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Background: Although extracorporeal shockwave therapy (ESWT) is a common treatment for horses with back pain, effects on mechanical nociceptive threshold (MNT) and multifidus muscle cross sectional area (CSA) in the spine are unknown., Objectives: To evaluate effects of ESWT on spinal MNT and multifidus muscle CSA in horses with thoracolumbar pain., Study Design: Non-randomised trial., Methods: Thoracolumbar spines of 12 horses with thoracolumbar pain were radiographed to document existing pathology. Each horse received three ESWT treatments, 2 weeks apart (days 0, 14, 28). Palpation scores were documented (days 0, 45 and 65). Ultrasonographic CSA of left and right multifidus muscles was recorded at T12, T14, T16, T18, L3 and L5 (days 0, 45 and 65). MNT was measured at the same spinal sites every 7 days (day 0-56)., Results: Mechanical nociceptive threshold in 10/12 horses (83%) was greater at each time point compared with day 0 (P < 0.05). Mechanical nociceptive threshold increased at all time points at six sites in 2/12 (16%), at five sites in 3/12 (25%), at four sites in 4/12 (33%) and at one site in 1/12 (8%; P < 0.05). Mechanical nociceptive threshold average per cent  increase from day 0 to 56 was 64% for the thoracic region (T12-T18) and 29% for the lumbar region (L3-L5). There was no statistical difference in MNT from day 35 to 56 (P = 0.25). A bimodal analgesic trend was observed following ESWT. Degree of radiographic change was not associated with response to treatment. No significant change in multifidus muscle CSA was observed., Main Limitations: Small study size and lack of control group., Conclusions: Three treatments of ESWT 2 weeks apart raised MNT over a 56-day period in horses with back pain, but did not influence change in CSA of the multifidus muscle. While ESWT appears justifiable for analgesia, physiotherapeutic techniques may be necessary in conjunction for concurrent muscle rehabilitation., (© 2019 EVJ Ltd.)

Background: There are no published studies on the pharmacokinetics of acetaminophen at the dosage used clinically (20 mg/kg), nor has the safety of multiple doses in horses been investigated., Objective: Define the pharmacokinetic parameters of oral acetaminophen at 20 mg/kg in adult horses as a single dose, and twice daily for 14 days to assess the safety of multiple dosing., Study Design: Pharmacokinetic study, multiple dose safety study., Methods: Eight healthy Thoroughbred geldings were given acetaminophen (20 mg/kg; 500 mg tablets) orally as a single dose followed by doses every 12 h for 14 days. Serial blood samples were collected for determination of plasma acetaminophen concentrations using high performance liquid chromatography with ultraviolet detection. Serum biochemical analysis, gastroscopy and liver biopsy were examined during the safety study., Results: Following a single dose, mean maximum concentration (C max ) was 16.61 μg/mL at 1.35 h (T max ), and drug concentration was below the lower limit of detection in most horses by 24 h. Elimination half-life (T 1/2 ) was 2.78 h. No significant accumulation was noted following multiple doses. Average C max of acetaminophen following multiple oral dosing was 15.85 μg/mL, with a T max of 0.99 h and T 1/2 of 4 h. Serum activities of sorbitol dehydrogenase were significantly decreased and total bilirubin concentrations were significantly increased following the last dose. No statistically significant changes were noted in gastroscopy scores., Main Limitations: Only one dose level (20 mg/kg) was studied, sample size was small and only a single breed and sex was used, with no pretreatment liver biopsies., Conclusion: This study described the pharmacokinetics of acetaminophen following single and multiple 20 mg/kg oral doses in adult horses and demonstrated the safety of acetaminophen with multiple oral dosing over 14 days. The summary is available in Portuguese - see Supporting information., (© 2019 EVJ Ltd.)

