Guy D. Lester

Factors associated with survival of neonatal foals with bacteremia and racing performance of surviving Thoroughbreds: 423 cases (1982-2007).

OBJECTIVE To identify factors associated with short-term survival in bacteremic neonatal foals, evaluate the racing performance of Thoroughbred survivors, and evaluate changes in causative organisms and their antimicrobial susceptibility. DESIGN Retrospective case series. ANIMALS 423 bacteremic foals. PROCEDURES Medical records of foals that were hospitalized in 1982 through 2007 were reviewed, and those with bacteremia were included in the study. Data retrieved included signalment, physical examination and clinicopathologic findings at admission, localized infections, concurrent illnesses, duration of hospitalization, and outcome (survival to discharge from the hospital vs nonsurvival). The number, identity, and antimicrobial susceptibility of organisms isolated from blood samples were also obtained. Racing records for surviving Thoroughbred foals and maternal siblings were examined. RESULTS Of 423 bacteremic foals, 254 survived. Odds of survival were negatively associated with age at admission, septic arthritis, band neutrophil count, and serum creatinine concentration and positively associated with year of admission, diarrhea, rectal temperature, neutrophil count, and arterial blood pH. Overall, microbial culture of blood samples yielded 554 isolates; Escherichia coli was consistently isolated most frequently. Percentage of isolates susceptible to enrofloxacin, but no other antimicrobial, decreased over time. Surviving Thoroughbred foals did not differ from siblings with regard to percentage of starters, percentage of winners, or number of starts; however, surviving foals had significantly fewer wins and total earnings. CONCLUSIONS AND CLINICAL RELEVANCE During the study period, microbial resistance to antimicrobials commonly used to treat bacteremic foals did not develop. Surviving bacteremic Thoroughbred foals were as likely to start races as their siblings but earned less money.

Factors Associated with Outcome in Foals with Neonatal Isoerythrolysis (72 Cases, 1988–2003)

BACKGROUND Neonatal foals with isoerythrolysis (NI) often die, but the risk factors for death have not been identified. OBJECTIVES To identify factors associated with outcome in foals with NI and to identify factors associated with death from liver failure or kernicterus in the same population. ANIMALS Seventy-two foals with NI examined at referral institutions. METHODS Retrospective case series. Information on signalment, clinical examination findings, laboratory testing, treatment, complications, outcome, and necropsy results were obtained. RESULTS The overall survival rate was 75% (54 of 72). Liver failure (n=7), kernicterus (n=6), and complications related to bacterial sepsis (n=3) were the 3 most common reasons for death or euthanasia. The number of transfusions with blood products was the factor most strongly associated with nonsurvival in a multivariate logistic regression model. The odds of liver failure developing in foals receiving a total volume of blood products >or= 4.0 L were 19.5 (95% confidence intervals [CI]: 2.13-178) times higher than that of foals receiving a lower volume (P= .009). The odds of kernicterus developing in foals with a total bilirubin >or= 27.0 mg/dL were 17.0 (95% CI: 1.77-165) times higher than that of foals with a lower total bilirubin (P= .014). CONCLUSIONS AND CLINICAL IMPORTANCE Development of liver failure, kernicterus, and complications related to bacterial sepsis are the most common causes of death in foals with NI. Foals administered a large volume of blood products are at greater risk for developing liver failure.

Effect of dietary composition on abomasal and duodenal myoelectrical activity

The changes in the frequency of abomasal slow waves and their propagation, the abomasal spike burst rate and the duodenal spike burst rate were assessed in sheep fed three diets containing either 100 per cent concentrate, 50 per cent concentrate and 50 per cent forage, or 100 per cent forage. The frequency of abomasal slow waves and spike burst frequency were both significantly reduced in sheep fed the diets high in concentrate when compared with animals fed the 100 per cent roughage diet. The velocity of propagation of the slow waves and the duodenal spike burst frequency were not significantly affected by the dietary composition. The sheep consumed significantly less of the 100 per cent concentrate diet in the 45 minutes before recording than of the other two diets, but the amount of feed consumed was not correlated significantly with the changes observed in the myoelectrical activity. These are consistent with an inhibitory effect of concentrate on abomasal motility.

