrogenase activity was measured in 27 abdominal effusions from horses with colic presented to Murdoch University Veterinary Teaching Hospital using three different LDH test methods. Lactate in effusions was also measured in 11 of the horses. Lactate dehydrogenase activity was significantly different for each test method used—the ratio of Randox wet chemistry LDH lactate to pyruvate:Randox wet LDH pyruvate to lactate (P-L):IDEXX dry chemistry P-L was approximately 1:2:4. Lactate dehydrogenase activity in the abdominal effusions was significantly higher with all methods in the horses that died or were euthanized because of abdominal sepsis or advanced neoplasia than in those that survived after treatment for colic signs because of mechanical obstructions or nonseptic abdominal inflammation. Lactate dehydrogenase activity showed moderate-to-good correlation (r = 0.73 to 0.86) with lactate concentration of the fluid. In conclusion, LDH activity in abdominal fluid may be a useful prognostic test in horses with colic. The test method for LDH measurement must be known and remain constant for meaningful interpretation. Significantly higher levels of LDH activity may be present in horses with colic because of sepsis or advanced neoplasia than in those with colic because of nonseptic inflammation or mechanical obstructions that may respond to treatment.     

Plasma Adrenocorticotropin Concentration in Healthy Horses and in Horses With Clinical Signs of Hyperadrenocorticism

Pituitary adenomas are commonly reported in older horses. The typical clinical signs associated with this condition, also known as equine Cushing's disease (ECD), are related to increased adrenocorticotropin (ACTH) production resulting in hyperadrenocorticism. The primary purpose of this study was to determine whether plasma ACTH concentrations differed between cushingoid and healthy horses. The second objective was to determine the effects of blood sample handling techniques on ACTH concentrations. A commercial human ACTH radioimmunoassay (RIA) was used to quantify equine plasma ACTH. Intra-assay and interassay variations, as well as dilutional parallelism were determined during the RIA validation. Plasma ACTH concentrations were evaluated in a group of healthy equids composed of 18 horses and 9 ponies, and in 22 equids with a clinical diagnosis of hyper adrenocorticism (11 horses and 11 ponies). The mean plasma ACTH concentrations in healthy horses and ponies, (18.68 ± 6.79 pg/mL (mean ± SD) and 8.35 ± 2.92 pg/mL, respectively), were significantly different (P = .009). The mean plasma ACTH concentration in horses and ponies with ECD, (199.18 ± 182.82 pglmL and 206.21 ± 319.56 pg/mL, respectively), were significantly higher than the mean ACTH concentration in the control animals (P < .001). Plasma ACTH concentrations appeared to be a sensitive and specific indicator of ECD in horses and ponies. ACTH concentrations measured in plasma samples kept at room temperature (19°C) as long as 3 hours after blood collection were not statistically different from those of samples kept at 1°C. J Vet Intern Med 1996;10:1–6. Copyright 1996 by the American College of Veterinary Internal Medicine .     

Oxidative Stress Associated With Spasmodic,Flatulent, and Impaction Colic in Draft Horses

The aim of the present study was to evaluate the oxidative stress level and antioxidant trace elements status associated with spasmodic, flatulent, and impaction colic in draft horses. For this purpose, venous blood samples were obtained from 20 randomly selected clinically healthy draft horses (control group) and 60 draft horses with different types of colic (spasmodic colic, n = 20; flatulent colic, n = 20; and impaction colic, n = 20). In horses with flatulent and impaction colic, there was a significant (P < .05) decrease in the total antioxidant capacity and activity of reduced glutathione (GSH) and catalase (CAT) as well as level of selenium, copper, zinc, and iron. However, there was a significant (P < .05) increase in the activity of superoxide dismutase (SOD) and in the level of malondialdehyde (MDA), interleukin-6 (IL-6), and manganese. Meanwhile, glutathione reductase (GR) was significantly (P < .05) increased in flatulent colic and significantly (P < .05) decreased in impaction colic. The oxidative stress index (OSI) was significantly (P < .05) increased in horses with flatulent and impaction colic. In horses with flatulent colic, there was a negative correlation between CAT and SOD (r = −0.446), MDA and zinc (r = −0.450), and IL-6 and zinc (r = −0.470). However, those with impaction colic, a negative correlation was recorded between CAT and MDA (r = −0.602), copper and GSH (r = −0.474), iron and GR (r = −0.511), and OSI and GR (r = −0.662). The results of the present study indicate that oxidative stress, with alteration of antioxidant trace element levels, is a feature of flatulent and impaction colic in draft horses.     