Reasons for Performing Study: Acute monensin intoxication in equids is well described; however, the long-term effects of sublethal intoxication and ability to return to previous use are less well understood. Long-term observations may allow improved estimation of prognosis in cases of sublethal intoxication., Objectives: To assess horses and ponies exposed to sublethal amounts of monensin for evidence of chronic sequelae and ability to return to prior/intended use., Methods: Twenty-nine horses and 8 ponies were assessed utilising serum biochemistry, treadmill exercise stress testing, electrocardiography, and pre- and post exercise echocardiography > or = 6 weeks after ingestion of monensin-contaminated feed. Animals with evidence of monensin-induced cardiomyopathy were re-examined after a period of rest of > or = 11 months. Follow-up information was obtained by owner telephone interview > or = 52 months after exposure., Results: During resting echocardiography, 11 animals had reduced/low-normal left ventricular fractional shortening (FS); an increase in FS in 8 of these animals was measured > or = 11 months later. Six animals had reduced or low-normal FS during post exercise echocardiography. Two horses had ventricular premature depolarisations during exercise. Follow-up information was available for 35 animals: 21 returned to athletic/reproductive use, 13 were retired immediately and one died. Mean FS increased significantly (P < 0.001) between initial and second examination in 15 animals that underwent resting echocardiography on 2 occasions., Conclusions: Some equids exposed to sublethal doses of monensin may not develop permanent myocardial disease and a return to athletic/reproductive use is possible., Potential Relevance: Exercise stress testing, echocardiography and electrocardiography may be useful for detection and monitoring of cardiac dysfunction in equids exposed to monensin and determining whether a return to athletic/reproductive use is possible.

Reasons for Performing Study: Recombinant equine growth hormone (reGH) has recently been evaluated for effects on body condition and wound healing. It has the potential to influence articular cartilage via stimulation of IGF-1., Objectives: To investigate effects of administration on synovial joint metabolism., Methods: Six mature horses were given 20 microg/kg bwt reGH daily for 8 weeks by i.m. injection. Three control horses were injected with sterile water. Serum and synovial fluid samples were collected at 6, 8, 11 and 16 weeks for GH and IGF-1 assays. Articular cartilage harvested at week 16 was evaluated by Western analysis using monoclonal antibodies BC-13, BC-4, 8-A-4 and CH-3., Results: Concentrations of IGF-1 in serum and synovial fluid were significantly elevated (P < 0.05) at 6 and 8 weeks in the reGH group. Glycosaminoglycan concentrations in synovial fluid were significantly less than controls at these time points, suggesting that reGH may modulate proteoglycan metabolism in articular cartilage. In the reGH group, there were not any alterations in synovial fluid content of 3B3(-) epitope or aggrecan metabolite, or in aggrecan or link protein catabolites retained within cartilage, that might be expected with development of osteoarthritis., Conclusions: Intramuscular administration of reGH may be a more efficient means of delivery of IGF-1 to joints for cartilage resurfacing initiatives., Potential Relevance: We found no alterations in cartilage metabolism indicative of development of osteoarthritis.

In order to investigate the role of infectious agents in the aetiology of lower respiratory tract disease in Thoroughbred racehorses, a matched case-control study was conducted. Cases were identified by the presence of coughing, and were compared to a control population matched on time of sample collection and location within the same training establishment. Tracheal wash samples were collected from 100 cases and 148 controls. Case horses were more likely than controls to have endoscopic and cytological evidence of airway inflammation. There was no significant association between serological evidence of infection by commonly implicated respiratory viruses and coughing. Similarly, mycoplasma were rarely isolated and were not associated with disease. In contrast, there was a strong association between isolation of greater than a total of 10(3) colony-forming units/ml of tracheal wash and coughing. Individual bacterial species associated with disease included Streptococcus zooepidemicus, Streptococcus pneumoniae, Streptococcus suis, Streptococcus sanguis, Pasteurella spp and Bordetella bronchiseptica. This study provides evidence of the role of bacterial infection in the aetiology of lower respiratory tract inflammation in racehorses. However, in 58% of cases, few or no bacteria were isolated. Hence, at the time of identification of disease, there was no evidence of viral, bacterial or mycoplasmal infection in the majority of coughing horses. The aetiology of the signs observed in these horses requires further investigation.

