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Heidi E Banse, Frank M AndrewsEquine Health Studies Program, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge LA, USAAbstract: Equine glandular gastric disease (EGGD) is an increasingly recognized disease of the glandular mucosa of the equine stomach. Diagnosis is confirmed by gastric endoscopy and scored based upon one of several different endoscopic scoring systems. Prevalence appears to be variable, depending upon breed and discipline. Primary identified risk factors include exercise frequency, and stress; therefore, management strategies are focused on reducing exercise and stress. Limiting grain intake and increasing pasture turnout may also be helpful preventative measures. Pharmacologic treatment consists primarily of an approved omeprazole product with or without misoprostol or sucralfate. Further research into the pathophysiology of EGGD may allow for identification of other targeted treatments.Keywords: gastric ulcer, inflammation, exercise, stress, omeprazole, misoprostol

Equine glandular gastric disease (EGGD) is a common disease among athletic horses that can negatively impact health and performance. The pathophysiology of this EGGD remains poorly understood. Previous studies using controlled populations of horses identified differences in the gastric glandular mucosal microbiome associated with disease. The objective of this study was to compare the gastric microbiome in horses with EGGD and those without across multiple barns and differing management practices. We hypothesized that alterations in the microbiome of the gastric glandular mucosa are associated with EGGD. A secondary objective was to perform a risk factor analysis for EGGD using the diet and management data collected. Microbial populations of biopsies from normal pyloric mucosa of horses without EGGD (control biopsies), normal pyloric mucosa of horses with EGGD (normal biopsies) and areas of glandular mucosal disruption in horses with EGGD (lesion biopsies) were compared. Lesion biopsies had a different microbial community structure than control biopsies. Control biopsies had a higher read count for the phylum Actinomycetota compared to lesion biopsies. Control biopsies also had an enrichment of the genera Staphylococcus and Lawsonella and the species Streptococcus salivarius. Lesion biopsies had an enrichment of the genera Lactobacillus and Actinobacillus and the species Lactobacillus equigenerosi. These results demonstrate differences in the gastric glandular microbiome between sites of disrupted mucosa in horses with EGGD compared to pyloric mucosa of horses without EGGD. Risk factor analysis indicated that exercise duration per week was a risk factor for EGGD., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: HEB has previously received (greater than five years ago) other grant funding and performed consultancy work for Boehringer Ingelheim Animal Health. The other authors (LJP, FMA, ACE, ZM, MLK, MPS) have declared that no competing interests exist., (Copyright: © 2023 Paul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To compare small intestinal inflammation with gastric inflammation in horses with and without equine gastric glandular disease (EGGD), we evaluated endoscopic, macroscopic, and microscopic findings of the glandular stomach and microscopic findings of the small intestine., Animals: 36 horses., Methods: Horses underwent endoscopy and were scored for EGGD. After euthanasia, stomachs were collected and macroscopically evaluated. Normal pyloric mucosa, glandular lesions, and small intestinal (duodenum, mid-jejunum, and ileum) samples were collected and processed for microscopic examination. Cellular infiltrate was scored. Immunohistochemistry (CD3, CD20, and Iba-1) was performed on the ventral pylorus and small intestine of horses with mild to moderate lymphoplasmacytic infiltrate. A Spearman's correlation coefficient was used to evaluate the relationship of EGGD grade with gastric glandular inflammation, and the relationships of cellular infiltrate type and severity among glandular stomach, duodenum, jejunum, and ileum., Results: Gastrointestinal inflammation was common, with gastric inflammatory infiltrate identified in 92%, duodenal inflammatory infiltrate in 83%, jejunal inflammatory infiltrate in 92%, and ileal inflammatory infiltrate in 92% of horses. Endoscopic evidence of gastric disease (hyperemia or EGGD grade ≥ 2/4) was not associated with the presence or severity of duodenal, jejunal, or ileal inflammation. Gastric lymphoplasmacytic inflammation grade ≥ 2 was associated with duodenal lymphoplasmacytic inflammation grade ≥ 2. This was a convenience sample of horses presenting for euthanasia. Medical history (including deworming history) was unknown., Clinical Relevance: Gastric lymphoplasmacytic inflammation is associated with duodenal lymphoplasmacytic inflammation but not more distal small intestinal inflammation. Intestinal inflammation is not associated with endoscopic findings (hyperemia or EGGD grade ≥ 2/4).

Ileus is a common life-threatening problem in horses, and currently available treatments may be ineffective. The purpose of this study was to determine whether bit chewing, a form of sham feeding, decreases the gastric emptying time (GET), small intestinal transit time (SITT), and total orocecal transit time (OCTT) in clinically normal horses in a prospective crossover study. Nine healthy horses were acclimated and fed a standardized diet. Following 24 h of fasting, self-contained video endoscopy capsules and acetaminophen were administered into the stomach via a nasogastric tube. Each horse underwent experimental (bit chewing for 20 min every 6 h) or control (no bit chewing) conditions, with a 3-week minimum washout period between conditions. The horses were enrolled in either part of the study until all video capsules were retrieved and/or 30 days lapsed. The video capsules were recovered from manure, and GET, SITT, and OCTT were determined from a video analysis. Bit chewing significantly decreased OCTT ( p = 0.015) compared to the control conditions. Bit chewing decreased GET and SITT, but the differences were not significant. The mean (median) times determined via the video capsule analysis for the bit-chewing conditions were as follows: GET, 2.34 h (2.86 h); SITT, 3.22 h (3.65 h); and OCTT, 5.13 h (6.15 h), and for the control conditions, they were as follows: GET, 3.93 h (5 h); SITT, 3.79 h (4.4 h); and OCTT, 8.02 h (9.92 h). Bit chewing decreased OCTT in healthy horses. Because this segment of the gastrointestinal tract is frequently affected by ileus, bit chewing may be a safe and inexpensive intervention for that condition in horses. Further investigation in clinical patients with ileus is warranted.