Usefulness of a Point-of-Care Analyzer to Measure Cardiac Troponin I and D-Dimer Concentrations in Critically Ill Horses With Gastrointestinal Diseases

Point-of-care (POC) systems for the joint measurement of Troponin and D-dimers have not been studied in horses. The aim of this study was to perform the validation of a POC system (AQT90 FLEX) for the measurement of cardiac troponin I (cTnI) and D-dimers in the serum of horses with gastrointestinal diseases. The main objective was to evaluate whether or not this system can distinguish healthy animals from diseased animals. A sample of 33 horses was included in the study: control group (n = 10) and horses with gastrointestinal disorders (n = 21), which were classified according to their outcome in survivors (subgroup A = 9) and nonsurvivors (subgroup B = 12). Considering the diagnosis of the process, ill horses were classified into three groups: inflammatory (I = 7), obstructive (O = 9), and strangulating diseases (S = 5). The clinical usefulness of AQT90 FLEX was validated by the study of linearity, coefficient of variation, and detection limits. Later, concentrations of D-dimers and cTnI were measured. A significant increase in both parameters was detected in ill animals (cTnI: control: 0.014 ± 0.01 μg/mL, survivors: 0.27 ± 0.37 μg/mL, nonsurvivors: 0.60 ± 1.21 μg/mL; D-dimers: control: 104.90 ± 30.82 ng/mL, survivors: 1,217.22 ± 1,213.28 ng/mL, nonsurvivors: 1,613.67 ± 1,426.75 ng/mL), although there were no statistically significant differences in concentrations according to diagnosis and outcome. In conclusion, AQT90 FLEX POC analyzer can be used in horses with gastrointestinal diseases to measure cTnI and D-dimer concentrations. It is a quick, practical, and minimally invasive tool that helps in determining the severity of illness.     

Nitrate Poisoning in Horses Associated With Ingestion of Forage and Alfalfa

This report describes nitrate poisoning observed in thoroughbred mares. Nine horses died at a farm in Bursa, Turkey, between February and April of 2008. Five of them were pregnant. Clinical findings developed over a short period and included severe abdominal pain, limited response to analgesics and antispasmodics, diarrhea, shallow and rapid breathing, tachycardia, blue-brown discoloration of the mucosal membranes, tremors, ataxia, convulsions before death, and abortion in the pregnant mares. The main postmortem finding was chocolate brown–colored blood as well as congestion and inflammation of the intra-abdominal organs. Uterine rupture, colonic ruptures, and torsio uteri were seen in the pregnant mares. Stomach and intestinal ruptures were seen in four nonpregnant mares. High nitrate concentrations were determined in some grass and alfalfa samples used to feed the animals. Nitrate poisoning is considered to be very rare in horses, but, in this case, the clinical symptoms, postmortem findings, and nitrate levels in the collected samples supported nitrate and nitrite poisoning as the cause of deaths.     

Comparison of Serum Amyloid A in Horses With Infectious and Noninfectious Respiratory Diseases

The acute phase protein serum amyloid A (SAA) has been shown to be a useful inflammatory parameter in the horse, but studies showing SAA responses to specific respiratory disease etiologies are limited. The goal of this study was to evaluate SAA responses in horses with infectious and noninfectious respiratory diseases as well as healthy, control horses. Two hundred seven horses were grouped into the following categories: equine influenza virus (EIV), equine herpesvirus-4 (EHV-4), Streptococcus equi subspecies equi (S. equi ss equi), inflammatory airway disease (IAD), and healthy controls. Serum amyloid A concentrations were determined for all horses on serum using a stall-side lateral flow immunoassay test. Serum amyloid A levels were found to be significantly greater for infectious respiratory diseases (EIV, EHV-4, S. equi ss equi) and horses with IAD when compared to control horses. There was a significant difference between viral and bacterial infections and IAD. Although SAA values from horses with S. equi ss equi were significantly greater when compared to horses with viral infections (EIV/EHV-4), the wide range of SAA values precluded accurate classification of the infectious cases. In conclusion, SAA is more reliably elevated with infections of the respiratory tract rather than noninfectious airway conditions. This can facilitate early detection of respiratory infections, help track disease progression, and aid practitioners in making recommendations about proper biosecurity and isolation of potentially contagious horses.     

