Jorge E. Nieto

Myopathy in horses with pituitary pars intermedia dysfunction (Cushing’s disease)

Fifteen horses with pituitary pars intermedia dysfunction were studied. The horses were of various breeds and between 15 and 28 years of age. Control horses matched for breed and age were studied for comparison. Evaluations included complete blood cell count and serum biochemical analysis, electromyography, and gluteus medius muscle biopsies for histochemical, morphometric, and ultrastructural analysis. No differences were found between groups of horses on routine laboratory analysis or electromyography. We demonstrated that muscle wasting in diseased horses was the result of atrophy of types 2A and 2B muscle fibers and loss of type 2B myofibers. Mild non-specific non-inflammatory myopathic alterations such as myofiber size variation, internal nuclei, perimysial, endomysial and sarcoplasmic fat accumulation were observed. At the ultrastructural level, subsarcolemmal mitochondrial accumulation and increased lipid droplets were evident. Similar to other species, this study confirmed atrophy of type 2 fibers as the cause of muscle mass loss in horses with Cushings disease.

Prevalence of gastric ulcers in Thoroughbred broodmares in pasture: A preliminary report

Gastroscopic examinations were performed in 62 Thoroughbred broodmares (33 pregnant, 29 non-pregnant) at one breeding farm to investigate the prevalence of gastric ulceration. Age, pregnancy status, race earnings, last race start, herd size, medical history, number of live foals, breeding years, feed type and number of feedings were recorded, plus coat condition and body condition score were determined. Twenty-one mares were re-evaluated after foaling, and the foaling date, foal weight at birth and placenta weight were recorded. The overall prevalence of gastric ulcers was 70.9%, with a median ulcer score of 3.0 (range: 2-5). Most ulcers were present on the squamous portion of the stomach, while two mares had glandular ulcers. There were no differences in the presence, location and severity of gastric ulcers between pregnant and non-pregnant mares. Furthermore, there were no significant associations between the variables measured and the presence of gastric ulceration. The prevalence of gastric ulceration in this specific population of horses was higher than expected and further investigation is warranted to determine the factors that contributed to this finding.

Effect of lipopolysaccharide infusion on gene expression of inflammatory cytokines in normal horses in vivo

Horses are exquisitely sensitive to bacterial endotoxin and endotoxaemia is common in colic cases. In this study, gene expression of inflammatory cytokines was characterised in the blood of healthy horses following i.v. administration of lipopolysaccharide (LPS). Six horses received an LPS infusion and 6 controls received an equivalent volume of saline. Gene expression of genes encoding interleukin (IL)-1alpha, IL-1beta, IL-6, IL-8, and tumour necrosis factor-alpha (TNF-alpha) was quantified by real-time PCR. Gene expression of all inflammatory cytokines was upregulated following administration of LPS. Interleukin-1alpha, IL-1beta, IL-8 and TNF-alpha gene expression peaked at 60 min, while IL-6 expression peaked at 90 min post LPS infusion. Interleukin-1beta and IL-6 messenger RNA expression levels were above the baseline values 3 h post LPS infusion, whereas IL-1alpha, IL-8 and TNF-alpha expression levels returned to baseline values by 3 h after LPS infusion. It was concluded that LPS infusion upregulated gene expression of inflammatory cytokines in the blood of healthy horses.

Malignant hyperthermia associated with ryanodine receptor 1 (C7360G) mutation in Quarter Horses.

BACKGROUND Anesthetic-induced malignant hyperthermia (MH) has been documented in Quarter Horses with a single point mutation in the ryanodine receptor 1 gene (RyR1) at nucleotide C7360G, generating a R2454G amino acid substitution. However, there have been no reports of nonanesthetic manifestations of MH in horses with the C7360G mutation. OBJECTIVE To describe clinical manifestations of Quarter Horses with the C7360G mutation. ANIMALS Eleven Quarter Horses with the RyR1 C7360G mutation. METHODS This prospective study included horses with suspected MH, undetermined etiology of sudden death, death within hours of onset of rhabdomyolysis, muscle rigidity, stiffness, intermittent sweating, and persistent increases in serum muscle enzyme activities. Whole blood in EDTA and skeletal muscle were processed for genetic and histochemical analysis. Medical records and pedigrees were collected when available. RESULTS Both anesthetic- and non-anesthetic-associated myopathic manifestations of MH occurred in halter Quarter Horses with mutation of RyR1. The disease is inherited as an autosomal dominant trait. Clinical and laboratory abnormalities were similar in both forms. Rhabdomyolysis was a common finding in both groups of horses. Skeletal muscle histochemical findings were nonspecific and compatible with a noninflammatory myopathic process. CONCLUSIONS AND CLINICAL IMPORTANCE MH is a potentially fatal disease of Quarter Horses that could be triggered by halogenated anesthetics and other nonanesthetic factors that may include exercise, stress, breeding, illnesses, and concurrent myopathies.

