S. A. May

Evidence of bias affecting the interpretation of the results of local anaesthetic nerve blocks when assessing lameness in horses.

Eighteen observers were influenced to different extents in the grades of lameness they allocated to eight horses by whether they knew that a nerve block had been administered; on a scale from 0 to 10 the mean difference in grade allocated once the observer knew a horse had been nerve-blocked was increased by 0·4. The consistency of the assessments made by the individual observers was good, with a an average of 0·6 of a grade difference when grading the same horse on two occasions. The agreement between the assessments of four orthopaedic experts was reasonable (±1 grade), but significantly poorer for four non-experts and 10 final year veterinary students.

Comparison of radiography and scintigraphy in the diagnosis of dental disorders in the horse

Scintigraphy, with 99mTechnetium methylenediphosphonate (99mTc-MDP) and 99mTc-labelled leucocytes, was compared to radiography in the diagnosis of dental disease in the horse in a prospective case-controlled study, comprising 30 horses with clinical signs of dental disease and 30 control horses. In each case, right and left lateral, ventral and dorsal soft tissue and bone phase scintigraphic images were obtained after i.v. injection of 1 GBq/100 kg bwt 99mTc-MDP, using a gamma camera. The same views were acquired in 10 horses with clinical signs of dental disease and 12 control horses after injection of 99mTc-labelled leucocytes. Standard radiographic projections of the paranasal sinuses and of the apices of the maxillary and mandibular teeth were obtained. The scintigraphs and radiographs were assessed subjectively by 2 board-certified surgeons and one board-certified radiologist, with extensive experience of equine radiology, from who the clinical history was withheld. Sensitivity, specificity and kappa, as a measure of agreement, were calculated for the different methods. Bone phase images were also scored subjectively on a scale from 0 to 3 on the basis of isotope uptake over the teeth. Regions of interest were defined over the teeth, and normal teeth compared to diseased counterparts. Total scintigraphic counts were related to the age of the animal and to the disease process. Differences in density ratios between left and right teeth were evaluated using the Mann-Whitney Test. Dental disease was confirmed in 22 horses at surgery or postmortem examination. Horses with dental disease showed a significant increase in scintigraphic activity over the affected tooth compared to the contralateral tooth, with a typical pattern for different diseases. The sensitivity of scintigraphy with 99mTc-MDP proved to be excellent (95.5%), whereas the specificity was moderate (86.4%). In contrast, radiography had excellent specificity (95.0%) and a low sensitivity (51.5%). The greatest sensitivity and specificity were achieved by evaluating radiographs and scintigrams together. The objective scintigraphic density ratios were found to be significantly different between diseased and control horses. The results of this study suggest that, if a density ratio of 1.5 or greater between a suspected diseased tooth and its contralateral number is regarded as abnormal, only 1% false positive diagnoses and 20% false negative diagnoses will occur. In contrast, scintigraphy with 99mTc-labelled leucocytes was not very successful, due to the lack of anatomical detail provided by this technique, which made identification of the diseased tooth impossible. Accurate radiographic interpretation of dental disease presents difficulties, both in terms of missed diagnoses and mistaken diagnoses. Scintigraphy complements radiographic examination of dental structures by providing information important for accurate diagnosis and is, therefore, conceived to be essential for selection of the appropriate treatment for dental disease.

Vertical head and trunk movement adaptations of sound horses trotting in a circle on a hard surface.

Trotting a horse in circles is a standard and important part of the subjective equine lameness examination, yet objective data on this form of locomotion are sparse. The aim of this study was to investigate the effect of trotting in a circle on head and trunk movement symmetry. Vertical movements of the head, withers, os sacrum and left and right tuber coxae were measured using inertial sensors as 12 sound horses were trotted on a hard surface in a straight line and in a circle on both reins. Seven asymmetry measures and hip hike were calculated for each horse for at least nine strides of comparable stride duration across the three conditions (deviation on horse level ≤3.7% stride duration). Trotting in a circle introduced systematic changes to the movement pattern of all five body landmarks, affecting most asymmetry measures. On average the asymmetry magnitude was comparable for midline locations between reins and for the tuber coxae on opposite reins with few exceptions, although individual horses showed unsystematic differences between the two reins. The results from this study showed that the thresholds for objective discrimination between lame and non-lame horses will need adjustment on the circle due to the observed asymmetry bias.

