Clinical Updates II: Topics of Interest Pertaining to the Distal Limb

Regional limb perfusion is used to treat infections of the distal limb and can be performed using a peripheral vein or the intraosseous route; the peripheral vein is the preferred technique. Other distal limb entities of clinical importance include foot conformation problems, bruising, heel pain, navicular disease, degenerative joint disease, tendonitis and desmitis. Specific clinical problems of the distal limb seen in the foal and aged horse are frequently managed with good foot care.     

Antinociceptive Effect of Intravenous Regional Analgesia in Horses Underwent Selected Short-Time Distal Limb Surgeries

The aim of the present study was to establish appropriate doses for both lidocaine hydrochloride (Hcl) and mepivacaine in intravenous regional analgesia (IVRA) and to assess their intraoperative and postoperative analgesic effects in horses with distal limb surgeries. A total of 55 draft horses were included in the present study. Six clinically healthy horses were selected randomly for establishing the doses of lidocaine Hcl and mepivacaine in IVRA in horse limbs. After selection, 32 horses suffered from various distal limb surgical affections were randomly allocated into three groups: thiopental group (n = 6), animals were operated under general anesthesia using thiopental sodium; IVRA-LID group (n = 12), animals were operated under both general anesthesia and IVRA using lidocaine Hcl; and IVRA-MEP group (n = 14), horses were operated under both general anesthesia and IVRA using mepivacaine. Postoperative pain was measured using both Horse Grimace Pain Scale and multifactorial numerical rating composite pain. The results showed that conjunction of IVRA along with thiopental general anesthesia using either lidocaine or mepivacaine significantly decreased the total required doses of thiopental sodium during the operations and significantly increased the duration of postoperative analgesia to 60 and 150 minutes using lidocaine and mepivacaine, respectively. In conclusion, the uses of local IVRA before distal limb surgery improve the depth of general anesthesia and reduced postoperative pain, despite thiopental anesthesia alone. Mepivacaine is superior to lidocaine in IVRA, with a longer duration of action.     

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.     

The Forelimb and Hoof Conformation in a Population of Mongolian Horses

This article describes the lower limb and hoof conformation of a population of semi-feral Mongolian horses living on an open tundra/steppe environment. Data were collected from a convenience sample of 120 Mongolian horses used in the 2011 Mongolian Derby. Digital images of the hooves were obtained, and the lower limb conformation was assessed by four veterinarians involved in the screening of the horses offered for the derby. The horses were predominantly geldings (96%, 100/104), approximately 8.6 ± 2.5 years old, and 137 ± 8 cm at the withers. None of the horses were subjected to routine hoof trimming. Based on a 7-point linear score, lower limb conformation was normal, with a trend (>1 linear score deviation) slightly toward carpal valgus, mildly offset cannon (third metacarpal), and valgus at the matacarpophalangeal joint. Hoof measurements were within the norm for horses of this size. Fetlock valgus was associated with a smaller hoof width:length ratio (P = .016). None of the other hoof measurements were significantly associated with abnormal conformation scores. Overall, few conformation abnormalities were observed, and hoof shape and size was within the normal expected range for horses of this size. The hoof conformation in this population of Mongolian horses represented the natural interaction of the hoof with the environment.     

Equal Outcomes with and without Human-to-Horse Eye Contact When Catching Horses and Ponies in an Open Pasture

Each of 104 horses and ponies was approached for catching at pasture by the same human handler in a standard manner, either maintaining human-to-animal eye contact (EC+; n = 51) or avoiding eye contact (EC−; n = 53). A subset of 74 of these subjects were reevaluated 3 weeks later under similar standard conditions except with the eye contact condition opposite to that used in the first round. Nonparametric statistical methods were used to evaluate between subjects (round 1, n = 104) and within subjects (rounds 1 and 2, n = 74) comparisons of successful or unsuccessful catching outcome with EC+ and EC−. Catching outcomes were similar with eye contact condition. Although this study represents a single handler at one study site, results suggest that human-to-horse eye contact may not be an important influence on catching pastured horses. Certainly, further work is needed to better understand the role of eye contact in horse handling.     