Serum hepatitis associated with commercial plasma transfusion in horses

This report describes 4 fatal cases of serum hepatitis associated with the administration of commercial plasma in the horse. Serum hepatitis in the horse is characterized by acute hepatic central lobular necrosis, and it has been associated with the administration of biological products of equine origin. None of these horses had a recent history of equine biologic-origin vaccination; however, they had received 1.5-5 L of commercial plasma, and in I horse, an additional 8 L of fresh blood. Acute, severe colic unresponsive to medical therapy, lethargy, or sudden death developed in these 4 horses 41 to 60 days later. Two of the horses developed encephalopathy, confirmed in 1 horse by the presence of severe diffuse Alzheimer type II astrocytes in the brain. Although the prevalence of serum hepatitis associated with the administration of commercial plasma appears to be low in the horse, it should be considered an uncommon but potentially fatal risk factor.

Effect of gastric ulceration on physiologic responses to exercise in horses

OBJECTIVE To develop a protocol to induce and maintain gastric ulceration in horses and to determine whether gastric ulceration affects physiologic indices of performance during high-speed treadmill exercise. ANIMALS 20 healthy Thoroughbreds. PROCEDURES Each horse was acclimatized to treadmill exercise during a 2-week period. Subsequently, baseline data were collected (day 0) and each horse began an incrementally increasing exercise training program (days 1 through 56). Beginning on day 14, horses were administered omeprazole (4 mg/kg, PO, q 24 h until day 56) or no drug (10 horses/group) and underwent alternating 24-hour periods of feeding and feed withholding for 10 days to induce gastric ulceration. Extent of gastric ulceration was assessed weekly thereafter via gastroscopy. Physiologic indices of performance were measured at days 0 and 56. Gastric ulceration and exercise performance indices were compared within and between groups. RESULTS In untreated horses, gastric ulcers were induced and maintained through day 56. Gastric ulcer formation was prevented in omeprazole-treated horses. There were significant interactions between time (pre- and post-training data) and treatment (nonulcer and ulcer groups) for mass-specific maximal O(2) consumption ([Formula: see text]O(2max)/M(b)) and mass-specific maximal CO(2) production ([Formula: see text]CO(2max)/M(b)). Post hoc analysis revealed a difference between groups for [Formula: see text]O(2max)/M(b) at day 56. Within-group differences for [Formula: see text]O(2max)/M(b) and [Formula: see text]CO(2max)/M(b) were detected for omeprazole-treated horses, but not for the horses with ulcers. CONCLUSIONS AND CLINICAL RELEVANCE In horses, gastric ulcers were induced and maintained by use of alternating periods of feeding and feed withholding in association with treadmill exercise (simulated racetrack training). Gastric ulcers adversely affected physiologic indices of performance in horses.

Sensory Nerve Conduction and Somatosensory Evoked Potentials of the Trigeminal Nerve in Horses with Idiopathic Headshaking

BACKGROUND Idiopathic headshaking (HSK) in horses is a distressing disorder in which the etiology and pathophysiology are unknown. HYPOTHESIS Differences in sensory function of the trigeminal nerve exist between healthy and affected horses. ANIMALS Six healthy mature geldings and 6 mature geldings with idiopathic HSK. METHODS Prospective study. Sensory nerve action and somatosensory evoked potentials studies were performed. The stimulus site comprised the gingival mucosa dorsal to the maxillary canine. A pair of recording electrodes was placed along the sensory pathway of the trigeminal complex at the infraorbital nerve (R1), maxillary nerve (R2), spinal tract of trigeminal (R3), and somatosensory cortex (R4). Sensory nerve action potential latency (ms), amplitude (μV), duration (ms), area under the curve (μVms), and conduction velocity (m/s) were calculated. RESULTS Threshold for activation of the infraorbital branch of the trigeminal nerve was significantly different between 5 affected (≤ 5 mA) and 6 control horses (≥ 10 mA). After initiation of an action potential, there were no differences in all parameters measured and no differences between left and right sides. A horse with seasonal HSK tested during a time of no clinical manifestations showed a threshold for activation similar to control horses. CONCLUSIONS AND CLINICAL IMPORTANCE This study confirms involvement of the trigeminal nerve hyperexcitability in the pathophysiology of disease. Further, results might support a functional rather than a structural alteration in the sensory pathway of the trigeminal complex that can be seasonal. The horse could serve as a natural animal model for humans with idiopathic trigeminal neuralgia.

Peritoneal and plasma D-lactate concentrations in horses with colic.

