Bit‐induced asphyxia in the racehorse as a cause of sudden death

The prevention of sudden death requires removal of its cause and this is unknown. The author's hypothesis is that bit‐induced asphyxia, partial or complete, is a cause of sudden death. Antemortem data on bit‐induced asphyxia were compared with post mortem data on sudden deaths to explore a possible cause‐and‐effect relationship. Causal categories from sudden death necropsy data were reclassified. Those causing a horse to fall (cardiopulmonary failures) were considered primary effects and those resulting from a fall (CNS trauma and haemorrhagic shock) secondary effects. Cardiac failure from negative pressure pulmonary oedema caused by bit‐induced obstruction of the nasopharynx was consistent with the hypothesis. In 1988, asphyxia from recurrent laryngeal neuropathy was posited as a cause of exercise‐induced pulmonary haemorrhage (EIPH). It is now suggested that the bit is another cause of asphyxia; EIPH is a sign of negative pressure pulmonary oedema which, in turn, causes cardiac failure and sudden death. By breaking the airtight lip‐seal at exercise, a bit dissipates negative pressure in the oral compartments, destabilises the soft palate and obstructs the nasopharynx. Bitted rein pressure, kinking the airway and rendering parts of it flaccid, is a further cause of asphyxia. The data comparison supports a unifying hypothesis on 4 problems currently considered idiopathic; that the bit is an ultimate cause of palatal instability, dynamic collapse of the upper respiratory tract, EIPH and sudden death. Bitless training and racing trials are recommended as a means of demonstrating that bitless racing is possible, preferable and predicted to reduce the prevalence of all 4 problems.     

Comparison of direct and indirect methods of intra‐abdominal pressure measurement in normal horses

Objectives – To develop a direct method for measuring intra‐abdominal pressures in the standing horse, identify a reference interval for direct intra‐abdominal pressures, compare these pressures to indirect intra‐abdominal pressures measured from the bladder, and determine the optimal bladder infusion volume for indirect pressure measurement. Design – Prospective, experimental study. Setting – A university‐based equine research facility. Animals – Ten healthy adult horses, 5 males and 5 females. Interventions – Direct intra‐abdominal pressures were measured through an intraperitoneal cannula and zeroed at the height midway between the height of the tuber ishii and point of the shoulder. Indirect measurements of intra‐abdominal pressure were performed by measuring intravesicular pressures through a transurethral catheter zeroed at the tuber ishii. Measurements and Main Results – Direct pressure measurements obtained in the standing horse were subatmospheric (mean, ?1.80 cm H₂O; SD, 1.61 cm H₂O; 95% CI, ?2.80 to ?0.80) and were shown to decrease as the horse's weight increased (Pearson's r=?0.67, P=0.04), with no effect of head position (P=0.15). Mean baseline indirect pressure measurements (mean, ?8.63 cm H₂O; SD, 4.37 cm H₂O; 95% CI, ?13.05 to ?4.21) were significantly different from the pressures measured directly from the abdomen (P<0.001). Indirect pressure measurements were noted to increase with increasing volumes infused into the bladder, and were statistically different at a volume of 100 mL (P=0.004). There was low to moderate correlation between direct and indirect pressure measurements of intra‐abdominal pressure over a range of fluid volumes infused into the bladder (Pearson's correlation range ?0.38 to 0.58). Conclusion – Pressures measured directly in the standing horse were subatmospheric, and increased as the horse's weight increased. Indirect pressures measured were altered by increasing volumes infused in the bladder. There was no significant correlation between the 2 methods of intra‐abdominal pressure measurement.     

Pathophysiology of bit control in the horse

The use of one and often two bits, in traditional or normal horsemanship, constitutes a welfare problem, a hazard to health, and a handicap to performance.