Variation in conformation in a cohort of National Hunt racehorses

REASONS FOR PERFORMING THE STUDY Assessment of conformation is commonly used in the selection of horses for performance purposes. Little information is available on the normal range of conformational traits within the Thoroughbred population. OBJECTIVES To describe variations in conformation in a cohort of racing Thoroughbreds in order to provide a set of baseline standards within which conformational traits can be considered normal. MATERIALS AND METHODS Ninety-eight conformational parameters were measured in a cohort of 108 National Hunt racehorses using a digital motion analysis system. The measurements consisted of segment lengths, joint angles in 2D and 3D, inclinations, deviations and circumference measurements. The differences between left and right sides were determined to obtain a measure of asymmetry. Conformational parameters were related to each horses country of origin, preferred race distance and race type. RESULTS The majority of parameters followed a normal distribution with the biggest relative variation in hoof related measurements and in stifle and coxal angle. All circumference measurements and the majority of the length measurements were significantly correlated with the height of the horse at the withers. No underlying pattern of combinations of conformational parameters was identified. Twenty-five per cent of the parameters showed a significant difference between left and right-sided measurements. A significant difference in girth and intermandibular width was observed between Irish and French horses. CONCLUSIONS Thoroughbreds differ from other breeds, not only with regard to segment lengths but also with regard to joint angles and deviations. Variation in conformational parameters was relatively small and no distinct pattern of combinations of conformational traits identified. CLINICAL RELEVANCE The variation in conformational measurements in Thoroughbred racehorses establishes a set of baseline measurements of conformational range against which individual horses can be assessed.

Accuracy and precision of hind limb foot contact timings of horses determined using a pelvis-mounted inertial measurement unit

Gait analysis using small sensor units is becoming increasingly popular in the clinical context. In order to segment continuous movement from a defined point of the stride cycle, knowledge about footfall timings is essential. We evaluated the accuracy and precision of foot contact timings of a defined limb determined using an inertial sensor mounted on the pelvis of ten horses during walk and trot at different speeds and in different directions. Foot contact was estimated from vertical velocity events occurring before maximum sensor roll towards the contralateral limb. Foot contact timings matched data from a synchronised hoof mounted accelerometer well when velocity minimum was used for walk (mean (SD) difference of 15 (18)ms across horses) and velocity zero-crossing for trot (mean (SD) difference from -4 (14) to 12 (7)ms depending on the condition). The stride segmentation method also remained robust when applied to movement data of hind limb lame horses. In future, this method may find application in segmenting overground sensor data of various species.

Reliability of conformational measurements in the horse using a three-dimensional motion analysis system

REASONS FOR PERFORMING STUDY The importance of a reliable method for conformation studies is generally acknowledged, but there are only limited data on the accuracy and precision of current assessment methods. OBJECTIVES To assess (1) the accuracy and repeatability of marker placement, (2) influence of stance of the horse on conformational parameters, (3) practicality of a computerised motion analysis system and (4) to compare the computerised motion analysis system to photographic systems of assessment. METHODS Twenty-eight reflective markers placed over anatomical landmarks were located in 3D using a computerised motion analysis system and their coordinates used to calculate segment lengths and joint angles. Four experiments, involving a cadaver study, a series of repeated measures on a single Thoroughbred and repeat measurements on 108 racehorses were performed. RESULTS Identification of anatomical landmarks was found to introduce the biggest variation in the measurements for proximal conformation parameters with the interoperator being larger than intraoperator variation. Length measurements were least influenced by stance, with distal interphalangeal and metacarpo/metatarsophalangeal joint angles being the most variable. In some measurements, the variation between stances within a horse proved to be almost as large as between horses, rendering these parameters less useful as predictors of performance or orthopaedic health. CONCLUSIONS A computerised motion analysis system allows 3D assessment of conformation with high accuracy and precision. It eliminates 3 major sources of error associated with photography-based methods and increases accuracy of conformational assessment by allowing repeat measurements in a relatively short period. POTENTIAL RELEVANCE Studies on conformation should be viewed in the light of the limitations of the measurement technique used. The presented method maximises accuracy and precision and is a valuable basis for future studies investigating the effect of conformation on performance or orthopaedic health.