Abdominal and Thoracic Radiography in the Neonate

Plain and contrast radiographic techniques are used infrequently in the diagnostic evaluation of abdominal or thoracic disease in the adult horse because of the animals large body size and the limited availability and expense of suitable equipment. The importance of radiography as a critical tool has also been lessened through the accessibility of ultrasound, although this technique is limited by depth and offers only a superficial window. Traditional radiographic techniques can be readily used in young foals because of their small body size, and radiography frequently provides critical information that aids in decision making. The ability to physically restrain a foal allows not only standing lateral images, but laterally recumbent and ventrodorsal views without the necessity for general anesthesia.

Isolation of Brachyspira pilosicoli from weanling horses with chronic diarrhoea

from youngthoroughbred horses.The thoroughbred weanlings came from a rural stud prop-erty north of Perth,Western Australia.The stud had a historyof an annual recurrence of chronic diarrhoea and poorgrowth among weanlings. The property had received regularveterinary visits, but attempts to identify potentially patho-genic bacteria, protozoa or other intestinal parasites in thefaeces of affected animals had been unsuccessful.Faecal samples from eight affected weanlings eight to 10months of age, four with diarrhoea and four with apparentlynormal faeces at the time of sampling, were collected andplated on to selective trypticase soy agar (Jenkinson andWingar 1981). The plates were incubated at 37°C for up to10 days under anaerobic conditions (94 per cent hydrogen, 6per cent carbon dioxide).Spirochaetes were identified on fiveplates, as a low, flat haze of growth surrounded by weak

Systemic, renal, and colonic effects of intravenous and enteral rehydration in horses

BACKGROUND Intravenous (IV) and intragastric (IG) administration of fluid therapy are commonly used in equine practice, but there are limited data on the systemic, renal, and enteric effects. HYPOTHESIS IV fluid administration will increase intestinal and fecal hydration in a rate-dependent manner after hypertonic dehydration, but will be associated with significant urinary water and electrolyte loss. Equivalent volumes of IG plain water will result in comparatively greater intestinal hydration with less renal loss. ANIMALS Six Thoroughbred geldings. METHODS Experimental study. 6 by 6 Latin square design investigating constant rate IV administration at 50, 100, and 150 mL/kg/d over 24 hours in horses dehydrated by water deprivation. Equivalent volumes of IG plain water were administered by 4 bolus doses over 24 hours. RESULTS Water deprivation resulted in a significant decrease in the percentage of fecal water, and increases in serum and urine osmolality. IV fluids administered at 100 and 150 mL/kg/d restored fecal hydration, but increasing the rate from 100 to 150 mL/kg/d did not confer any additional intestinal benefit, but did result in significantly greater urine production and sodium loss. Equivalent 24-hour volumes of plain water resulted in greater intestinal water and less urine output. CONCLUSIONS AND CLINICAL IMPORTANCE IV polyionic isotonic fluids can be used to hydrate intestinal contents in situations where enteral fluids are impractical. IV fluids administered at three times maintenance are no more efficacious and might be associated with adverse physiological findings after withdrawal. Bolus dosing of IG water can be used to restore intestinal water with minimal adverse effects.

Temporohyoid osteoarthropathy in two young horses

Two cases of temporohyoid osteoarthropathy (THO) in young Australian horses are described. The pathogenesis of THO is yet to be fully elucidated, but current theories include extension of infection from otitis media or interna to the temporohyoid joint or a primary but non-infectious degenerative condition within the temporohyoid joint. The young age of the horses and the unilateral distribution suggested an infectious aetiology. Both horses partially responded to treatment with broad-spectrum antimicrobial and anti-inflammatory drugs with concurrent management of ulcerative keratitis. The management of violent head shaking in one horse included the administration of gabapentin, an anticonvulsant known to have antihyperalgesic effects and reduce neuropathic pain.

