A Comparative Review of Vitamin E and Associated Equine Disorders

Vitamin E is a primary chain‐breaking antioxidant that prevents cyclic propagation of lipid peroxidation. Across species, vitamin E is essential for normal neuromuscular function by acting as a potent antioxidant, as well as by modulating the expression of certain genes, inhibiting platelet aggregation and stabilizing plasma membranes. This review focuses on vitamin E structure, absorption, metabolism, current equine dietary recommendations, the interplay between antioxidants and exercise, a discussion of the necessity of vitamin E supplementation in the horse above the Nutritional Research Council (NRC) 2007 requirements, and a review of equine diseases that are associated with a vitamin E deficiency. Particular emphasis is placed on the proteins involved in vitamin E absorption, transport, and metabolism as potential candidates for vitamin E‐associated diseases across species.     

Tree-Based Methods as an Alternative to Logistic Regression in Revealing Risk Factors of Crib-Biting in Horses

Determining the risk factors might help in designing prevention of crib-biting. Logistic regression is a commonly used statistical method for finding risk factors, but tree-based methods are also getting more popular. An important difference between these two statistical approaches is that logistic regression makes a number of assumptions about the underlying data, whereas tree-based methods do not. Another difference is that logistic regression can be used to derive odds ratios for the significant risk factors, whereas tree-based methods create a tree where the ramifications represent the risk factors. The probability of occurrence is assigned to each end of branch in the tree. Data of horses used for noncompetition purposes were analyzed with three statistical approaches: logistic regression, classification tree, and conditional inference tree methods. By this, we compared the advantages and disadvantages of these statistical methods. No difference was found between the two tree-based methods regarding the structure and prediction accuracy of the trees. Compared to them, logistic regression revealed fewer risk factors, and also the number of the stereotypic horses classified correctly by the model was less. The representation of the tree-based methods is closer to medical reasoning and also high-order interaction of the risk-factors can easily be visualized. Our results suggest that tree-based methods can be a new alternative in revealing risk factors, even if used alone or together with logistic regression.     

Diagnostic and Predictive Capability of Routine Laboratory Tests for the Diagnosis and Staging of Equine Inflammatory Disease

Background

A wide spectrum of laboratory tests is available to aid diagnosis and classification of equine inflammatory disease.

Objectives

To compare diagnostic efficacy and combined predictive capability of the myeloperoxidase index (MPXI), and plasma fibrinogen, iron and serum amyloid A (SAA) concentrations for the diagnosis of inflammation.

Animals

Twenty‐six hospitalized horses with systemic inflammation (SI), 114 with local inflammation (LI) and 61 healthy horses or those with noninflammatory disease (NI) were included.

Methods

A retrospective study was performed; clinicopathologic data from horses were compared between groups. Receiver‐operator characteristic (ROC) curves were used to evaluate diagnostic efficacy; classification and regression tree analysis (CART) and logistic regression analysis were used to generate diagnostic algorithms.

Results

Horses with SI had significantly higher SAA than horses with LI (P = .007) and NI (P < .001) and lower iron concentrations than horses with LI (P < .001) and NI (P < .001). Fibrinogen concentration was higher in horses with inflammation than in those without inflammation (P = .002). There was no difference between the SI and LI groups. White blood cell count, neutrophil count and MPXI were similar between groups. SAA had the highest accuracy for diagnosing inflammation (area under ROC curve [AUC], 0.83 ± 0.06) and iron and SAA concentration had the highest accuracy for differentiating SI from LI (AUC, 0.80 ± 0.09 and 0.73 ± 0.10 respectively). Predictive modeling failed to generate useful algorithms and classification of cases was moderate.

Conclusions and Clinical Importance

Very high SAA and low iron concentrations may reflect SI, but diagnostic guidelines based on quantitative results of inflammatory markers could not be formulated.     