• The bit method of control is invasive, physiologically contraindicated and counterproductive

• A bit often causes discomfort, pain and injury

• It can be responsible for a horse's poor attitude to exercise and many behavioral problems in all types of equitation from dressage (e.g., headshaking) to racing (e.g., dorsal displacement of the soft palate). Horses are happier in a bridle without a bit

• The bit can be the sole cause of abnormal inspiratory noise (stridor) at exercise

• To govern the speed of a racehorse using a bit and traction on both reins depends on poll flexion, which obstructs the airway and leads to premature fatigue, poor performance, and asphyxia-induced pulmonary edema (“bleeding”). Measurement of jowl angle is recommended as an indicator of upper airway patency

• A bit triggers digestive tract reflexes, which are physiologically opposed to rapid breathing. Horses are being expected to eat and exercise simultaneously, two activities that are mutually exclusive

• As the bit interferes with breathing and as breathing is coupled with locomotion, the bit also interferes with locomotion.

• A horse that leans on the bit loses self-carriage, and becomes heavier on the forehand. Its stride becomes shorter and, therefore, slower. In addition, greater stress is placed on the tendons, ligaments, joints and bones of the forelegs. In racing this factor, coupled with fatigue, renders breakdowns and fatal accidents more likely

• Resistance to the bit causes rigidity of the neck, which is incompatible with optimum performance, and also reduces the effectiveness of some important energy conservation mechanisms. Human athletes need complete freedom of their neck

• The horse is an obligatory nose-breather. At exercise, a horse's lips should be sealed and mouth closed so that no air enters the digestive tract. A bit breaks this seal and the mouth is often open

• “Nonacceptance of the bit” includes problems such as buccal ulcers, wolf tooth sensitivity, pain during eruption of cheek teeth, star fractures of the mandible, lacerations of the lip, tongue and gingiva, open mouth, tongue movement, tongue behind the bit, tongue over the bit, ‘swallowing the tongue,’ ‘flipping the palate,’, headshaking, fighting the bit, chewing on the bit, ‘bit between the teeth,’ boring, pulling and bolting

• The safety of rider and horse are imperiled when justifiable resentment of bit-induced pain leads a horse to take the bit between its teeth and bolt.

In the practice of natural horsemanship, horses can be controlled for early schooling without a bit, and for advanced schooling with a snaffle. In this way, the above problems can be either solved or minimized, respectively. A new design of bitless bridle, that is neither a hackamore nor a bosal, permits control by painless pressure on the skin behind the ear and facilitates the humane, non-invasive and natural approach, even for advanced schooling.     

A fluoroscopic study of the position and action of different bits in the horse's mouth

Fluoroscopy was used to visualize the position and movements of different types of bits within the horse's oral cavity. The jointed eggbutt snaffle normally lay between the tongue and palate with the joint hanging down toward the incisor teeth. By arching and elevating the tongue the horse was able to raise the mouthpiece between the cheekteeth. The jointed mouthpiece was suspended in a more horizontal position when keepers were used with a cheek snaffle to fix the position of the bit rings relative to the cheekpieces of the bridle. In addition, the mobility of the bit within the oral cavity was reduced by using keepers. Similarly less intra-oral movement was observed in bits with an unjointed mouthpiece.The Dr. Bristol bit, which has two joints connected by an angled plate, could be attached to the bridle in two ways so that the plate lay either parallel to the tongue and palate or perpendicular to them. This would be expected to have a marked effect on the severity of action of the bit. The high tongue port of the Hannoverian pelham pressed against the palate when the reins were used, causing considerable discomfort.     