Autogenous Cancellous Bone Grafts From the Sternum in Horses Comparison With Other Donor Sites and Results of Use in Orthopedic Surgery

Cancellous bone was collected from the fourth or fifth sternebra of six horses aged 12 to 36 months, and compared quantitatively and qualitatively with cancellous bone collected from the tuber coxa, proximal tibia, and rib at the time of necropsy, 28 to 49 days after surgery. Cancellous bone collected from the sternum was equivalent in amount and in microscopic appearance to that collected from the other three sites.
Cancellous bone also was collected from the sternum for use during clinical orthopedic surgery in 18 horses. Wound dehiscence occurring in two horses healed uneventfully by second intention. In each horse, an adequate amount of cancellous bone was obtained from one sternebra, with the exception of one horse where cancellous bone from two sternebra was used. Major complications with the donor sites were not encountered.     

Systemic and Local Effects Associated With Long-Term Epidural Catheterization and Morphine-Detomidine Administration in Horses

Objective — The purpose of this study was to determine the systemic and local effects associated with long-term epidural catheterization and epidural morphine-detomidine administration in horses. Study Design — Development of systemic or local effects was assessed by placing caudal epidural catheters in study horses and administering injections through the catheters every 12 hours for 14 days. Animals — Ten horses with epidural catheters that received daily injections; six uncatheterized horses presented for euthanasia. Methods — Horses received either 0.2 mg/kg morphine sulfate and 30 μg/kg detomidine hydrochloride or an equivalent volume of physiologic saline solution through epidural catheters. Systemic effects were compared between control and treatment horses by measuring physical parameters and hay and water consumption, as well as by evaluating major organs after euthanasia. Local effects were studied by examining cerebrospinal fluid and by grading representative samples of the spinal cord and surrounding tissues histologically for inflammation and fibrosis. Local effects were compared between control and treatment horses, as well as between catheter-ized (control plus treatment) horses and uncatheterized horses. Results — No significant difference was identified in daily variables or hay and water consumption between control and treatment horses. No growth was obtained from cerebrospinal fluid cultures. No significant difference in cerebrospinal fluid values or spinal tissue inflammation or fibrosis grades was shown between control and treatment horses. However, when compared with uncatheterized horses, cerebrospinal fluid red blood cell values were marginally higher and protein concentrations were significantly higher in the catheterized group. Lumbosacral and sacral spinal tissue segment inflammation grades, and sacral segment fibrosis grades were significantly higher in catheterized horses. Conclusions — Long-term epidural administration of a morphine-detomidine combination is not associated with apparent adverse systemic effects in horses. Localized inflammation and fibrosis seem to be catheter-related. Clinical Relevance — Potential systemic and local effects are important considerations with long-term administration of a morphine-detomidine combination through indwelling epidural catheters for alleviation of chronic musculoskeletal pain in horses.     

Outbreak of Lice in Horses: Epidemiology,Diagnosis, and Treatment

The aim of this study is to report an outbreak of lice (Bovicola equi) in horses in southern Brazil, focusing on epidemiology, diagnosis, and treatment. Twenty-three horses in a stud farm presented with intense itching, crusted lesions, focal alopecia, and scaly skin. The outbreak occurred during the winter and probably due to the absence of sanitary barriers on the property. The diagnosis was carried out based on clinical signs associated with macroscopic and microscopic visualization of lice identified as B. equi. The treatment was performed with a single dose of Fipronil (Topline® Merial Brasil, Campinas, São Paulo, Brazil) spray (0.5%), eliminating immature and adult stages of lice. The clinical signs caused by the lice in horses disappeared few days after treatment.     