Introduction: Accurate quantitative analysis of equine insulin in blood samples is critical for assessing hyperinsulinemia in horses. Although there are various laboratory methods for evaluating equine serum insulin, different immunoassays show significant discrepancies between the determined insulin concentrations and are often not comparable. The aim of this study was to evaluate the Immulite® 1000 chemiluminescent immunoassay (CLIA) to establish independent laboratory and assay-specific cut values to provide an accurate diagnosis of hyperinsulinemia in horses. Thus, the analytical and clinical performance of Immulite® 1000 CLIA in terms of precision (intra- and inter-assay coefficient of variance, CV) and recovery upon dilution were evaluated and compared with radioimmunoassay (RIA), which has been previously validated for use in horses., Material and Methods: Archived serum samples ( n = 106) from six Quarter horse mares enrolled in the glucose phase of a Frequently Sampled Insulin and Glucose Test (FSIGT) study were used to measure blood insulin., Results: The Immulite® 1000 CLIA had good precision with acceptable intra- and inter-assay CVs, adequate recovery on dilution, and a strong correlation with the RIA ( r = 0.974, P < 0.0001), with constant bias resulting in consistently lower values., Discussion: On this basis, the Immulite® 1000 Insulin Assay is valid for measuring equine serum insulin for diagnostic and monitoring purposes when cut values are appropriately adjusted., Competing Interests: NF was employed by Siemens Healthcare Diagnostics Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Go, Hazard, Balasuriya, Chapman, Fitton, Kenéz and Andrews.)

Osteoarthritis (OA) accounts for up to 60% of equine lameness. Agmatine, a decarboxylated arginine, may be a viable option for OA management, based on reports of its analgesic properties. Six adult thoroughbred horses, with lameness attributable to thoracic limb OA, received either daily oral phenylbutazone (6.6 mg/kg), agmatine sulfate (25 mg/kg) or a control for 30 days, with 21-day washout periods between treatments. Subjective lameness, thoracic limb ground reaction forces (GRF), plasma agmatine and agmatine metabolite levels were evaluated using an established rubric, a force platform, and mass spectrometry, respectively, before, during and after each treatment period. Gastric ulceration and plasma chemistries were evaluated before and after treatments. Braking GRFs were greater after 14 and 29 days of agmatine compared to phenylbutazone administration. After 14 days of phenylbutazone administration, vertical GRFs were greater than for agmatine or the control. Glandular mucosal ulcer scores were lower after agmatine than phenylbutazone administration. Agmatine plasma levels peaked between 30 and 60 min and were largely undetectable by 24 h after oral administration. In contrast, plasma citric acid levels increased throughout agmatine administration, representing a shift in the metabolomic profile. Agmatine may be a viable option to improve thoracic limb GRFs while reducing the risk of glandular gastric ulceration in horses with OA.

Supplements containing Cannabidiol (CBD) are available for horses, however, few studies have been published on their effects on behavior and health parameters. The purpose of this study was to determine if a daily oral supplement containing CBD would cause sedation, ataxia or alterations in other health parameters during administration for 56 days. Twenty clinically healthy adult Thoroughbred horses were housed in stalls. Before treatment was initiated, a complete physical examination, complete blood count (CBC) and biochemical panel were evaluated. In addition, horses were examined for sedation and ataxia using standard scoring systems. Horses were randomly divided into two treatment groups, treated (supplement pellets containing CBD as Hemp Extract, 150 mg) or control (supplement pellets without CBD). Horses were treated daily and sedation and ataxia scores were assigned by two masked observers once weekly for 56 days. Horses were monitored daily for clinical signs or adverse events and body weights were recorded weekly. A CBC and biochemical panel were repeated on days 28 and 56, two hours after administration of the supplement. The supplement was readily consumed by the horses and no adverse effects were seen over the treatment period. Sedation and ataxia scores ranged from zero to two for all horses during the weekly examinations and there was no statistical difference between treatment groups. There were no treatment effects on blood values, including indicators of anemia and blood proteins, liver enzymes, kidney values, electrolytes or calcium. Body weight significantly increased in all horses, by Day 56 compared to Day zero but no treatment by day effect was noted. The CBD supplement (150 mg) was readily consumed and safe and did not result in changes in mentation, gait, or other health parameters, and no adverse clinical signs were observed during 56 days of oral administration., (Copyright © 2022. Published by Elsevier Inc.)

Objective: The purpose of this study was to characterize the relationship of diet and management factors with the glandular gastric mucosal microbiome. We hypothesize that the gastric mucosal microbial community is influenced by diet and management factors. Our specific objective is to characterize the gastric mucosal microbiome in relation to these factors., Animals: 57 client-owned horses in the southern Louisiana region with and without equine glandular gastric disease., Procedures: Diet and management data were collected via a questionnaire. Gastroscopy was used for evaluation of equine gastric ulcer syndrome and collection of glandular mucosal pinch biopsies. 16S rRNA amplicon sequencing was used for microbiome analysis. Similarity and diversity indices and sequence read counts of individual taxa were compared between diet and management factors., Results: Differences were detected in association with offering hay, type of hay, sweet feed, turnout, and stalling. Offering hay and stalling showed differences in similarity indices, whereas hay type, sweet feed, and turnout showed differences in similarity and diversity indices. Offering hay, hay type, and sweet feed were also associated with differences in individual sequence read counts., Clinical Relevance: This study provides preliminary characterization of the complex relationship between the glandular gastric microbiome and diet/management factors. The ideal microbiome to promote a healthy glandular gastric environment remains unknown.

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of equids. Following natural infection, up to 70% of the infected stallions can remain persistently infected over 1 year (long-term persistent infection [LTPI]) and shed EAV in their semen. Thus, the LTP-infected stallions play a pivotal role in maintaining and perpetuating EAV in the equine population. Previous studies identified equine C-X-C motif chemokine ligand 16 (CXCL16) as a critical host cell factor determining LTPI in the stallion's reproductive tract. Two alleles ( CXCL16 S and CXCL16 r ) were identified in the equine population and correlated with the susceptibility or resistance of a CD3 + T cell subpopulation in peripheral blood to in vitro EAV infection, respectively. Interestingly, CXCL16 S has been linked to the establishment of LTPI in stallions, and thus, genotyping stallions based on CXCL16 S/r would allow identification of those at the highest risk of establishing LTPI. Thus, we developed a TaqMan ® allelic discrimination qPCR assay for the genotyping of the equine CXCL16 gene based on the identification of a single nucleotide polymorphism in position 1,073 based on NCBI gene ID: 100061442 (or position 527 based on Ensembl: ENSECAG00000018406.2) located in exon 2. One hundred and sixty horses from four breeds were screened for the CD3 + T cell susceptibility phenotype to EAV infection by flow cytometry and subsequently sequenced to determine CXCL16 allelic composition. Genotyping by Sanger sequencing determined that all horses with the resistant CD3 + T cell phenotype were homozygous for CXCL16 r while horses with the susceptible CD3 + T cell phenotype carried at least one CXCL16 S allele or homozygous for CXCL16 S . In addition, genotypification with the TaqMan ® allelic discrimination qPCR assay showed perfect agreement with Sanger sequencing and flow cytometric analysis. In conclusion, the new TaqMan ® allelic discrimination genotyping qPCR assay can be used to screen prepubertal colts for the presence of the CXCL16 genotype. It is highly recommended that colts that carry the susceptible genotype ( CXCL16  S/S or CXCL16 S/r ) are vaccinated against EAV after 6 months of age to prevent the establishment of LTPI carriers following possible natural infection with EAV., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Thieulent, Carossino, Balasuriya, Graves, Bailey, Eberth, Canisso, Andrews, Keowen and Go.)