Behavioural assessment of pain in 66 horses,with and without a bit

Horses can be ridden with or without a bit. Comparing the behaviour of the same horse in different modes constituted a ‘natural experiment’. Sixty-nine behaviours in 66 bitted horses were identified as induced by bit-related pain and recognised as forms of stereotypic behaviour. A prototype questionnaire for the ridden horse was based on 6 years of feedback from riders who had switched from a bitted to a bit-free bridle. From a template of 69 behavioural signs of pain derived from answers to the questionnaire, the number of pain signals shown by each horse, first when bitted and then bit-free, was counted and compared. After mostly multiple years of bit usage, the time horses had been bit-free ranged from 1 to 1095 days (median 35). The number of pain signals exhibited by each horse when bitted ranged from 5 to 51 (median 23); when bit-free from 0 to 16 (median 2). The number of pain signals for the total population when bitted was 1575 and bit-free 208; an 87% reduction. Percentage reduction of each of 69 pain signals when bit-free, ranged from 43 to 100 (median 87). The term ‘bit lameness’ was proposed to describe a syndrome of lameness caused by the bit. Bit pain had a negative effect on proprioception, i.e. balance, posture, coordination and movement. Only one horse showed no reduction in pain signals when bit-free. The welfare of 65 of 66 horses was enhanced by removing the bit; reducing negative emotions (pain) and increasing the potential to experience positive emotions (pleasure). Grading welfare on the Five Domains Model, it was judged that – when bitted – the population exhibited ‘marked to severe welfare compromise and no enhancement’ and – when bit-free – ‘low welfare compromise and mid-level enhancement.’ The bit-free data were consistent with the ‘one-welfare’ criteria of minimising risk and preventing avoidable suffering.     

Transendoscopic injection of poly-L-lactic acid into the soft palate in horses: A new therapy for dorsal displacement of the soft palate?

The purpose of this study was to establish a minimal invasive, transendoscopic technique for injection of poly-L-lactic acid into the free edge of the soft palate that can be performed on the standing sedated horse. Furthermore, whether the implant material induces an increase in fibrous tissue at the injection site, resulting in a greater rigidity of the soft palate, was determined.In 4 horses, the injection was performed bilaterally along the caudal margin of the soft palate, and the influence of the treatment on the soft palate function was determined. Clinical, radiographic and endoscopic examinations at rest were performed before and up to 168 days after injection according to a standardized examination protocol.In 6 horses, the implant material was injected unilaterally into the right half of the caudal margin of the soft palate. After clinical and endoscopic follow-up examinations, 2 horses each were killed 28, 84, and 168 days after the implantation procedure. At necropsy, macroscopic comparison of the treated and the untreated halves of the soft palate showed the influence on the size of the ostium intrapharyngeum and on the soft palate thickness. The localization of the implant material in the soft palate and the tissue response to the poly-L-lactic acid were evaluated histologically.Transendoscopic injection into the soft palate requires neither general anesthesia nor wound management, and it is noted for minimal tissue trauma. After injection, no alteration of the soft palate function was observed in horses with normal upper airway mechanics. One horse with intermittent dorsal displacement of the soft palate showed an improvement of the soft palate function for 112 days after implantation. No significant alteration in the size of the ostium intrapharyngeum was evident in any horse. Histologic assessment indicated the presence of implant material during the entire observation period of 168 days. The implant was accompanied by a granulomatous inflammation, and it was encapsulated by fibrous tissue. This may result in an increase in stiffness, and subsequent a greater rigidity of the soft palate, preventing it from displacement. The injection may therefore be considered an alternative to established therapies in horses showing dorsal displacement of the soft palate because of its unstable free edge.     

Three‐Dimensional Study of the Terminal Portion in Sprague‐Dawley Rat Ejaculatory Ducts

In mammals, a pair of ejaculatory ducts exists in the urethra at the seminal colliculus. The detailed anatomical structures of the distal end of the ejaculatory ducts of Sprague‐Dawley rats were investigated by the computer‐assisted three‐dimensional reconstruction analysis using light‐microscopic serial sections. A three‐dimensional reconstruction revealed that in adult rats, the ejaculatory sinus pair consists of two parts: the cranial section – a compartment region composed of a fusion of the ampullary gland duct and the seminal vesicle duct, and the caudal section – a grooved region composed of a long slitlike ejaculatory ostium that extends into the urethra on both sides of the seminal colliculus. But the sphincter structure was not observed. The long axis of the compartment region was approximately 58 μm in length, and that of the groove region was approximately 495 μm. Although many epithelial glands ducts were distributed throughout the ejaculatory sinuses, the prostate and coagulation gland ducts did not open in these sinuses. The urethra was composed of transitional epithelium, while the ejaculatory sinuses were composed of single to stratified cuboidal epithelium. The ejaculatory ducts continued to the ejaculatory ostium in male adult Sprague‐Dawley rat were composed of the seminal vesicle ducts received the ampullary gland ducts.     

