Hypophosphatemia in Cats After Renal Transplantation

Objective— To report the prevalence of hypophosphatemia after renal transplantation in a historical cohort of cats. Design— Case series. Animals— Cats (n=86) that received a renal allograft. Methods— Medical records (January 200–June 2006) were reviewed. Signalment, clinical signs, pre‐ and postoperative diet, pre‐ and postoperative clinicopathologic variables, renal histopathology, and outcome were retrieved. Prevalence, onset, duration, treatment and associated clinical signs of hypophosphatemia were recorded. A χ² test was used to compare hemolysis frequency between cats with normal serum phosphorus concentration or a single spurious low serum phosphorus concentration for <24 hours duration (group 1) and confirmed hypophosphatemia for >24 hours (group 2). A Cox proportional hazards model was used to evaluate the effects of hypophosphatemia on survival while controlling for other potentially confounding variables (age, sex, weight, body condition score, and pre‐ and 24 hours postoperative clinicopathologic variables). Results— Eighty‐six cats (mean age, 7.7 years) were identified. Hypophosphatemia occurred in 32 cats (37%), with a median onset of 2 days and median duration of 4 days. Treatment was initiated in 48 (56%) of hypophosphatemic cats. Survival and hemolysis frequency was not significantly different between groups, and no risk factors were identified. Conclusion— Hypophosphatemia occurs in cats after renal transplantation and does not affect survival. Clinical Relevance— The clinical importance of hypophosphatemia in renal transplant recipients remains unknown.     

Carpometacarpal Osteoarthritis in Thirty‐Three Horses

Objective— To describe signalment, clinical, and radiographic changes associated with carpometacarpal osteoarthritis (CMC‐OA) and to report long‐term outcome. Study Design— Case series. Animals— Horses (n=33) with CMC‐OA. Methods— Medical records (1992–2007) of horses diagnosed with CMC‐OA were reviewed and signalment, clinical, and radiographic findings retrieved. Owners were contacted for information on the impact of lameness on intended use, response to treatment, progression of lameness, outcome, and owner satisfaction with response to treatment. Results— CMC‐OA identified in 39 limbs, occurred predominantly in middle‐aged and older Quarter Horses and Arabians, and caused severe lameness that prevented normal use. Characteristic swelling was centered over the 2nd metacarpal bone/2nd carpal bone articulation. Radiographic changes consisted of proliferative new bone, narrowed joint space, and subchondral lysis. Of 20 horses with follow‐up, 7 of 14 treated horses were euthanatized within 4 years and 4 of 5 nontreated horses within 3 years. Response to treatment was short lived and considered very poor by most owners. Conclusion— CMC‐OA seemingly occurs primarily in Quarter Horses and Arabians in our region. Response to conservative treatment is very poor and short‐lived with most horses being euthanatized. Clinical Relevance— Conventional treatment methods are unsuccessful for treating CMC‐OA.     

Treatment of a Periarticular Tibial Fracture in a Foal with a Hybrid External Fixator

Objective— To report repair of a right proximal tibial Salter-Harris type II fracture in a foal with a hybrid external fixator (HEF).
Study Design— Case report.
Animals— A 5-month-old male foal.
Methods— After open surgical reduction, an HEF built with wires, 2 half-rings, 3 half-threaded connecting rods, and Schanz pins was used to stabilize the fracture.
Results— Immediately after surgery, the foal had relatively good weight bearing. The HEF was removed at 60 days after radiographic confirmation of healing.
Conclusions— HEF can be used to stabilize a proximal tibial Salter-Harris type II fracture in a 5-month-old foal.
Clinical Relevance— HEF should be considered as another option for repair of proximal tibial Salter-Harris type II fractures in foals.     

Minimum Inhibitory Concentration and Postantibiotic Effect of Amikacin for Equine Isolates of Methicillin-Resistant Staphylococcus aureus In Vitro

Objective— To report the minimum inhibitory concentration (MIC) of amikacin sulfate for equine clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and characterize the initial kill and duration of the postantibiotic effect (PAE) for selected strains.
Study Design— Experimental study.
Methods— Isolates of MRSA (n=35) had their amikacin MIC determined using the E-test agar diffusion method. Two isolates with MICs>256 μg/mL limit were further characterized using broth macrodilution. Six distinct isolates with amikacin MICs of 32, 48, 128 (2 isolates) and 500 (2 isolates) μg/mL had PAE determinations made over a range of amikacin concentrations from 31.25–1000 μg/mL using standard culture-based techniques.
Results— Median MIC of the 35 isolates was 32 μg/mL (range 2 to >256 μg/mL). Mean PAE of selected MRSA strains had an overall mean (all amikacin doses) of 3.43 hours (range 0.10–9.57 hours). PAE for MRSA exposed to amikacin at 1000 μg/mL was 6.18 hours (range 3.30–9.57 hours), significantly longer than that for all other concentrations ( P <.0001). There was no statistically significant effect of isolate MIC on PAE.
Conclusions— Isolates had a wide range of MIC; however, growth of all 6 selected strains were inhibited within the range of concentrations tested, including 2 strains with MICs of 500 μg/mL. PAE duration was not influenced by the MIC of amikacin but was significantly longer with treatment at 1000 μg/mL than at lower concentrations.
Clinical Relevance— Clinical isolates of MRSA are susceptible to amikacin at concentrations achieved by regional perfusion: however, the modest duration of PAE observed suggest that further laboratory and in vivo evaluation be conducted before recommending the technique for clinical use.     