Objective: To determine the influence of bit chewing on gastrointestinal transit in clinically normal horses., Study Design: Prospective crossover designed study., Animals: Six healthy adult horses., Methods: Horses were assigned randomly to treatment (apple flavored bit) and control (no-bit) groups and studied for 2 × 1-week trial periods with a 2-week washout period between trials. Horses were fasted for 24 h and slowly refed over 3 days. The bit was placed for 20 min every 6 h. Duodenal contractions and borborygmi auscultations were evaluated every 12 h, approximately 5 min following bit placement. Gastrointestinal total transit time (GI TTT) was measured by administering 200 colored beads via stomach tube and then collected in the manure until 50% and 80% were recovered. Measured variables were compared using an ANOVA or Wilcoxon signed-rank test and the P value was noted., Results: The GI TTT was shortened in the bit chewing group (median: 106.37 h, range: 70-171 h) compared to the no-bit group (median: 170.1 h, range: 149-186 h) (P = .0156) at 80% bead passage (only 4/6 horses passed 80%). Borborygmi (P = .8193), duodenal contractions (P = .2605), and 50% bead passage (P = .0781) showed no differences., Conclusion: Bit chewing was safe, inexpensive, and well tolerated. Bit chewing shortened GI TTT and might be an adjunct therapy to augment GI TTT. Further clinical studies are warranted., Clinical Significance: Ileus is a common complication following equine abdominal surgery with no current consistently successful treatment. Bit chewing may be a simple and inexpensive way to augment progressive GI motility., (© 2021 American College of Veterinary Surgeons.)

Equine protozoal myeloencephalitis (EPM) is a debilitating neurologic disease affecting horses across the Americas. Gaps in understanding the inflammatory immune response in EPM-affected horses create difficulties with diagnosis and treatment, subsequently negatively impacting the prognosis of affected horses. The purpose of the current study was to evaluate circulating levels of the inflammatory immune marker soluble CD14 (sCD14), in horses with EPM (n = 7) and determine if they differed from healthy neurologically normal horses (n = 6). Paired sera and cerebrospinal fluid (CSF) samples were analyzed for sCD14. Inclusion criteria for EPM horses consisted of the presence of neurologic signs consistent with EPM, Sarcocystis neurona surface antigens 2, 4/3 (SnSAG 2, 4/3) ELISA serum: CSF antibody ratio ≤ 100, and a postmortem diagnosis of EPM. Control horses were neurologically normal, healthy horses with SnSAG 2, 4/3 ELISA serum: CSF antibody ratios of > 100. Serum anti-Sarcocystis neurona antibodies indicate that healthy control horses were exposed to S. neurona but resistant to developing clinical EPM. EPM cases had significantly greater concentrations of sCD14 in CSF samples compared to control horses and increased serum sCD14 concentrations. A positive correlation between sCD14 serum and CSF concentrations was observed in EPM-affected horses but not healthy horses. Soluble CD14 is an inflammatory marker, and the study results suggest it is elevated in EPM patients. When performed in conjunction with clinical evaluation and standard antibody testing, there may be potential for sCD14 to be utilized as a correlate for EPM., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The role of the gastric microbiome in development or persistence of equine glandular gastric disease (EGGD) remains to be investigated., Hypothesis/objectives: The objective was to characterize the glandular mucosal and gastric fluid microbiomes of horses with and without EGGD. It was hypothesized that differences in the mucosal microbiome are associated with EGGD., Animals: Twenty-four horses were enrolled., Methods: Gastroscopy was performed and EGGD scores recorded (score 0, n = 6; score 1, n = 8; score ≥2, n = 10). Gastric fluid and pinch biopsies of healthy glandular mucosa and EGGD lesions were collected via gastroscope. 16S rRNA amplicon sequencing of the gastric fluid and glandular mucosal biopsies was performed. Relationships between gastric fluid and mucosal microbial community composition were evaluated among EGGD score groups (EGGD 0-BX, EGGD 1-BX, EGGD ≥2-BX) and among endoscopic appearances: controls from horses without EGGD and normal areas, hyperemic areas, and lesions from horses with EGGD., Results: Microbial community structure of mucosal biopsies differed among EGGD score groups (Jaccard similarity index; P = .009). Principal coordinate analysis showed separate clusters for EGGD 0-BX and EGGD ≥2-BX., Conclusions and Clinical Importance: A modest difference was detected in the community structure of the gastric glandular mucosal microbiome in association with EGGD score., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Purpose: To evaluate the clinical effects of an intra-articular injection of 117m Sn-colloid for management of canine grade 1 or 2 elbow osteoarthritis (OA)., Patients and Methods: This was a prospective study in 23 dogs with grade 1 or 2 elbow OA. An orthopedic examination and elbow radiographs were performed to confirm the presence of OA. Dogs were randomly assigned to receive unilateral intra-articular (IA) injection of low-dose (LD: 1.0mCi, n =8), medium-dose (MD: 1.75mCi, n =6), or high-dose (HD: 2.5mCi, n =9) of 117m Sn-colloid. The primary outcome measure was peak vertical force (PVF) from force-plate gait analysis and secondary outcome measures included the Canine Brief Pain Inventory score (CBPI) and elbow goniometry. The CBPI was evaluated at pretreatment and then monthly post treatment for 1 year, and goniometry and PVF were evaluated at pretreatment, and at 1, 3, 6, 9 and 12 months post treatment., Results: PVF improved at 3, and 9 months compared to pretreatment values in the HD group. CBPI scores improved at most of the time points in all dose groups. There was no significant difference in elbow goniometry between treated and untreated elbows. There were no self-reports of any adverse effects of the injection by the owners and none were noted by the examining veterinarian at the time of regularly scheduled re-evaluations., Conclusion: 117m Sn IA injection was free of any obvious adverse effects, improved CBPI scores, and increased weight bearing in limbs with elbow OA providing preliminary evidence that 117m Sn may be beneficial in the management of elbow OA in dogs. Although 17m Sn appeared to be effective for management of elbow OA in these dogs, this pilot study has inherent limitations; therefore, future studies with larger numbers and with placebo group are needed., Competing Interests: Dr Andrews reports grants from Exubrion Therapeutics, during the conduct of the study. Dr Lattimer reports grants from Exubrion Therapeutics, during the conduct of the study. Dr Lattimer, however, had a career long interest in therapeutics of this type and has participated in privately and publicly funded work that employs radiopharmaceuticals and devices. None of this work has been done in the last several years except that associated with the parent project to this work. The study was funded by Exubrion Therapeutics, Buford, GA, USA. Drs. Aulakh, Hudson, and Fabiani are advisory board members for Exubrion Therapeutics and receive a small honorarium for consultation. All authors declare no other conflicts of interest related to this report., (© 2021 Aulakh et al.)