Pulmonary oedema associated with anaesthesia for colic surgery in a horse

A 506 kg Warmblood horse with colic was anaesthetized for exploratory celiotomy. Anaesthesia was complicated by arterial hypoxaemia which persisted throughout surgery from the induction of anaesthesia. After endotracheal extubation in the recovery box, a degree of airway obstruction probably occurred during a brief delay in naso-tracheal intubation. Signs of pulmonary oedema were seen shortly afterwards. Furosemide and oxygen were given. Arterial hypoxaemia was present [PaO2: 6.5 kPa (49 mmHg)] when FIO2 was an estimated 0.3. The horse recovered and stood after 45 minutes. It was re-anaesthetized 3 days later when arterial blood gas analysis did not reveal hypoxaemia. The horse was killed on this occasion; post-mortem examination revealed the presence of pulmonary oedema, which probably resulted from multiple causes.     

Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse

Objective – To develop an indirect method for measurement of intraabdominal pressures in the standing horse using measurement of gastric pressures as a less invasive technique, and to compare this method with direct intraabdominal pressures obtained from the peritoneal cavity. Design – Prospective, experimental study. Setting – University‐based equine research facility. Animals – Ten healthy adult horses, 7 geldings and 3 mares. Interventions – Gastric pressures were measured using a nasogastric tube with a U‐tube manometry technique, while intraperitoneal pressures were measured with a peritoneal cannula. Measurements of intraabdominal pressure were obtained by both methods, simultaneously, and were evaluated using 5 increasing volumes of fluid infused into the stomach (0, 400, 1,000, 2,000, and 3,000 mL). Bias and agreement between the 2 methods were determined using Bland‐Altman analysis and Lin's concordance correlation coefficients. Measurements and Main Results – Mean gastric pressure was 14.44±4.69 cm H₂O and ranged from 0 to 25.8 cm H₂O. Intraperitoneal pressure measurements were generally subatmospheric, and ranged from ?6.6 to 3.1 cm H₂O (mean±SD, ?1.59±2.09 cm H₂O). Measurements of intraperitoneal pressures were repeatable; however, intra‐ and interindividual variance was significantly larger for measurements of gastric pressures. The mean and relative bias for comparison between the 2 techniques was 15.9±5.3 cm H₂O and 244.3±199.2%, respectively. The Lin's concordance correlation coefficient between gastric and intraperitoneal pressures was ?0.003 but this was not statistically significant (P=0.75). Conclusions – There was no statistical concordance between measurements of intraabdominal pressure using gastric and intraperitoneal pressure measurement, indicating that gastric pressures cannot be substituted for intraperitoneal pressure measurement. Direct measurement of intraperitoneal pressures may be a more consistent method for comparison of intraabdominal pressures between horses, due to less variability within and between individuals.     

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

This case report describes a 5‐year‐old pregnant Warmblood mare that was being treated for fibrinous bacterial pleuropneumonia. Since initial attempts to drain and lavage both pleural cavities were ineffective due to the presence of extensive intrapleural fibrin loculations, recombinant human tissue plasminogen activator (tPA) was instilled into both pleural cavities, to promote fibrinolysis and improve drainage. Within 1–2 h of instilling tPA, the horse became distressed, with increasing dyspnoea, tachycardia, pleurodynia and hypoxaemia. At 4 h post tPA instillation, diffuse bilateral pulmonary oedema was evidenced by the onset of widespread audible inspiratory crackles and ultrasonographic ring‐down artefacts. Ultrasonography demonstrated that tPA had induced pleural fibrinolysis, thereby removing the restrictive effects of pleural adhesions on lung motion and facilitating lung re‐expansion. Re‐expansion pulmonary oedema was suspected, although an adverse drug reaction could not be excluded. The complication resolved with nasal oxygen supplementation, and administration of frusemide, meloxicam, morphine and hydroxyethyl starch. Subsequent repetition of intrapleural tPA instillation and thoracic drainage had no apparent adverse effect. The mare was discharged from the hospital and subsequently foaled successfully. The pathogenesis, diagnosis and management of re‐expansion pulmonary oedema are reviewed.     