Comparison of radiography, scintigraphy and ultrasonography in the diagnosis of a case of temporomandibular joint arthropathy in a horse

Diagnosis of temporomandibular joint disease in the horse presents a challenge to the equine veterinarian. This case report illustrates a combined imaging approach using radiography, scintigraphy and ultrasonography in a horse with severe arthropathy of the left temporomandibular joint Radiographs were inconclusive. Scintigraphy with Tc99m methylenediphosphonate localised, but failed to characterise the disease process; ultrasonography was the only imaging method which both localised and characterised the lesion. Ultrasonography proved to be a relatively cheap, technically easy to perform and non-invasive method for the assessment of the disease.

Interleukin-1 stimulation of equine articular cells.

Prostaglandin E2 (PGE2) and stromelysin are produced by equine chondrocytes and synovial cells in vitro in response to recombinant human (rh) interleukin-1 (IL-1) alpha and beta, and equine mononuclear cell supernatants (MCS) containing IL-1. However, culture conditions are important. PGE2 concentrations increase in proportion to the concentration of fetal calf serum (FCS) in the culture medium, whereas stromelysin concentrations are inversely proportional to the concentration of FCS. Equine MCS, containing a lower concentration of IL-1 than the concentration of rhIL-1 used in these experiments, stimulated production of much higher levels of PGE2 than rhIL-1. In addition, equine MCS induced the production of broadly similar levels of PGE2 by both chondrocytes and synovial cells, whereas rhIL-1 was more active on equine synovial cells than equine chondrocytes. Although equine MCS induced both stromelysin and PGE2 production by equine articular cells, on the whole rhIL-1 failed to induce stromelysin production. This supports previous observations of species restrictions in the activity of human IL-1 on equine cells. Therefore, experiments using mammalian cells and heterologous IL-1 should be interpreted with caution.

Interleukin-1-like activity in synovial fluids and sera of horses with arthritis.

Synovial fluid samples of horses with osteoarthritis were investigated to detect interleukin-1 (IL-1) activity which could contribute to the disease pathogenesis. Of the 32 samples tested, 12 (37.5 per cent) showed an augmented phytohaemagglutinin induced proliferation of C3H/HeJ mouse thymocytes. Positive results were also seen in horses with infected arthritis, osteochondritis, traumatic arthritis and undefined synovial effusions. Normal synovial fluid and sera from all groups failed to show any detectable IL-1 activity. Fractionation of synovial fluid showed that the IL-1 activity was in the 15 to 20 Kd fractions. In the absence of mitogen, synovial fluid failed to stimulate thymocytes and did not stimulate the growth of an interleukin-2 (IL-2) dependent CTLL cell line, but synovial fluid stimulated IL-2 release by mouse spleen cells incubated with suboptimal doses of lectin. Evidence of an IL-1 inhibitor in synovial fluid from osteoarthritic horses was provided by ultrafiltration experiments and by the inhibitory activity of synovial fluid at particular dilutions in the thymocyte assay. The presence of IL-1-like activity could be relevant in the pathogenesis of arthritis in horses.

Effect of foot balance on the intra-articular pressure in the distal interphalangeal joint in vitro

REASONS FOR PERFORMING STUDY Increased joint pressure has been implicated in the progression of osteoarthritis. HYPOTHESIS That intra-articular pressure in the distal interphalangeal joint (DIP) is significantly higher in legs loaded with heel up (HU), low heel (TU), lateral side up (LU) and medial side up (MU) imbalance compared to the balanced position. METHODS Twelve elbow down limbs were compressed in a hydraulic loading jig and DIP pressure measured. RESULTS Elevating the heels by 5 degrees significantly increased DIP pressure. After 5 ml of contrast was injected into the joint, heel elevation caused a greater increase in DIP pressure and heel lowering decreased DIP pressure. Silicone rubber castings were taken of 20 DIP whilst under load. The articular contact area was localised on the dorsal aspect in the HU position, palmar aspect in the TU position and towards the elevated side with lateromedial imbalance. CONCLUSIONS Altered foot orientation, which could result from trimming and shoeing, therefore influences intra-articular pressure in the DIP and the articular contact area. POTENTIAL CLINICAL RELEVANCE The results support the view that a balanced foot is the ideal and that the elevated heels may be detrimental to long term viability of the DIP joint.