Background: Phenylbutazone is commonly prescribed for treatment of various painful or inflammatory disorders in horses, but is associated with gastrointestinal (GI) adverse effects. Anecdotally, many practitioners prescribe omeprazole concurrently with phenylbutazone to reduce development of equine gastric ulcer syndrome (EGUS), but the efficacy and safety of this practice remains unknown., Objectives: To evaluate the effect of omeprazole on phenylbutazone-induced equine glandular gastric disease (EGGD) and equine squamous gastric disease (ESGD)., Study Design: Randomised block experimental design., Methods: Twenty-two horses with EGGD and ESGD scores ≤2 were included. Horses were assigned to treatment groups: phenylbutazone (4.4 mg/kg PO q 12 h; PBZ), phenylbutazone plus omeprazole (4 mg/kg PO q. 24 h; PBZ/OME) or placebo (CON) in a randomised block design based upon initial EGGD score. Horses were treated for up to 14 days. Gastroscopy was performed weekly; CBC and biochemistry were performed at Day 0 and study end. Horses were monitored for signs of colic and/or diarrhoea., Results: EGGD score increased in PBZ (median change 1, inter-quartile range, [IQR], 0-2) compared to PBZ/OME (median change 0, IQR -1 to 0; P = .05). PBZ/OME (6/8) had more intestinal complications than CON (0/6; difference between proportions = 75%; 95% CI, 23%-93%; P = .03). Plasma protein concentrations decreased in PBZ, compared to CON (mean difference between groups, 14 g/L; 95% CI, 1.04-27; P = .03). Five horses were withdrawn from the study due to intestinal complications (n = 3 PBZ/OME and n = 2 PBZ); one horse (PBZ) was withdrawn due to severe grade 4 EGGD., Main Limitations: Small sample size and changes in management for the 2-3 days prior to study initiation; variable treatment duration among groups due to development of complications., Conclusions: Administration of omeprazole ameliorated PBZ-induced EGGD, but was associated with an increase in intestinal complications. Caution should be exercised when co-prescribing NSAIDs and omeprazole in horses, particularly in association with change in management., (© 2020 EVJ Ltd.)

Low gastric pH for extended periods of time can increase the risk of gastric ulceration in horses. Therefore, nutritional interventions that buffer stomach acid may be helpful to decrease ulcer risk. The objective of this trial was to evaluate whether the incorporation of calcified Lithothamnion corallioides and Phymatolithon calcareum (Calmin; Celtic Sea Minerals, Cork, Ireland) into an equine ration would buffer equine gastric juice. Nine mature, Thoroughbred-cross horses, including 6 geldings and 3 mares (524 ± 49 kg) were housed in stalls and fed 2 kg/day of a texturized concentrate (Purina Omolene 100) and 1.5% BW grass hay/day. On testing days 0, 7, and 14, the horses received one of three pelleted dietary treatments (CON, MIN1 ×, MIN2 ×) in a randomized, crossover design. CON contained no added Calmin, MIN1 × provided Calmin at a 1 × concentration, and MIN2 × provided a 2 × dose. All horses underwent gastroscopy (Karl Storz, El Segundo, CA) prior to feeding the treatments, and at 2 and 4 hours postfeeding. Gastric juice was aspirated and pH measured using a benchtop pH meter (ThermoOrion pH Meter Model 410A). Overall, there was a significant time effect (P < .0001) with an increase in gastric juice pH from time 0 (2.31 ± 0.58) to 2 hours (5.52 ± 0.48) and 4 hours (3.59 ± 0.48). Gastric juice pH at 2 hours was higher (P = .0122) in MIN1 × (5.92 ± 0.58) and MIN2 × (5.92 ± 0.57) than CON (5.08 ± 0.58). These results demonstrate that adding Calmin to a meal increases buffering capacity at 2 hours postfeeding., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The human health benefits attributed to turmeric/curcumin spice has resulted in its wide utilization as a dietary supplement for companion pets and other animals including horses. While the quantification of free curcuminoids (curcumin, demethoxycurcumin, bisdemethoxycurcumin) and their phase-2 metabolites (curcumin-O-sulfate, curcumin-O-glucuronide) have been extensively investigated in human and rodent biological samples (primarily plasma and serum), there is lack of similar data for horses. Herein, we report a validated LC-ESI-MS/MS method for the simultaneous quantification of the aforementioned free curcuminoids and their metabolites in equine plasma. The linearity of the aforementioned curcuminoids and curcumin-O-sulfate was in the range of 0.5-1000 ng/mL and 1-1000 ng/mL for curcumin-O-glucuronide with 85-115% accuracy and <15% precision in equine plasma. The method was validated based on US FDA criteria and applied to characterize the pharmacokinetics of curcumin-O-sulfate in equine plasma., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Equine gastric ulcer syndrome (EGUS) primarily describes ulceration in the terminal esophagus, nonglandular squamous mucosa, glandular mucosa of the stomach, and proximal duodenum. EGUS is common in all breeds and ages of horses and foals. This article focuses on the current terminology for EGUS, etiologies and pathogenesis for lesions in the nonglandular and glandular stomach, diagnosis, and a comprehensive approach to the treatment and prevention of EGUS in adult horses and foals., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Reasons for Performing the Study: Limited data are available on the relative pharmacokinetics and pharmacodynamics of different omeprazole formulations., Objectives: To compare pharmacokinetic and pharmacodynamic effects of a novel omeprazole formulation against a currently registered product., Study Design: Masked 2 period, 2 treatment crossover., Methods: Twelve clinically healthy horses were studied over two 6-day treatment periods. Horses were randomly assigned to receive a novel omeprazole paste (Ulcershield: ULS) or a currently registered reference omeprazole product (OMO). Gastric pH was measured continuously for 10 h on the day prior to commencing treatment (Day -1) and after 6 days of oral treatment (Day 5) using in situ antimony pH probes within an indwelling nasogastric tube. Plasma pharmacokinetics were determined on Days 0 and 6., Results: Treatment significantly (P<0.005) increased gastric pH on Day 5, compared to results obtained prior to treatment (Day -1) and there was no significant difference between products (P = 0.773). Similarly, comparison of median hourly gastric pH (P = 0.593), mean gastric pH (P = 0.154), percentage time pH<4 (P = 0.259) and area under the time-gastric pH response curve (P = 0.734) did not discriminate between products. Both treatments resulted in significantly lower gastric ulcer severity scores (both P = 0.004), with no difference between treatments (P = 0.688). Comparison of mean log area under time-plasma concentration curves demonstrated that, although the lower limit of the 90% confidence interval was within the -20% limit for bioequivalence, the upper limit was exceeded, suggesting that the test product could have greater bioavailability than the reference product., Main Limitations: The small sample size, large interhorse plasma omeprazole concentrations, and low bioavailability of omeprazole impacted the sensitivity of the bioequivalence analysis., Conclusions: ULS matched or slightly exceeded OMO plasma concentrations. Both products resulted in equivalent increases in gastric pH, gastric pH profiles and decrease in gastric ulcer scores. Thus, ULS was pharmacodynamically equivalent to OMO and was associated with an equivalent beneficial effect on gastric squamous mucosal ulceration., (© 2017 EVJ Ltd.)