Negative-Pressure Wound Therapy as Management of a Chronic Distal Limb Wound in the Horse

Wound healing in distal limb wounds with tissue loss in horses may be an expensive and long process due to prolonged inflammatory phase. Negative pressure wound therapy (NPWT) (also known as vacuum-assisted closure) is well established method of wound therapy in human plastic and reconstructive surgery for many years. It consists of a leak free bandage and a pump that applies subatmospheric pressure to the wound area. This report describes the successful use of the NPWT intended for the suppression of exuberant granulation tissue development of the wound on distal limb in a horse.     

Mitral valve and tricuspid valve dysplasia in a 9‐week‐old Standardbred colt

A 9‐week‐old Standardbred colt was presented for investigation of dull demeanour, exercise intolerance and heart murmurs. Cardiac auscultation revealed a grade 5/6 holosystolic murmur and a grade 5/6 pansystolic murmur over the left and right cardiac apex respectively, and an irregularly irregular cardiac rhythm. Electrocardiographic examination findings were consistent with atrial fibrillation and tachycardia. Echocardiographic examination identified marked atrioventricular regurgitation and atrial dilation bilaterally, thickening of the mitral and tricuspid valves and dilation of the pulmonary artery consistent with pulmonary hypertension. No ventricular or atrial septal defect was present. Cardiomegaly and diffuse pulmonary oedema were evident on examination of lateral thoracic radiographs. Dysplasia of the mitral and tricuspid valves, eccentric cardiomegaly and pulmonary oedema were confirmed by post mortem examination. Dysplasia of the atrioventricular valves represents a rare cause of biventricular failure in the horse.     

Leukoencephalomalacia in a horse induced by fumonisin B1 isolated from Fusarium moniliforme

Each of two horses was dosed by stomach tube with culture material on maize of Fusarium moniliforme MRC 826. One horse developed severe hepatosis and mild oedema of the brain after 6 doses of 2.5 g of culture material/kg body mass/day in 7 days. The second horse, in a similar experiment but at a dosage rate of 1.25 g/kg/day, developed mild hepatosis and moderate oedema of the brain. In both animals the brain oedema was particularly noticeable in the medulla oblongata. The mycotoxin fumonisin B1 was extracted and purified from the culture material of F. moniliforme MRC, 826 which contained approximately 1 g/kg of this compound. A horse was injected intravenously 7 times from Day 0-Day 9 with 0.125 mg of fumonisin B1/kg body mass/day. Clinical signs of neurotoxicosis, which appeared on Day 8, included nervousness followed by apathy, a wide-based stance, trembling, ataxia, reluctance to move, paresis of the lower lip and tongue, and an inability to eat or drink. Euthanasia was performed on the horse on Day 10 while the animal was in a tetanic convulsion. The principal lesions were severe oedema of the brain and early, bilaterally symmetrical, focal necrosis in the medulla oblongata. This report provides experimental evidence that fumonisin B1, produced by F. moniliforme, causes equine leukoencephalomalacia.     

Septic peritonitis in a Percheron mare associated with Clostridium haemolyticum

This report describes an 11‐year‐old Percheron mare that presented with signs of colic and was ultimately diagnosed with bacterial peritonitis of unknown origin. Bacterial culture of a peritoneal fluid sample isolated 2 Clostridial species, one of which was strongly suspected to be Clostridium haemolyticum. The horse was markedly hypoalbuminaemic at presentation, leading to the development of low oncotic pressure and ventral oedema. The mare was administered a low molecular weight/low molar substitution hydroxyethyl starch solution in conjunction with other therapies that resulted in marked improvement of clinical signs. The purpose of this report is to describe the clinical findings associated with equine peritonitis associated with C. haemolyticum, a rarely identified pathogen in the horse. Secondly, this report serves to describe the beneficial effects of tetrastarch administration in a clinical case with severe hypoalbuminaemia and ventral oedema.     