This study was undertaken to determine the hydrophobicity of the luminal surface of the equine stomach and to elucidate the ultrastructure of the lining imparting that property. Gastric and duodenal mucosal samples from 5 horses were collected immediately after euthanasia and subjected to surface contact angle measurement using a goniometer. Gastric mucosal samples from 4 horses and a foal were examined by electron microscopy following a fixation procedure known to preserve phospholipids and oligolamellar structures. Contact angles for the equine gastric glandular mucosal surface (mean +/- s.e. 78.0 +/- 11.0 degrees) were greater than for the duodenum (33.4 +/- 8.7 degrees), (P = 0.003). The contact angles for gastric squamous tissue (50.4 +/- 4.5 degrees) tended to be greater than for duodenum (P = 0.15). Electron microscopy revealed the existence of surfactant as abundant osmiophilic phospholipid material within both squamous and glandular gastric mucosae. These results indicate the hydrophobic nature of the equine gastric mucosae. We propose that the water-repellent nature of the stomach contributes to the 'gastric mucosal barrier' and is imparted by surface-active phospholipid adsorbed to the surface. Phospholipids may also be utilised as a physical barrier to back-diffusion of acid by lining intracellular canaliculi and oxyntic ducts where other defence mechanisms are absent.

The superficial digital flexor tendon (SDFT) is an elastic structure that during maximal exercise appears to operate close to its functional limits. The biomechanical and biochemical responses to exercise, injury, and healing are still poorly understood but ongoing research is providing valuable new information which is addressed in this review. It appears that the SDFT matures early, after which time it has limited ability to adapt to stress and undergoes progressive degeneration. Focal hypocellularity, collagen fibril degeneration, selective fibril loading and alterations in the noncollagenous matrix occur primarily within the central core region of the midmetacarpal segment. Current treatment strategies have had equivocal results in returning animals to optimal athletic activity. To date it would seem that progressive rehabilitation programmes coupled with regular ultrasonographic evaluations are a cost-effective and comparable strategy when compared to surgical treatment methods. Recent interest in pharmacological modulation of intrinsic healing of collagenous structures has led to the investigation of various growth factors as potential therapeutic aids in the healing of tendon injuries. However, one of the major goals in tendon research, and one which holds the most optimism for success in the immediate future, is the prevention of tendon injuries.

Cytological and bacteriological results from tracheal fluid samples obtained endoscopically using a telescoping, plugged catheter (TPC) were compared with results from samples collected by percutaneous transtracheal aspiration (PTA). The TPC technique and PTA were performed in random order on 9 healthy Standardbred geldings. Three weeks later the procedures were performed on the same horses in the reverse order. The presence of oropharyngeal contamination was determined by quantitative bacteriology and quantification of squamous epithelial cells (SEC)/ml sample. The relative numbers of macrophages, haemosiderophages, giant cells, neutrophils, lymphocytes and eosinophils did not differ between techniques. The number of SEC/ml was greater in samples with more colony forming units/ml indicating that quantification of SEC provides evidence of the probable degree of oropharyngeal contamination. Fifteen out of the 18 TPC samples were free of contamination, indicating that the TPC can provide adequate samples for bacteriology. The results also indicate that tracheoscopy sometimes results in oropharyngeal contamination of the trachea, but that this does not affect the results of the TPC sample.