Biochemical and Antioxidant Changes in Plasma, Serum, and Erythrocytes of Horses before and after a Jumping Competition

We designed an experiment to determine the concentrations of a marker of lipid peroxidation in erythrocytes of horses submitted to jumping competitions. Erythrocytes of exercised horses showed a significant increase in the concentration of thiobarbituric acid-reactive species content immediately after exercise (P < .001), which returned to normal levels 24 hours after exercise. Nonprotein sulfhydryl groups and superoxide dismutase activity (EC 1.15.1.1) in erythrocytes were significantly higher 24 hours after exercise, as compared with the resting period and control group (P < .001). Immediately after exercise, horses had increased serum concentrations of uric acid (P < .002) and plasma lactate, as well as increased creatine kinase (EC 2.7.3.2) and lactate dehydrogenase (EC 1.1.1.28) activities (P < .001), as compared with resting period and control group. All parameters returned to normal values 24 hours after exercise, except for uric acid serum levels that remained increased (P < .001). We conclude that the oxidative stress in erythrocytes of exercised horses may contribute to tissue damage. In addition, our results showed that horses submitted to a jumping competition showed higher production of free radicals and as a consequence, lipid peroxidation.     

Prematurity and Dysmaturity Are Associated With Reduced Height and Shorter Distal Limb Length in Horses

The long-term effects of gestational immaturity in the premature (defined as < 320 days gestation) and dysmature (normal term but showing some signs of prematurity) foal have not been thoroughly investigated. Studies have reported that a high percentage of gestationally immature foals with related orthopedic issues such as incomplete ossification may fail to fulfill their intended athletic purpose, particularly in Thoroughbred racing. In humans, premature birth is associated with shorter stature at maturity and variations in anatomical ratios, linked to alterations in metabolism and timing of physeal closure in the long bones. We hypothesized that gestational immaturity in horses might similarly be associated with reduced height and different anatomical ratios at maturity. In this preliminary study, the skeletal ratios of horses with a history of gestational immaturity, identified through veterinary and breeder records, were compared with those of unaffected, closely related horses (i.e., sire, dam, sibling). External measurements were taken from conformation photographs of cases (n = 19) and related horses (n = 28), and these were then combined into indices to evaluate and compare metric properties of conformation. A principal component analysis showed that the first two principal components account for 43.8% of the total conformational variation of the horses’ external features, separating horses with a rectangular conformation (body length > height at the withers), from those that are more square (body length = height at the withers). Varimax rotation of PC1 and analysis of different gestational groups showed a significant effect of gestational immaturity (P = .001), with the premature group being more affected than the dysmature group (P = .009, P = .012). Mean values for the four dominant indices showed that these groups have significantly lower distal limb to body length relationships than controls. The observed differences suggest that gestational immaturity may affect anatomical ratios at maturity, which, in combination with orthopedic issues arising from incomplete ossification, may have a further impact on long-term athletic potential.     

Colic Surgery in Horses: A Retrospective Study Into Short- and Long-Term Survival Rate,Complications and Rehabilitation toward Sporting Activity

Colic surgery in horses impacts both short-term well-being of horses due to possible surgical and anesthetic complications and also long-term return to a sporting career. In this retrospective study, survival and complication rates, as well as functional outcome and behavioral problems in horses that underwent colic surgery were studied. Data from 283 horses that underwent colic surgery at a veterinary teaching hospital were analyzed. Furthermore, owners were contacted and requested to fill out a questionnaire concerning the first year of rehabilitation. Of 283 horses that underwent colic surgery, 167 (59%) were discharged home. After discharge from hospital, 34 horses (12%) were lost to follow-up. Of the remaining 133 horses, 128 were still alive after 1 year (96.2%), while 5 horses were euthanized due to recurrent colic. Of the horses that did not survive the hospitalization period 73 horses (25.8%) were euthanized intraoperatively and 36 horses (12.7%) during intensive care unit (ICU) stay. Survival of horses entering the ICU up to discharge from hospital was 79.5%. During rehabilitation, 49 horses (59.8%) that returned home experienced one or more recurrences of colic. Fifty-two horses (63.4%) that returned home reached at least preoperative level of performance. Altered behavior and gait-related problems during specific elements of riding (for instance during collecting, lateral bending, etc.) were reported in up to 46.2% of horses. Improving veterinary aftercare in collaboration with other disciplines (e.g., physiotherapy and saddle fitting) during rehabilitation could be a means to further improve athletic performance and welfare after recovery from colic surgery.