The prevalence of oral ulceration in Swedish horses when ridden with bit and bridle and when unridden

Oral soft tissue ulcers are common disorders of horses, but it is unclear if their prevalence is increased by riding horses with a bit and bridle. Oral examinations were performed on 113 horses and ponies, all which had received routine dental floating, that were divided into four groups depending on when they had last been ridden with a bit and bridle. The subjects comprised: group 1, a randomly selected population of ridden horses; group 2, a group of horses examined after being rested at pasture for 5 weeks; group 3, the previous group following 7 weeks of riding with a bit and bridle, and group 4, brood mares that had not been ridden for at least 11 months. Lip and intraoral soft tissue lesions were recorded at seven pre-determined locations, with lesions classified as large or small; acute or chronic.The examinations showed that horses that were currently being ridden with a bit and bridle had a significantly higher prevalence of large and acute buccal ulcers opposite the maxillary Triadan 06 teeth and of the commissures of the lips, as compared to horses that were not being currently ridden. It was concluded that using a bit and bridle can cause oral ulceration even in horses that have regular prophylactic dental floating. It is suggested that riding tack should be individually fitted for each horse and also that prophylactic dental treatments should be individually adapted for each horse.     

Pilot study of behavior responses in young riding horses using 2 methods of making transitions from trot to walk

According to the principles of negative reinforcement, when an aid has been given to an animal, it should be released as soon as the desired response has been achieved, and, if performed well, may be associated with fewer conflict behaviors than otherwise. In riding, pressure in the horse’s mouth from the bit is used to give signals to the horse, and both rein tension and patterns of releasing this tension will vary. The aim of this pilot study was to study horse behavior during 2 different methodologies used to shape relatively naïve horses to a deceleration signal while making downward transitions from trot to walk. Method 1 involved relief from rein tension at the first attempt to perform a correct response (M1), and method 2 entailed that rein tension was relieved at the completed correct response (M2). Four horses were ridden by 4 riders over 4 days (1 rider each day), and each horse made 10 transitions each day for each method, which produced 320 transitions. Rein tension was recorded, and horse behavior and rider signal behaviors were evaluated from video recordings. Horse behavior was divided into the following 3 different categories: “pushing against the bit,” “moving away from the bit,” and “decelerating.” Linear models were constructed tracking the percent of the transition time that horses demonstrated at least 1 behavior in the “pushing against the bit,” “moving away from the bit,” and “decelerating” categories, and with random effects for rider, horse, and transition number nested within horse. Fixed effects analyzed were the methods, proportion of the transition time above 30 N for each rein, and the rider signal behaviors. M1 and M2 had on average 19% (standard deviation: 16) and 38% (standard deviation: 23) of the time with >30 N per rein, respectively. In the models for the “pushing against the bit” behaviors, M2 increased rein tension and “exerting pressure on the reins” increased the level of these behaviors. “Releasing pressure” interacted with “pulling back on the reins”; this combination was associated with an increased level of “pushing against the bit” behaviors. The “decelerating” behavior was associated with lower rein tension. In the “decelerating” behavior models, “pulling back on the reins” led to decreased “decelerating” behavior, whereas “still hand” and “releasing pressure” led to increased “decelerating” behavior; however, the interaction “pulling back on the reins” and “releasing pressure” led to decreased “decelerating” behavior. “Moving away from the bit” had no significant determinants. We concluded that fewer “pushing against the bit” behaviors were created by M1 and that a lower rein tension was associated with the “decelerating” behavior. Reinforcing the horse’s attempts, to assist in finding the correct response, benefits the welfare of the horse, and importance of a light hand should be continuously emphasized during riding education.     

Effects of extrathoracic airway obstruction on intrathoracic pressure and pulmonary artery pressure in exercising horses