Cytokine expression by neutrophils of adult horses stimulated with virulent and avirulent Rhodococcus equi in vitro

Rhodococcus equi is an intracellular pathogen of macrophages that causes rhodococcal pneumonia in foals and immunocompromised people. Evidence exists that neutrophils play a vital role in resistance to infection with R. equi; however, the means by which neutrophils exert their effects have not been clearly defined. In addition to directly killing bacteria, neutrophils also may exert a protective effect by linking innate and adaptive immune responses. In the present study we evaluated the cytokine expression profiles of adult equine neutrophils in response to stimulation with isogenic strains of virulent and avirulent R. equi in vitro. After 2 and 4 h incubation with virulent or avirulent R. equi, adult equine neutrophils expressed significantly (P < 0.05) greater tumor necrosis factor alpha (TNFα), interleukin (IL)-12p40, IL-6, IL-8 and IL-23p19 mRNA, but not interferon gamma (IFNγ) or IL-12p35 mRNA than unstimulated neutrophils. Furthermore, virulent R. equi induced significantly greater IL-23p19 mRNA than avirulent R. equi. These results demonstrate that R. equi-stimulated neutrophils are a source of many proinflammatory cytokines. Furthermore, these results suggest that IL-23 may be preferentially expressed over IL-12 in response to exposure with R. equi, and that this response may be more strongly induced by virulent R. equi than avirulent R. equi. Collectively, the data presented herein suggest a non-phagocytic role for neutrophils that may influence the type of adaptive immune response to R. equi.     

Collection Rates and Morphology of Equine Oocytes Obtained from Immature Follicles after Treatment with Equine Pituitary Extract (EPE) and Human Chorionic Gonadotropin

This study examined the effect of treating mares with equine pituitary extract (EPE) in combination with human chorionic gonadotropin (hCG; EPE/hCG) on the recovery rate of immature oocytes by ovum pick-up (OPU) and on oocyte morphology. Ten mares were subjected to each of two treatments in a random sequence: superstimulated with EPE (25 mg, twice daily) and treated with hCG (2,500 IU) or control (no exogenous treatment). The cytoplasmic morphology of oocytes recovered was evaluated through transmission electron microscopy. Follicular fluid was collected at aspiration for progesterone analysis, which was performed by radioimmunoassay. The EPE/hCG did not increase the oocyte recovery rate from immature follicles when compared with the controls (15.5% and 16.7%, respectively). A significantly higher oocyte recovery rate per mare was observed (70% versus 50%). However, precocious granulosa cell expansion was observed with EPE/hCG treatment in contrast to the control (64.4% and 33% of follicles with expanded cumulus, respectively), and increased intrafollicular progesterone concentration was also seen (158.80 ng/mL versus 82.05 ng/mL). The ultrastructural analysis of oocytes from both groups showed morphologic features related to immaturity. Numerous vesicles containing cortical granules were found, distributed in clusters into the cytoplasm, and junctional complexes were still seen between oocyte and granulosa cells. In conclusion, EPE/hCG treatment induced some follicular modifications, but the recovery rate was not increased. All oocytes examined presented signs of immaturity.     

Equine Granulocytic Anaplasmosis: A Case Report and Review

A 15 year-old Thoroughbred mare was examined for lethargy, fever, and inappetence of 1-day duration. A hard-bodied tick was removed from the horse. A complete blood count (CBC) demonstrated leukopenia with lymphopenia and thrombocytopenia. Morulae were visualized in circulating granulocytes. A polymerase chain reaction (PCR) confirmed the identity of these organisms as Anaplasma phagocytophilum. The horse was treated symptomatically for fever and inappetence with flunixin meglumine (1.1 mg/kg [0.5 mg/lb]) and oral electrolyte paste. Oxytetracycline (6.6 mg/kg [3 mg/lb] intravenously every 24 hours) treatment was begun as soon as a definitive diagnosis was determined. The mare responded to treatment, but she was switched to oral doxycycline (10 mg/kg [4.5 mg/lb] every 12 hours) after 5 days because of perivascular swelling at the injection site. Complete resolution of clinical signs was seen. There was no evidence of recurrence 1 year later. No additional horses at the farm were affected. The horse in this report presented for lethargy, inappetence, and fever, with limited other abnormalities. This represents a classical presentation of a mild to moderate case of anaplasmosis, which had not previously been reported in Virginia. The disease may be more widespread than has been previously reported, and it should warrant inclusion on a complete differential diagnosis list in a case of fever of unknown origin.