A retrospective case-control study was conducted to identify and quantify risk factors for serious musculoskeletal injury sustained at 4 Australian metropolitan racetracks. During the period of study (August 1988-July 1995) there were 196 cases from flat racing, 52 cases from hurdle racing and 53 cases from steeplechases. The incidences of fatal musculoskeletal injuries per start for flat, hurdle and steeple races were 0.06, 0.63 and 1.43% respectively. Logistic regression identified harder track surfaces, horses being older than age 3 years, one racecourse (Flemington) and jumping races as significant risk factors which increased the risk of musculoskeletal breakdown. The incidence of fatal musculoskeletal injuries for flat races at the 4 study tracks was similar to that reported in the UK but less than the USA. Death rates for hurdle and steeple races in the study population were higher than in the UK. Strategies to reduce the incidence of serious musculoskeletal injuries may include avoidance of excessively hard track surfaces through closer regulation of track moisture content; implementation of more rigorous prerace lameness examinations of horses, particularly older horses; and altering the design and number of jumps in hurdle and steeple races. The quantification of risk, as we have reported here, is the first step towards addressing the causes of musculoskeletal breakdown and should help in applying a reasoned approach to intervention measures that may be effective in reducing racing injuries.

Twenty-one compromised neonatal foals hospitalised at the Rural Veterinary Centre (RVC) during 1993 were studied to determine i) serum gentamicin concentrations obtained when gentamicin was administered at 3.3 mg/kg bwt twice daily i.m.; ii) factors which contributed to inter-foal variation in serum gentamicin concentrations achieved and iii) clinical efficacy of gentamicin therapy in foals with confirmed septicaemia. Septicaemia was confirmed in 7 foals with positive blood cultures and suspected in 8 foals with a sepsis score > 11. Peak serum concentrations (Ps) were > 6 microg/ml in all foals and > 8 microg/ml in 60% of foals. Trough serum concentrations (Ts) were < 2 microg/ml in all foals. Factors found to produce inter-foal variation in the Ps achieved included age (< 24 h; decreased), bodyweight (< 38 kg; decreased) and severity of dehydration (8-12% bodyweight; increased). Clinical response was not associated with achievement of Ps > 8 microg/ml, but was negatively influenced by the severity of clinical signs of depression. None of the foals in this study developed septic arthritis or pneumonia during or after therapy. No serum biochemical evidence (i.e. elevated serum creatinine concentrations) of gentamicin-induced nephrotoxicity was noted during therapy.

The relationship between different grades of laryngeal function, as assessed by endoscopy at rest, and the measurements of indices of gas exchange and exercise capacity was assessed during a standardised treadmill exercise test in 149 horses. Horses with abnormalities other than idiopathic laryngeal hemiplegia (ILH) were excluded from the study and laryngeal function was graded according to an established system. There were no significant differences in age, weight, maximum oxygen uptake, maximum carbon dioxide production, maximum respiratory exchange ratio, maximum oxygen pulse and run time between the grades. Blood lactate concentration at 10 m/s was greater (P < 0.01) in horses with grade 5 laryngeal function than other grades. Minimum PaO2 (P < 0.001) and SaO2 (P < 0.01) were lower and maximum PaCO2 (P < 0.001), higher in horses with grades 4 and 5 laryngeal function than other grades. Horses with grade 4 function had a lower minimum CaO2 (P < 0.01) than horses with other grades. Minimum PAO2 decreased from grades 1 and 2 to grades 4 and 5 (P < 0.05). The minimum alveolar ventilation was lower (P < 0.05) in horses with grades 4 and 5 laryngeal function compared to other grades. The results of this study indicate that endoscopic assessment of laryngeal function at rest, using a simple grading system, provides an indication of dynamic changes in ventilation and the effects on blood gases during exercise. From the data, we suggest that horses that have some movement of the left arytenoid cartilage but are unable to achieve full abduction have similar ventilatory effects and blood gas responses during maximal exercise to those with complete paralysis. Some horses with grade 3 laryngeal function had blood gas results similar to those of horses with grades 4 and 5 laryngeal function, indicating that discrepancies may occur between the resting assessment and laryngeal function during strenuous exercise.