Comparison of Nutrient Digestibility Between Adult and Aged Horses

There is little published work comparing digestibility in healthy adult versus healthy aged horses. Researchers hypothesized that there would be no differences in macronutrient digestibility between eight adult (5–12 years) and nine aged (19–28 years) horses fed three diets in a Latin square design. Seventeen stock-type mares were randomly assigned for a 5-week period to one of three diets: hay only (HAY), hay plus a starch- and sugar-rich concentrate (CHO), or hay plus a fat- (oil) and fiber-rich concentrate (FF). Each diet period comprised 3 weeks of outdoor group drylot feeding, 2 weeks of indoor stalled individual feeding, followed by a 72-hour digestibility trial including total urine and fecal collection. Feed, fecal, and/or urine samples were analyzed to determine dry matter, crude protein, fat, energy, calcium, and phosphorus apparent retention as well as apparent digestibility. Neutral detergent fiber digestibility was also determined. Mean body weight was lower in aged than in adult horses (455 ± 12 kg vs. 500 ± 13 kg; P = .02), but body condition score (BCS) did not differ between groups (aged horses, 4.8 ± 0.2 BCS and adult horses, 5.1 ± 0.2 BCS; P = .20). No age differences in digestibility, apparent digestibility, or apparent retention were seen for any of the variables measured. Based on the results of this study, total tract macronutrient digestibility appears to be similar between healthy adult and aged horses.     

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.     

Ultrasonography of the Collateral Ligaments of the Distal Interphalangeal Joint in Horses: Technique and Reference Images

This study describes ultrasound (US) technique and reference images of the equine distal interphalangeal joint collateral ligaments (CLs), and evaluates the portion of the CLs assessable by US in a series of normal forelimbs. Transverse and longitudinal US images were obtained on five healthy horses and on 25 equine cadaver forelimbs. On six limbs, a needle was placed under US-guidance at the distal limit of visualization of each CL, and the portion of CL visible at US was evaluated on computed tomographic (CT) images. The normal CLs appear as oval structures located abaxial to the fossae of the middle phalanx in the transverse sections, obtained at the level of the coronary band. A centrodorsal hypoechoic image appears with increasing proximodistal probe inclination, demonstrating different fiber orientations within the ligament. Two main fascicles, a deep and a superficial, distally divergent, are visible on longitudinal images obtained in the central part of the ligament. The proportion of CL visible at US examination was more than 50% of the total ligament length in nine of the 12 CLs assessed by CT. Awareness of the estimated portion of distal interphalangeal joint CLs visible at US and detailed knowledge of the US technique and CLs morphology are essential to efficiently use US examination on clinical cases.     

In Vivo Investigation of Communication Between the Distal Intertarsal and Tarsometatarsal Joints in Horses and Ponies

The frequency of communication between the tarsometatarsal and distal intertarsal joints was investigated in 27 horses and 12 ponies. After the injection of diluted latex into the tarsometatarsal joints using the plantarolateral approach, the horses and ponies were walked for 200 meters. Latex was found in the distal intertarsal joints of 19 of 73 tarsi (26% communication) at necropsy. In 3 tarsi, latex was also found in the proximal intertarsal and tar-socrural joints.     

Radiographic Differences Between Uneven Feet in Horses With Foot Lameness and Admitted for MRI Examination

Unevenness is an important feature of foot conformation and coincides with both kinetic and kinematic asymmetrical locomotor differences. It reportedly may lead to early retirement of elite horses from a warmblood population. The aim of this study was to evaluate the radiological consequences of an uneven feet conformation and on distal limb tissue development. In a retrospective study, the complete sets of good quality radiographs of both distal forelimbs were compared objectively for 121 “foot lame” horses that had been admitted for magnetic resonance imaging of one or both front feet (2003–2010). A chi-square test was used to test for significant radiometric differences between the upright and the lower angle foot (P < .05); 60% of the horses were unilaterally lame in the upright foot, whereas 40% were lame in the lower angle foot, which appeared to be a nonsignificant difference. In 84% of the horses, the navicular bone (NB) had a substantially more radiolucent, osteoporotic structure (P < .05). In 88% of the horses, the deep digital flexor tendon (DDFT) in the upright foot was significantly more radiodense and pronounced than in the lower angle foot (P < .05). The NB showed a significantly more osteoporotic structure as scored in the upright foot than in the lower angle foot, whereas the DDFT appeared was scored more compact in the upright foot than in the lower angle foot, suggesting less tension on the DDFT. In conclusion, radiological differences between uneven feet in foot lame horses seem to be related to differences in distal limb locomotor tissue development.     