Method for Blind Catheter Placement in the Equine Pulmonary Artery

The navigation behavior of catheters within the equine pulmonary artery (PA) was investigated using en bloc heart and lung preparations for the purpose of developing a method of blind catheter placement. An equine ex vivo heart and lung perfusion system with controlled perfusate pulsatile flow, pressure, and temperature was used to evaluate a blind navigation technique for placement of balloon-tipped catheters into the distal main stem of the PA. Catheter performance was observed with an intravascular endoscope. Three balloon catheters were selected for navigation trials: a 4 mm diameter × 1.2 cm, 2.7Fr, 142 cm angioplasty catheter (C4mm); a 10 mm diameter × 4 cm, 5Fr, 150-cm angioplasty catheter (C10mm); and a 16-mm diameter, 7Fr, 200-cm pancreatic duct sphincteroplasty catheter (C16mm). Successful catheter placement was defined as insertion within a left or right main stem of the PA to a distance greater than 20 cm beyond the bifurcation. A method of blind catheter placement into the distal main stem of the equine PA using balloon-tipped catheters was successfully developed. The 16-mm catheter was superior with an average proportion of successful insertions (PSIavg) of 93.6%; an average insertion distance in the main stem (IDMavg) of 30.1 ± 5.7 cm; and an average insertion distance anywhere in the PA (IDAavg) of 29.3 ± 6.4 cm versus the 10 mm (PSIavg 25%, IDMavg 39.3 ± 11.4 cm, IDAavg 19.3 ± 15.1 cm) and 4 mm (PSIavg 11%, IDMavg 40.0 ± 11.0 cm, IDAavg 12.8 ± 13.2 cm), respectively.     

Arthroscopic Anatomy of the Equine Femoropatellar Joint and Approaches for Treatment of Osteochondritis Dissecans

Arthroscopic approaches to the femoropatellar joint were developed to determine their usefulness for evaluation and surgical treatment of osteochondritis dissecans. It was found that the articular cartilage of the lateral trochlear ridge, medial trochlear ridge, intertrochlear groove, patella, and the lateral and medial reflections of the joint capsule could be examined from an infrapatellar arthroscopic portal. The suprapatellar pouch could be examined partially. Lateral and medial instrument portals were evaluated to determine the accessibility of the lateral and medial trochlear ridges of the femur in the areas where osteochondritis dissecans lesions frequently occur. Sliding the arthroscope sleeve beneath the patella when entering the joint was associated with iatrogenic cartilage lesions. A new technique that directed the arthroscope lateral to the lateral trochlear ridge eliminated iatrogenic cartilage damage.     

A Comparison of Two Surgical Approaches to the Equine Femoropatellar Joint for the Treatment of Osteochondritis Dissecans

The femoropatellar joints of four mature, clinically normal horses were surgically entered by a craniolateral or a lateral approach. Visualization of intra-articular structures was documented for each approach. Horses were euthanized 21, 42, and 63 days after surgery. Joint healing was evaluated clinically, and the joints were subjected to gross pathological and histopathological examination. Healing was by first intention following arthrotomy in six limbs. Skin dehiscence occurred in two limbs with healing by second intention. Subcutaneous seromas developed which resulted in peri-incisional swelling in seven limbs. The lateral approach to the femoropatellar joint provided greater exposure of the lateral femoral trochlear ridge and articular surface of the patella.
Surgery was performed on nine joints of seven clinical patients with osteochondritis dissecans. The craniolateral approach was used on four joints, and the lateral approach was used on five joints. Skin dehiscence occurred following four arthrotomies. Location of the lesion was concluded to be the main criterion for selection of the surgical approach.     

Magnetic Resonance Assessment of the Equine Distal Phalanx Facies Flexoria

Abnormalities of the facies flexoria of the distal phalanx (FF) of the horse associated with podotrochlear syndrome have been scarcely described in the literature. The objective of this retrospective study was to determine correlation between modification of the FF and lesions of the podotrochlear apparatus. This study includes 100 horses referred for forelimb lameness that underwent a standardized magnetic resonance (MR) imaging protocol of the affected foot. Of the 100 MR studies, 74 had podotrochlear lesions and 26 free of podotrochlear lesions served as controls. A comparison of the FF compact bone thickness between affected and control feet was performed. Presence and location of a deep digital flexor tendon (DDFT) lesion was noted. Grading systems were used to score: FF osseous resorption, FF bone marrow lesion, FF sclerosis and abnormalities of the navicular bursa and the distal interphalangeal joint. Compact bone thickness of the FF was not increased in case of tendinopathy of the DDFT or other podotrochlear lesions (P = .86). Significant correlation was observed between osseous resorption of the FF at the level of the distal recess of the navicular bursa and synovial proliferation of the navicular bursa (P = .05). Compact bone thickening at the DDFT enthesis is not predictive of podotrochlear syndrome and should rather be considered as an interindividual anatomical variation. Navicular bursitis may play a role in osseous resorption of the FF.