The VO2(max) in racehorses is approximately double that of elite human athletes and the rate of increase in VO2 at the onset of high intensity exercise is much greater than in man. The kinetics of gas exchange are affected by a warm-up prior to exercise in humans, there being a greater aerobic contribution to high intensity exercise after warm-up. Our hypothesis was that a warm-up would increase aerobic energy delivery in racehorses during high intensity exercise. Thirteen fit Standardbred racehorses ran to fatigue at 115% of VO2(max) on a treadmill at 10% slope. Prior to acceleration, horses were exercised either for 5 min at 50% VO2(max) followed by 5 min walk, or walked for 2 min. Samples of expired gas were collected every 10 s during the run for determination of VO2 and VCO2 and measurement of maximal accumulated oxygen deficit (MAOD). Blood lactate concentration was measured 5 min post exercise. We found that with a warm-up, horses had faster kinetics of gas exchange and a greater proportion of their total energy requirement was supplied by aerobic sources. The aerobic contribution to total energy requirement with and without warm-up was, respectively, 79.3 +/- 1.0% and 72.4 +/- 1.7% (P < 0.01). There was also a higher MAOD (P < 0.01) in horses that had not been given a warm-up (mean +/- s.e.m. 34.7 +/- 2.6 and 47.3 +/- 2.6 mLO2eq/kg bwt with and without a warm-up respectively). However, there were no significant differences in total run time or estimated total energy expenditure between the 2 protocols. We concluded that during high intensity exercise to fatigue lasting 1 to 2 min, more than 70% of energy supply is from aerobic energy sources and that this contribution is even greater when the horses have received a warm-up.

The effects of exercise on urinary excretion of red blood cells, pigments (haemoglobin and myoglobin) and protein were studied in 8 mares performing treadmill exercise at speeds eliciting 40, 60 and 95% of the maximal oxygen consumption (VO2max). Gross haematuria and pigmenturia were observed in all horses during exercise at the 2 higher intensities, while these findings were detected in only one of 8 mares during exercise at 40% of the VO2max. For the remaining 7 mares exercised at 40% of the VO2max, increased urinary excretion of red blood cells (RBCs) and pigments was evident after centrifugation of urine samples and reagent strip analysis of the supernatant fractions. An increase in urine flow (UF) during exercise at 40% of the VO2max may have contributed to the infrequent observation of gross haematuria and pigmenturia during exercise at this intensity. A transient increase in UF following exercise at 60 and 95% of the VO2max resulted in rapid resolution of gross haematuria and pigmenturia, but increased urinary excretion of RBCs and pigments remained evident by reagent strip analysis for up to 60 min following exercise. Mean +/- s.e. urinary protein excretion increased from a resting value of 2.2 +/- 0.2 mg/min to 5.6 +/- 0.9, 14.5 +/- 4.7 and 78.4 +/- 18.6 mg/min after exercise at 40, 60 and 95% of the VO2max, respectively. These results demonstrate that exercise induced haematuria and pigmenturia and post exercise proteinuria are common in horses. Their occurrence is transient and does not appear to be associated with any lasting changes in renal function.

We examined the effects of sodium bicarbonate in 6 Thoroughbred horses during submaximal and maximal treadmill exercise. Cardiorespiratory function was assessed together with the effect on exercise capacity by determining the run time to fatigue at maximal intensities. To discriminate between sodium bicarbonate's alkalinising effects and the fluid shifts that could result from the high osmotic load, we administered an equimolar solution of sodium chloride as a control. The horses were given sodium bicarbonate (1 g/kg bwt) or an equivalent number of moles of sodium chloride by nasogastric tube. Arterial blood samples were collected before exercise and 5 h after treatment, resulting in mean standard bicarbonate values of 39.6 mmol/l in horses treated with sodium bicarbonate compared with 24.2 mmol/l in horses that received saline. The horses were exercised on a treadmill at 40, 60 and 80% of their VO2max for 4, 2 and 2 mins respectively. The horses were walked for 3 mins and accelerated rapidly to a speed approximately equivalent to 110% VO2max and run until fatigued. The horses ran for 170 +/- 20 secs (mean +/- sem) after administration of sodium bicarbonate compared with 128 +/- 13 secs after receiving sodium chloride (P < 0.02). At rest and throughout submaximal and maximal exercise, the bicarbonate-treated horses had significantly lower arterial oxygen tensions and higher arterial carbon dioxide tensions. There were no differences in cardiac output, heart rate, oxygen uptake or carbon dioxide production between the saline and bicarbonate treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