Relationship Between Echocardiographic Measurements and Body Size in Horses

The objectives of this study were to evaluate the optimal body size variable, and to determine mathematical model that best fits echocardiographic measurements to body size in the equine species. One hundred fifty horses of various breeds, aged 1 week to 17 years, body weight (BW) 38-890 kg, and free from cardiac disease were used in this study. Based on their age (ie, younger or older than 2 years), animals were separated into two groups. In each horse, the BW, height at withers (HT), thoracic circumference (TC), and the body length were measured; the body surface area was calculated; and a standard two-dimensional and M-mode echocardiography was performed allowing classic cardiac measurements to be taken. Correlations between each echocardiographic measurement and each of the anthropometric variables were assessed via a Pearson's product-moment analysis and using linear, logarithmic, and power regression analysis in all animals and within the two groups. The dimensional, but not functional, echocardiographic measurements showed a close correlation with all body size variables, especially during growth. The relationship between cardiac measurements and body size was best described using power regression models with TC as the anthropometric variable, but the relationship was also very accurately described using BW, body surface area, or body length. In the equine species, dimensional echocardiographic reference values should be established using power regression equations on TC. Such a correction for body size could increase the diagnostic value of echocardiography in equine cardiology.     

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.     

朱鹮的前、后肢比较解剖学观察

用解剖学方法对朱和白的前、后肢进行了比较,发现他们的前肢各部分长度差异不大,白略长。后肢各部分长度差异较大,白后肢各部分：股骨部、小腿、附跖部、趾部骨骼均比朱粗壮,并分别比朱长９％,３５．２％,７１,４０％～４３％。利于在稻田、小河、湖水边较深地方采食。白的前、后肢的肌肉也比朱发达。在体重差别较大的情况下,体重轻的白肌肉仍比朱发达,这样更利于飞翔。因而,朱没有白的生存适应性强。     

Possible Relationship Between Performance and Oxidative Stress in Endurance Horses

The purpose of this study was to evaluate oxidative stress, antioxidant biomarkers, and performance during a multiday 210-km endurance race. Nine endurance athlete horses participated in this study. Samples were always taken at the same times of day, before the beginning of the race and after every day of competition. Analytic measurements included glutathione reductase (GR) and catalase activity, thiobarbituric acid–reactive substances (TBARs), and reactive carbonylated derivatives. Competition intensity was low, with an average speed of 12.56 ± 0.9 km/h. Four horses were unable to finish the race because of metabolic problems or fatigue. GR activity increased progressively (P < .001) throughout the competition, and TBARs showed a significant rise compared with baseline values (P < .01) but remained at the same levels throughout the 3 days of competition. Catalase and reactive carbonylated derivatives did not show any significant alterations in any time period. The best performance was obtained from horses who demonstrated higher GR capacity and/or lower TBAR concentration. In conclusion, redox status seems to modulate horses' performance in endurance races, but further studies are needed to better determine the adequate oxidant/antioxidant ratio to acquire optimal performance.     

Platelet-Rich Plasma as an Adjunctive Therapy for the Management of a Severe Chronic Distal Limb Wound in a Foal

Distal limb wounds are frequent in horses after traumatic events. The use of platelet-rich plasma (PRP) represents a simple method of treating wounds in equines. A case of a chronic severely contaminated distal limb wound in an 8-month-old foal is presented. The patient was managed with the combination of standard wound therapy (debridement and bandages), surgery, and PRP obtained by a manual tube protocol. No complications were observed with the PRP treatment, and the foal was fully recovered 2 months later. The results from this case report indicate that PRP and its by-products (platelet-poor plasma) could be used as an adjunctive treatment in severe distal limb wounds in horses. A clinical controlled study should be performed to test this hypothesis.