This study evaluated the usage of Beckman Coulter AU680 analyzers for measurement of TCO 2 in horse serum, and the effect of sodium bicarbonate administrations on serum TCO 2 levels in resting horses. Treatment of horses with sodium bicarbonate did not result in any adverse events. Mean TCO 2 concentration was significantly higher from 1 to 8 h in the sodium bicarbonate-treated horses compared to the untreated controls. Within an hour, administration of sodium bicarbonate increased the TCO 2 level from 31.5 ± -2.5 (SD) to 34.0 ± 2.65 (SD) mmol/L and at 2-8 h post-administration, the TCO 2 level was above the 36 mmol/L cut-off level. In all quality control analysis of Australian standard by Beckman Coulter AU680 analyzer, the instrument slightly over estimated the TCO 2 level but the values were in close agreement with mean TCO 2 level being 38.03 with ± 0.87 mmol/L (SD). Expanded uncertainty was calculated using different levels of confidence interval. Based on 99.5% confidence interval using 0.805% expanded uncertainty using mean measured concentration of 38.05 mmol/L, it was estimated that any race samples TCO 2 level higher than 38.5 mmol/L will be indicative of sodium bicarbonate administration using Beckman Coulter AU680 analyzer in Louisiana.

Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are necessary for prevention of recurrence., (Copyright © 2016 Elsevier Inc. All rights reserved.)

West Nile Virus (WNV) is endemic in the US and causes severe neurologic disease in horses since its introduction in 1999. There is no effective pharmaceutical treatment for WNV infection rendering vaccination as the only approach to prevention and control of disease. The purpose of this study was to evaluate a recombinant vaccine containing domain III (DIII) of the WNV envelope glycoprotein with and without a natural adjuvant equine (CD40L) in producing virus neutralizing antibodies in horses. Serum IgG1 concentration in the groups of horses vaccinated with the DIII-CD40L+TiterMax and DIII-CD40L proteins were significantly increased (p<0.05) after the second booster vaccination compared to other groups. Serum IgG4 and IgG7, IgG3 and IgG5 concentrations were not significantly increased among all groups. Western blot results showed that animals immunized with the DIII-CD40L protein (with or without TiterMax) exhibited the highest specific anti-DIII antibody activities after vaccinations. Moreover, animals immunized with the DIII-CD40L protein (with or without TiterMax) exhibited significantly stronger neutralization activity (p<0.05) compared to other groups starting at week eight. The DIII-CD40L protein (with or without TiterMax) stimulated more CD8 + T cells, but not CD4 + T cells in equine PMBCs. The results demonstrated that vaccination with recombinant WNV E DIII-CD40L protein induced superior humoral and cellular immune response in healthy horses that may be protective against WNV-associated disease in infected animals. CD40L could be utilized as a non-toxic, alternative adjuvant to boost the immunogenicity of subunit vaccines in horses., (Copyright © 2016. Published by Elsevier B.V.)

The objective of this study was to evaluate the effect of a commercial feed supplement containing pectin-lecithin on squamous mucosa ulceration in horses exposed to an experimental ulceration model. Five mares were treated while five mares were controls for this crossover, blinded study. The mares were fed concentrates and hay and were stabled with a two-hour turn out per day for a period of four weeks. The pectin-lecithin complex was fed for the duration of the study on the treated group. At the end of a four-week period, all mares underwent a seven-day alternating feed deprivation (week 5). The study was repeated again after a four-week washout period. Gastroscopy was performed on days 1, 28 and 35 of the study and was digitally recorded. Independent evaluation of the recordings and scoring of the lesions using the Equine Gastric Ulcer Syndrome (EGUS), severity and number scores were performed by three experienced gastroscopists. The prevalence and severity of squamous ulcers significantly increased after intermittent feed deprivation (P<0.001). No significant effect of the treatment was observed (P>0.05). In this study, the addition of a commercially available pectin-lecithin complex to the feed of horses for five weeks did not prevent or minimise the risk for gastric ulceration of the squamous mucosa., (British Veterinary Association.)

Objective: To characterize the response of skin of nonallergic horses following ID injection of polyclonal rabbit anti-canine IgE (anti-IgE) and rabbit IgG., Animals: 6 healthy horses., Procedures: Skin in the cervical area was injected ID with anti-IgE and IgG. Wheal measurements and skin biopsy specimens were obtained before and 20 minutes and 6, 24, and 48 hours after injection. Tissue sections were evaluated for inflammatory cells at 4 dermal depths. Immunohistochemical analysis for CD3, CD4, and CD8 was performed, and cell counts were evaluated., Results: Anti-IgE wheals were significantly larger than IgG wheals at 20 minutes and 6 and 24 hours after injection. There were significantly more degranulated mast cells after anti-IgE injection than after IgG injection. There were significantly more eosinophils at 6, 24, and 48 hours and neutrophils at 6 hours after anti-IgE injection, compared with cell numbers at those same times after IgG injection. There were significantly more eosinophils in the deeper dermis of anti-IgE samples, compared with results for IgG samples. No significant differences between treatments were detected for CD3(+), CD4(+), or CD8(+) cells., Conclusions and Clinical Relevance: Injection of anti-IgE antibodies was associated with the development of gross and microscopic inflammation characterized by mast cell degranulation and accumulation of inflammatory cells, particularly eosinophils and neutrophils. This pattern appeared to be similar to that of horses with naturally developing allergic skin disease, although lymphocytes were not increased; thus, ID injection of anti-IgE in horses may be of use for evaluating allergic skin diseases of horses.