A peripheral vasodilating agent, isoxsuprine hydrochloride, administered as an oral paste, was evaluated to determine its efficacy for the treatment of navicular disease. In a clinical trial, 13 horses with navicular disease were treated at a dose rate of 0.6 mg/kg body weight (bwt) twice daily for periods of six to 14 weeks. Twelve of the horses became completely sound while being treated, although two required a 50 per cent increase in dose. Nine of the horses have remained sound two to 10 months after ceasing therapy. In a controlled randomised double blind clinical trial, 16 horses with navicular disease were assigned to treatment with either a placebo paste or isoxsuprine paste for three weeks and then re-examined. All the horses treated with isoxsuprine showed improvement in gait, with seven of eight horses becoming sound, whereas only two horses treated with a placebo paste showed slight improvement. This difference in response was highly significant (P less than 0.001). To evaluate any physiological and biochemical effects of isoxsuprine, it was administered to five Standardbred geldings at dose rates of 0.6 mg/kg bwt and 1.2 mg/kg bwt. Complete blood counts, routine plasma biochemical parameters, cardinal signs and blood pressure measurements were performed up to 24 h after a single dose. No significant change in any of these parameters was found. To assess the peripheral vasodilatory action of isoxsuprine, infra-red thermography of the lower limb was performed before and up to 8 h after administration to horses. This revealed a significant increase in distal limb temperature which occurred from 90 to 480 mins after isoxsuprine administration. The maximum mean increase in distal limb temperature was 3.1 degrees C and this occurred 4 h after administration of the drug.

Eleven horses were studied throughout a 12 week training schedule. Serial blood samples were taken for haematological analysis and an extensive biochemical profile, including the following parameters: sodium, potassium, chloride, bicarbonate, glucose, creatinine, urea, bilirubin, iron, total protein, albumin, alkaline phosphatase, aspartate aminotransferase, creatine kinase, gamma glutamyl transferase, calcium phosphate and cholesterol. There were few significant changes detected and it was concluded that routine haematological and biochemical screening has no useful role in assessing the fitness of horses under these conditions.

The effects of training on skeletal muscle composition were studied in four Standardbred geldings given a seven week submaximal treadmill training programme. Before the start of training, muscle biopsies were collected from the left middle gluteal muscle for the determination of muscle fibre types, oxidative capacity and capillary numbers using histochemical techniques. The concentrations of citrate synthase, 3-hydroxyacyl-CoA dehydrogenase (HAD), lactate dehydrogenase and total muscle glycogen were measured using fluorometric methods. Muscle biopsy samples were repeated after one, three, five and seven weeks of training and the same measurements performed. No significant changes were found in muscle fibre types or capillary numbers as a result of training, although there was an increase in the oxidative capacity of the Type IIB fibres after seven weeks training. After seven weeks of training there were also increases in the concentrations of citrate synthase and HAD and a decrease in lactate dehydrogenase. Before commencement of training the horses underwent a standardised submaximal exercise test and muscle glycogen concentrations were measured before and immediately after the exercise. This procedure was repeated after one, three, five and seven weeks of training. A progressive decrease in the rate of glycogen utilisation occurred throughout the period of training, which by seven weeks was 36 per cent lower than that before training.