An Ex Vivo Biomechanical Study Comparing Strength Characteristics of a New Technique with the Three‐Loop Pulley for Equine Tenorrhaphy

OBJECTIVE To test single cycle to failure tensile strength characteristics of 6 suture material-pattern combinations in equine superficial digital flexor (SDF) tenorrhaphy, specifically to compare a 10-strand modification of the Savage core suture technique with the 3-loop pulley technique. STUDY DESIGN Ex vivo mechanical experiment comparing 3 different suture patterns with 2 different materials. SAMPLE POPULATION Forelimb and hindlimb SDF tendons (n=48) harvested from adult Thoroughbred and Standardbred horses of mixed age and gender. METHODS Six suture material-pattern combinations were evaluated: (1) 10-strand Savage, size 2 polydioxanone (PDS); (2) 10-strand Savage, size 2 polyglactin 910 (PG910); (3) 10-strand Savage, size 2 PDS with Lin-locking epitenon suture, size 2-0 PDS; (4) 10-strand Savage size 2 PG910 with Lin-locking epitenon suture, size 2-0 PDS; (5) 3-loop pulley, size 2 PDS; and (6) 3-loop pulley, size 2 PG910. Maximum load at failure (N), gap at failure (mm), and mode of failure (suture breakage or pull through) were evaluated for each of the 6 suture material-pattern combinations and underwent statistical analysis to determine significance of differences and interactions of the measured data. RESULTS The 10-strand Savage technique failed at a mean load of 872 (804-939, 95% CI). The 10-strand Savage with Lin-locking failed at a significantly greater mean load of 998 (930-1065, 95% CI). The 3-loop pulley pattern failed with a mean load of 337 (270-405, 95% CI). There were significant interactions between the technique and suture material used. CONCLUSION The 10-strand Savage technique for repair of transected cadaver SDF tendons has superior strength characteristics with or without the epitenon suture when compared to the 3-loop pulley. Suture material and pattern interactions were observed with PG 910 conferring higher strength for the 10-strand Savage whereas PDS did so for the 3-loop pulley.

The influence of spasmolytic agents on heart rate variability and gastrointestinal motility in normal horses.

The effects of hyoscine-N-butylbromide (hyoscine) and propantheline-bromide (propantheline) on heart rate (HR), HR variability (HRV) and gastrointestinal tract (GIT) contractions in the normal horse were determined. Five adult horses had ECG recordings for 180 min after treatment with propantheline (100mg), hyoscine (120 mg) or saline. Both propantheline and hyoscine reduced GIT sounds, with propantheline having a longer duration of effect (≥120 min). Both drugs elevated HR relative to the control baseline period (P<0.05), with the effects of propantheline again being of longer duration. HRV analysis indicated that propantheline suppressed Total Power (P<0.05), and both the high frequency (HF) and low frequency (LF) components of the power spectral analysis for up to 60-90 min post treatment. Hyoscine had no effect on HRV Total Power but reduced the HF component for 30 min after drug injection. Time domain variables correlated with Total Power and HF data (P<0.01). The marked effect of these compounds on parasympathetic control of cardiac and GIT function in normal horses should be taken into consideration when evaluating a clinical response to these agents.

Clostridial myonecrosis, haemolytic anaemia, hepatopathy, osteitis and transient hypertrophic cardiomyopathy after intramuscular injection in a Thoroughbred gelding

A 9-year-old Thoroughbred gelding was presented for swelling over the left neck and inappetence. There was recent history of intramuscular administration of flunixin meglumine into the left neck. On examination, there was evidence of focal myositis, anaemia, haemolysis and pigmenturia. Culture of aspirated fluid from the left side of the neck produced a heavy growth of a Clostridium species. Complications of infection included haemolytic anaemia, hepatopathy, osteitis and transient hypertrophic cardiomyopathy. Treatment included intravenous fluid therapy, antibiotics, anti-inflammatory drugs, blood transfusion and surgical debridement. There was complete resolution of clinical, haematological, biochemical and echocardiographic abnormalities, and the horse returned to ridden work. This report highlights the complications that can arise from clostridial myonecrosis, including the effect on the myocardium.