Sarcocystis neurona is the most common cause of Equine Protozoal Myeloencephalitis (EPM), affecting 0.5-1% horses in the United States during their lifetimes. The objective of this study was to evaluate the equine immune responses in an experimentally induced Sarcocystis neurona infection model. Neurologic parameters were recorded prior to and throughout the 70-day study by blinded investigators. Recombinant SnSAG1 ELISA for serum and CSF were used to confirm and track disease progression. All experimentally infected horses displayed neurologic signs after infection. Neutrophils, monocytes, and lymphocytes from infected horses displayed significantly delayed apoptosis at some time points. Cell proliferation was significantly increased in S. neurona-infected horses when stimulated nonspecifically with PMA/I but significantly decreased when stimulated with S. neurona compared to controls. Collectively, our results suggest that horses experimentally infected with S. neurona manifest impaired antigen specific response to S. neurona, which could be a function of altered antigen presentation, lack of antigen recognition, or both.

Background: The objectives of this study were to evaluate the effects of two commercial feed supplements, Egusin 250® [E-250] and Egusin SLH® [E-SLH], on gastric ulcer scores, gastric fluid pH, and blood gas values in stall-confined horses undergoing feed-deprivation., Methods: Nine Thoroughbred horses were used in a three-period crossover study. For the three treatment groups, sweet feed was mixed with E-250, E-SLH, or nothing (control group) and fed twice daily. Horses were treated for 21 days, then an additional 7 days while on an alternating feed-deprivation model to induce or worsen ulcers (period one). In periods two and three, horses (n=6) were treated for an additional 7 days after feed-deprivation. Gastroscopies were performed on day -1 (n=9), day 21 (n=9), day 28 (n=9) and day 35 (n=6). Gastric juice pH was measured and gastric ulcer scores were assigned. Venous blood gas values were also measured., Results: Gastric ulcers in control horses significantly decreased after 21 days, but there was no difference in ulcer scores when compared to the Egusin® treated horses. NG gastric ulcer scores significantly increased in E-250 and control horses on day 28 compared to day 21 as a result of intermittent feed-deprivation, but no treatment effect was observed. NG ulcer scores remained high in the control group but significantly decreased in the E-SLH- and E-250-treated horses by day 35. Gastric juice pH values were low and variable and no treatment effect was observed. Mean blood pCO2 values were significantly increased two hours after feeding in treated horses compared to controls, whereas mean blood TCO2 values increased in the 24 hour sample, but did not exceed 38 mmol/l., Conclusions: The feed-deprivation model increased NG gastric ulcer severity in the horses. However, by day 35, Egusin® treated horses had less severe NG gastric ulcers compared to untreated control horses. After 35 days, Egusin® products tested here ameliorate the severity of gastric ulcers in stall-confined horses after feed stress.

Methadone is an effective analgesic opioid that may have a place for the treatment of pain in horses. However, its absorption seems to be impaired by the presence of a transmembrane protein, P-glycoprotein, present in different tissues including the small intestine in other species. This study aims to determine the effect of the P-glycoprotein on methadone flux in the equine intestinal mucosa, as an indicator of in vivo drug absorption. Jejunum tissues from five horses were placed into the Ussing chambers and exposed to methadone solution in the presence or absence of Rhodamine 123 or verapamil. Electrical measurements demonstrated tissue viability for 120 min, and the flux of methadone across the jejunal membrane (mucosal to submucosal direction) was calculated based on the relative drug concentration measured by ELISA. The flux of methadone was significantly higher only in the presence of verapamil. P-glycoprotein was immunolocalized in the apical membrane of the jejunal epithelial cells (enterocytes), mainly located in the tip of the villi compared to cells of the crypts. P-glycoprotein is present in the equine jejunum and may possibly mediate the intestinal transport of methadone. This study suggests that P-glycoprotein may play a role in the poor intestinal absorption of methadone in vivo., (© 2012 Blackwell Publishing Ltd.)

Background: Sea buckthorn berries (Hippophae rhamnoides) are rich in vitamin C and E, carotenoids, flavonoids, fatty acids, plant sterols, lignans, and minerals. A feed supplement containing sea buckthorn berries might have efficacy in treatment and prevention of gastric ulcers in horses., Objectives: To test the efficacy of a commercially available formulation of sea buckthorn berries and pulp (SeaBuck SBT Gastro-Plus) for treatment and prevention of gastric ulcers in stall-confined horses., Animals: Eight Thoroughbred and Thoroughbred-cross horses (3-10 years of age, 5 geldings and 3 mares, 380-600 kg body weight)., Methods: This study was a 2-period crossover in which all horses received no treatment (untreated controls; n = 8) and treatment (SeaBuckSBT Gastro-Plus, 4 ounces [35.6 g berries and pulp], twice daily; n = 8) mixed with a pelleted complete feed (18% crude fiber; 9% starch; 14% crude protein). Horses were treated for 4 weeks followed by a 1-week (d28-d35) alternating feed-deprivation period to induce or worsen existing ulcers. Gastroscopic examinations were performed on days 0, 28, and 35. Gastric juice pH was measured and gastric ulcer number and severity scores were assigned by a masked investigator., Results: Mean nonglandular gastric ulcer scores significantly (P < .05) increased in all horses after day 28, as a result of intermittent feed deprivation. Mean nonglandular gastric ulcer number (P = .84) and severity (P = .51) were not significantly different between SBT-treated and untreated control horses. However, mean glandular ulcer number (P = .02) and glandular ulcer severity (P = .02) were significantly lower in the SBT-treated horses compared with the untreated control at week 5., Conclusions and Clinical Importance: SeaBuck SBT Gastro-Plus liquid fed to horses did not show efficacy in treatment or prevention of naturally occurring nonglandular ulcers in horses; however, glandular ulcer scores were significantly lower in SBT-treated horses after feed deprivation. Thus, SBT might have efficacy in prevention of glandular ulcers in horses housed in stalls and undergoing intermittent feeding., (Copyright © 2012 by the American College of Veterinary Internal Medicine.)