OBJECTIVE To evaluate the association between peritoneal fluid and plasma d-lactate concentration with variables used in the diagnosis and prognosis of horses with colic. ANIMALS Clinically healthy horses (n=6) and 90 horses with colic. STUDY DESIGN Prospective cross-sectional study. METHODS D-lactate concentration was determined in peritoneal fluid and plasma of all horses. Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, need for surgery, lesion location, and type was retrieved from medical records. RESULTS Peritoneal D-lactate concentration was strongly correlated with plasma D-lactate concentration (r=0.71; P<.001). Peritoneal and plasma D-lactate concentrations were positively correlated with peritoneal (r=0.8; P<.001) and plasma L-lactate (r=0.33; P=.001) concentrations, respectively. Peritoneal D-lactate concentration was negatively correlated with survival to discharge (U=430.5; P<.001). Median peritoneal D-lactate concentration of horses with septic peritonitis (455.2 μmol/L) and horses with gastrointestinal rupture (599.5 μmol/L) were higher compared with horses with nonstrangulating obstructions (77.7 μmol/L). A cut-off concentration of peritoneal D-lactate of 116.6 μmol/L had a sensitivity of 0.813 and a specificity of 0.651 to differentiate between nonstrangulating and strangulating obstructions. CONCLUSIONS Peritoneal D-lactate concentration may be more useful for identifying horses with strangulating obstructions (high sensitivity, low probability of a false negative) than to ruling out strangulating obstruction (moderate specificity, high probability of a false positive).

Di-tri-octahedral smectite for the prevention of post-operative diarrhea in equids with surgical disease of the large intestine: results of a randomized clinical trial.

The aim of this study was to evaluate the effects of a commercially available di-tri-octahedral (DTO) smectite product on clinical signs and prevalence of post-operative diarrhea in horses with colic associated with disease of the large intestine. Sixty-seven horses with surgical disease of the large intestine were randomly assigned to be treated with DTO smectite (n=37; 0.5 kg via nasogastric intubation every 24 h for 3 days post-operatively) or a placebo (n=30). The effect of treatment on fecal scores and clinical and hematological parameters, including heart rate, mucous membrane color, temperature, total white blood cell count, total neutrophil count and total plasma protein values, were determined. Horses treated with DTO smectite had a significant reduction in the prevalence of post-operative diarrhea (10.8%), compared with controls (41.4%). A significant improvement in mucous membrane color was observed 72 h post-operatively in horses receiving treatment, compared with placebo. Administration of DTO smectite to colic patients with disease of the large intestine reduced the occurrence of diarrhea in the early post-operative period.

Comparison of pH, Lactate, and Glucose Analysis of Equine Synovial Fluid using a Portable Clinical Analyzer with a Bench-Top Blood Gas Analyzer

OBJECTIVE To compare agreement between a portable clinical analyzer and laboratory-based bench-top analyzer for analysis of pH, lactate, and glucose concentrations in synovial fluid. STUDY DESIGN Prospective experimental study. ANIMALS Clinically normal horses (n=8); 6 horses euthanatized for reasons unrelated to the study; 11 horses that had synoviocentesis for reasons other than sepsis; 7 horses that had synoviocentesis for evaluation of sepsis; and 2 horses without recorded clinical data. Median age of horses was 8 years (range, 1 day to 24 years). METHODS Supernatant from each synovial fluid sample was analyzed for pH, lactate, and glucose concentrations using an ABL 705 laboratory-based bench-top analyzer and i-STAT portable clinical analyzer. Bland-Altman plots were constructed and concordance analysis performed to determine bias and agreement between the 2 analyzers. RESULTS There was acceptable agreement between analyzers for lactate and glucose concentrations, with biases of 0.198 mmol/L and 9 mg/dL and concordance correlation coefficients of 0.97 and 0.96 for lactate and glucose, respectively. The agreement between analyzers for pH was not acceptable, with a bias of -0.057 and concordance correlation coefficient of 0.89. CONCLUSIONS This study found that the portable clinical analyzer performed similarly to the bench-top blood gas analyzer for evaluation of lactate and glucose concentrations, but not pH, in synovial fluid.Objective To compare agreement between a portable clinical analyzer and laboratory-based bench-top analyzer for analysis of pH, lactate, and glucose concentrations in synovial fluid. Study Design Prospective experimental study. Animals Clinically normal horses (n=8); 6 horses euthanatized for reasons unrelated to the study; 11 horses that had synoviocentesis for reasons other than sepsis; 7 horses that had synoviocentesis for evaluation of sepsis; and 2 horses without recorded clinical data. Median age of horses was 8 years (range, 1 day to 24 years). Methods Supernatant from each synovial fluid sample was analyzed for pH, lactate, and glucose concentrations using an ABL 705 laboratory-based bench-top analyzer and i-STAT portable clinical analyzer. Bland–Altman plots were constructed and concordance analysis performed to determine bias and agreement between the 2 analyzers. Results There was acceptable agreement between analyzers for lactate and glucose concentrations, with biases of 0.198 mmol/L and 9 mg/dL and concordance correlation coefficients of 0.97 and 0.96 for lactate and glucose, respectively. The agreement between analyzers for pH was not acceptable, with a bias of −0.057 and concordance correlation coefficient of 0.89. Conclusions This study found that the portable clinical analyzer performed similarly to the bench-top blood gas analyzer for evaluation of lactate and glucose concentrations, but not pH, in synovial fluid.