OBJECTIVE: To determine whether dorsal displacement of the soft palate (DDSP) results in pulmonary artery hypertension and leads to increases in transmural pulmonary artery pressure (TPAP); to determine whether pulmonary hypertension can be prevented by prior administration of furosemide; and to determine whether tracheostomy reduces pulmonary hypertension. ANIMALS: 7 healthy horses. PROCEDURE: Horses were subjected to 3 conditions (control conditions, conditions after induction of DDSP, and conditions after tracheostomy). Horses were evaluated during exercise after being given saline (0.9% NaCl) solution or furosemide. RESULTS: Controlling for drug, horse, and speed of treadmill, DDSP-induced increase in intrathoracic pressure was associated with a significant increase in minimum (36 mm Hg), mean (82 mm Hg), and maximum (141 mm Hg) pulmonary artery pressure, compared with values for control horses (30, 75, and 132 mm Hg, respectively). Increases in pulmonary artery pressure did not induce concomitant increases in TPAP. Tracheostomy led to a significant reduction of minimum (53 mm Hg), and mean (79 mm Hg) TPAP pressure, compared with values for control horses (56 and 83 mm Hg, respectively). When adjusted for horse, speed of treadmill, and type of obstruction, all aspects of the pulmonary artery and TPAP curves were significantly decreased after administration of furosemide, compared with those for horses given saline (0.9% NaCl) solution. CONCLUSIONS: DDSP was associated with increases in pulmonary artery pressure but not with increases in TPAP. CLINICAL RELEVANCE: Expiratory obstructions such as DDSP are likely to result in pulmonary hypertension during strenuous exercise, but may not have a role in the pathogenesis of exercise-induced pulmonary hemorrhage.     

A numerical classification system for cleft lip and palate in the dog

An easy‐to‐use classification that enables an accurate record of canine cleft lip and palate is fundamental for effective communication between professionals and researchers and optimal use of published information. Here we present how a classification system for human cleft lip and palate can be used to register spontaneous cases in dogs, highlighting its advantages. This system is based on four topographic areas with a numerical representation of the severity of the cleft in each area. The use of spontaneous cases has the advantage of providing clefts that are naturally similar to their human counterparts for surgical, genetic and genomic studies and, furthermore, will reduce the need for experimental models of this condition.     

Pharmacokinetics of ganciclovir and valganciclovir in the adult horse

Equine herpes myeloencephalopathy, resulting from equine herpes virus type 1 (EHV‐1) infection, is associated with substantial morbidity and mortality in the horse. As compared to other antiviral drugs, such as acyclovir, ganciclovir has enhanced potency against EHV‐1. This study investigated the pharmacokinetics of ganciclovir and its oral prodrug, valganciclovir, in six adult horses in a randomized cross‐over design. Ganciclovir sodium was administered intravenously as a slow bolus at a dose of 2.5 mg/kg, and valganciclovir was administered orally at a dose of 1800 mg per horse. Intravenously administered ganciclovir disposition was best described by a three‐compartment model with a prolonged terminal half‐life of 72 ± 9 h. Following the oral administration of valganciclovir, the mean observed maximum serum ganciclovir concentration was 0.58 ± 0.37 μg/mL, and bioavailability of ganciclovir from oral valganciclovir was 41 ± 20%. Superposition predicted that oral dosing of 1800‐mg valganciclovir two times daily would fail to produce and maintain effective plasma concentrations of ganciclovir. However, superposition suggested that i.v. administration of ganciclovir at 2.5 mg/kg every 8 h for 24 h followed by maintenance dosing of 2.5 mg/kg every 12 h would maintain effective ganciclovir serum concentrations in most horses throughout the dosing interval.     

Traumatic bilateral stylohyoid bone fracture in an Appaloosa

An Appaloosa gelding presented for a traumatic puncture wound of the head ventral to the base of his left ear, bilateral epistaxis and upper respiratory compromise. The horse did not exhibit dysphagia or cranial nerve deficits. The horse suffered bilateral oblique fractures of both stylohyoid bones due to the traumatic incident, diagnosed upon endoscopy of the guttural pouches. Treatment consisted of anti‐inflammatory medication, broad‐spectrum antibiotics, guttural pouch lavage and dietary management with soft feeds. At a one‐month follow‐up examination, endoscopic evaluation revealed a union at both stylohyoid bone fracture sites. Guttural pouch mycosis was diagnosed in the left guttural pouch on the lateral wall at the entrance of the lateral compartment. The guttural pouch mycosis was treated with a nystatin and gentamicin flush, followed by a course of oral fluconazole. At the 3‐month re‐evaluation, the guttural pouch mycosis had completely responded to treatment.