Reasons for Performing Study: This study investigated the use of a wireless ambulatory capsule (WAC; SmartPill(®) pH.p GI Monitoring System) to determine WAC-gastric emptying time (GET) in ponies., Objectives: To measure WAC-GET and compare it to those findings with GET assessed by nuclear scintigraphy (S-GET)., Hypothesis: WAC-GET will be slower than S-GET, but will be significantly correlated., Methods: Seven healthy adult mixed-breed pony mares were used in this study. Feed was withheld for 12 h prior to the WAC administration. After administration, a complete-feed diet was fed to allow the WAC to pass into the stomach. Luminal pH, temperature and pressure were collected by a modified receiver secured to the pony. Once the pH reached a value of ≥ 8.0, it was determined that gastric emptying had occurred, and ponies were fed grass hay. After 5 days, data were downloaded and analysed using proprietary software. During the second period of the study, after at least 2 weeks, 4 of the ponies underwent a standard S-GET test., Results: The WAC was successfully administered, and data were collected from all ponies. The mean percentage of data packets collected by the receiver was 84.9 ± 3.51% (range 66.8-95.1%). Mean WAC-GET was 7.38 h (range 0.15-46.65 h). Mean gastric pH was 4.75 (range 2.07-6.99). Mean small intestinal transit time was 4.6 h. The mean pH for the small intestine was 8.0. The mean S-GET time (in hours) when 10% of the radioactive feed is present in the stomach (T-90%) was 2.3 h. The S-GET did not correlate significantly with the WAC-GET., Conclusions and Potential Relevance: The WAC was safely administered to ponies, and data were collected using a modified receiver. The WAC-GET varied considerably between ponies, but was ≤ 3 h in 5 of the 6 ponies. The WAC used in this study provided a noninvasive technique that produced novel information about the pony gastrointestinal tract, but owing to the substantial variability in GET values and long transit time it may not be a reliable clinical tool at this time., (© 2012 EVJ Ltd.)

Background: Pituitary pars intermedia dysfunction (PPID) is common in older horses., Objectives: To determine diagnosis frequency, prognostic factors, long-term survival, and owner satisfaction with treatment., Animals: Medical records from horses diagnosed with PPID, 1993-2004., Methods: A retrospective cohort design with data collected from the Veterinary Medical Data Base (VMDB) and a cohort of 3 VTHs. Proportional accessions, annual incidence, and demographics were compared for all accessions. During the same period, a subset of medical records (n = 44) was extracted and owners (n = 34) contacted to obtain long-term follow-up information., Results: Diagnoses of PPID were reported for 217 horses that presented to VTHs and were reported to the VMDB. Proportional diagnosis increased from 0.25/1,000 in 1993 to 3.72/1,000 in 2002. For 44 horses included in the follow-up study, the most commons signs were hirsutism (84%) and laminitis (50%). Of 34 horse owners contacted, the average time from onset of signs to diagnosis was 180 days. Improvement in ≥ 1 signs, 2 months after diagnosis, was reported by 9/22 (41%) of horse owners. Clinical signs and clinicopathologic data were not associated with survival, and 50% of horses were alive 4.6 years after diagnosis. Cause of death among horses (15/20; 85%) was euthanasia, and 11/15 (73%) were euthanized because of conditions associated with PPID. Most horse owners (28/29; 97%) said they would treat a second horse for PPID., Conclusion and Clinical Importance: PPID was diagnosed with increasing frequency, and 50% of horses survived 4.5 years after diagnosis. Owners were satisfied with their horses' quality of life and would treat a second horse if diagnosed., (Copyright © 2012 by the American College of Veterinary Internal Medicine.)

Background: Gastric ulcers are common in horses and treatment of horses that cannot be administered oral medication can be problematic., Objectives: To evaluate the efficacy of esomeprazole sodium administered intravenously on gastric juice pH and gastric ulcer scores in horses., Animals: Twelve adult female Quarter Horses., Methods: Esomeprazole sodium (0.5 mg/kg IV) was administered once daily to 8 horses (treatment group) and saline (5 mL IV) was administered to 4 horses (control group) for 13 consecutive days. Gastroscopy was performed and gastric juice pH and gastric ulcer score were recorded before and 1 hour after the administration of esomeprazole sodium or saline on days 1 and 5, then on day 14, 23 hours after the 13th daily dose of esomeprazole sodium or saline., Results: When compared with values before treatment, gastric juice pH was higher in esomeprazole sodium-treated horses after treatment (4.25 ± 2.39 versus 6.43 ± 1.18; P = .002). Also, gastric juice pH was higher (P = .001) in esomeprazole sodium-treated horses compared with saline-treated control horses on day 5 and on day 14 values. Gastric ulcers were seen in 5/12 (43%) horses in the study., Conclusions and Clinical Importance: Esomeprazole sodium shows promise for treatment of gastric ulcers in horses with signs of dysphagia, gastric reflux, or other conditions that restrict oral intake of the current Federal Drug Administration-approved omeprazole paste., (Copyright © 2011 by the American College of Veterinary Internal Medicine.)

Eighteen mature, healthy horses were divided into three groups (six per group) receiving either no treatment, 15 consecutive days of phenylbutazone (PBZ), or 15 consecutive days of suxibuzone (SBZ) at recommended label doses. Horses underwent endoscopy before and after the treatment period and were assigned gastric ulcer scores. Gastric ulcer number and severity scores were similar across treatment groups. These findings suggest that when administered at the recommended label dose for 15 days, neither PBZ nor SBZ causes an increase in the number or severity of gastric ulcers over what would be expected with traditional stabling and intermittent feeding patterns. Also, PBZ-treated horses did not have more severe gastric ulcers than SBZ-treated horses, indicating that SBZ does not appear to offer an advantage over PBZ in preventing gastric ulcers when used at recommended label doses. However, ulcers in other regions of the gastrointestinal tract (e.g., right dorsal colon, duodenum) were not evaluated in horses in this study.

Objective: To determine whether expression of mRNA for sodium-potassium adenosine-triphosphatase (NAKA) and sodium-hydrogen exchanger (NHE) in samples of the nonglandular portion of the equine gastric mucosa was altered by exposure to volatile fatty acids (VFAs) in an acidic environment., Animals: 10 horses (5 < or = 5 years old and 5 > or = 12 years old)., Procedures: Samples of the nonglandular portion of the gastric mucosa were collected and exposed in Ussing chambers to Ringer's solution (control samples), Ringer's solution containing a mixture of VFAs (pH, 1.5 or 4.0), or Ringer's solution containing acetic acid (pH, 1.5 or 4.0). Expression of mRNA for the gene for the beta1 subunit of NAKA and the gene for the NHE-3 isoform was determined by means of real-time PCR assays., Results: For horses < or = 5 years old, relative expression of mRNA for NAKA was significantly decreased and expression of mRNA for NHE was significantly increased following exposure to the mixture of VFAs or acetic acid, compared with expression in control samples. In contrast, for horses > or = 12 years old, relative expression of mRNA for both NAKA and NHE was significantly increased following exposure to the mixture of VFAs or acetic acid, compared with expression in control samples., Conclusions and Clinical Relevance: Results suggested that relative expression of mRNA for NAKA, but not NHE, in samples of the nonglandular portion of the equine gastric mucosa in response to exposure to VFAs in an acidic environment was an age-dependent event.

Equine gastric ulcer syndrome (EGUS) is common in horses. A history of mild intermitted recurrent colic signs after eating is noted in many horses. Management of horses with abdominal pain caused by gastric ulcers is especially difficult, because non-steroidal anti-inflammatory agents, typically used to control abdominal pain, may exacerbate this condition. Effective pharmacologic agents are available to treat EGUS and eliminate abdominal pain, but more comprehensive measures of environmental and dietary management are needed to manage horses with EGUS and prevent recurrence. This article focuses on the history, clinical signs, diagnosis, and management of horses with abdominal pain associated with gastric ulcers. The primary goal is to provide an understanding of EGUS and to review effective pain management and specific antiulcer treatments and management strategies in horses with EGUS.

The gastrointestinal tract of the horse has unique characteristics that make it well suited for the ingestion and utilization of roughage. The horse is considered a simple-stomached herbivore and is classed as a hindgut fermenter. The upper segments of the gastrointestinal tract resemble those of a typical simple-stomached animal. The lower have undergone modification to become voluminous and host to a large number of microbial populations similar to those of the compartmental stomach of ruminant animals. The main advantage of this arrangement is the ability of the horse to extract valuable nutrients from the diet before digesta reaches the hindgut where the rigid structural components that resisted enzymatic digestion at the small intestinal level undergo extensive fermentation processes.

Equine gastric ulcer syndrome (EGUS) is common in horses. Diagnosis is based on history, clinical signs, gastroscopic examination, and response to treatment. Effective pharmacologic agents are available to treat EGUS, but more comprehensive measures of environmental and dietary management are needed to decrease ulcer severity and recurrence. This article provides an understanding of dietary components and how feeds interact with stomach mucosal barrier function to cause EGUS. In addition, a secondary goal is to provide information on how diet and environmental management can reduce ulcer severity and prevent recurrence in horses with EGUS.

Reasons for Performing Study: Endotoxaemia is one of the most severe and ubiquitous disease processes in horses. Although dimethyl sulphoxide (DMSO) is used clinically in horses, there is no study indicating its efficacy in endotoxaemic horses., Hypothesis: DMSO ameliorates the clinical response to i.v. lipopolysaccharide (LPS) administration., Methods: Eighteen horses were assigned randomly to one of 4 groups: Normosol-LPS (0.2 mug/kg bwt, i.v.); DMSO (1 g/kg bwt, i.v.)-saline; high-dose DMSO (1 g/kg bwt, i.v.)LPS; low-dose DMSO (20 mg/kg bwt, i.v.)-LPS. Horses participating in the DMSO-saline group were later assigned randomly to one of the LPS groups. Data for physical parameters, white blood cell counts, plasma TNF-alpha, and blood lactate and glucose concentrations were examined for the effect of treatment using a repeated-measures mixed-model ANOVA. A value of P<0.05 was considered significant., Results: Endotoxaemia occurred in all horses receiving LPS, as indicated by the clinical score, physical parameters, haemoconcentration and leucopenia. High-dose DMSO ameliorated the effect of LPS on fever. DMSO, at either dose, but did not have a significant effect on LPS-induced changes in all other evaluated parameters., Conclusions: In this study, DMSO had minimal effects on clinical signs of induced endotoxaemia in horses. The effects were manifested by amelioration of LPS-induced fever.

Reasons for Performing Study: Volatile fatty acids, byproducts of carbohydrate fermentation by resident bacteria, have been implicated in causing nonglandular (NG) gastric ulcers. Lactic acid (LA), also produced by stomach bacteria, may cause gastric ulcers when exposed to the equine NG mucosa., Objectives: To investigate the in vitro effects of LA on equine NG mucosa bioelectric properties, sodium transport and tissue resistance., Methods: Gastric tissues obtained from 13 mature horses were studied in Ussing chambers. Short-circuit current (Isc) and potential difference (PD) were measured, and electrical resistance (R) and conductance (G) calculated for tissues after addition of HCl and LA (5, 10, 20 and 40 mmol/l) in normal Ringer's solution (NRS)., Results: Mucosa exposed to HCl or LA (5, 10 and 20 mmol/l) in NRS (pH 1.5 and to a lesser extent pH 4.0) had a significant decrease in Isc and PD. Mucosa exposed to a high concentration of LA (40 mmol/l) in NRS (LRS) at pH 1.5 showed an increased G, but this increase was not significant. Values returned to baseline after solutions were returned to pH 7.0. Histological changes were consistent with HCl-induced (pH <4.0) acid damage., Conclusions: HCl induced alteration in bioelectric properties of equine NG mucosa whereas addition of LRS did not, other than those changes seen with HCl alone.

Objective: To identify risk factors for equine protozoal myeloencephalitis (EPM) among horses examined at 11 equine referral hospitals., Design: Case-control study., Animals: 183 horses with EPM, 297 horses with neurologic disease other than EPM (neurologic controls), and 168 horses with non-neurologic diseases (non-neurologic controls) examined at 11 equine referral hospitals in the United States., Procedures: A study data form was completed for all horses. Data were compared between the case group and each of the control groups by means of bivariate and multivariate polytomous logistic regression., Results: Relative to neurologic control horses, case horses were more likely to be > or = 2 years old and to have a history of cats residing on the premises. Relative to non-neurologic control horses, case horses were more likely to be used for racing or Western performance., Conclusions and Clinical Relevance: Results indicated that cats may play a role in the natural epidemiology of EPM, that the disease is less common among horses < 2 years of age relative to other neurologic diseases, and that horses used for particular types of competition may have an increased risk of developing EPM.

Objective: To compare the effects of hydrochloric acid (HCl) and various concentrations of volatile fatty acids (VFAs) on tissue bioelectric properties of equine stomach nonglandular (NG) mucosa., Sample Population: Gastric tissues obtained from 48 adult horses., Procedures: NG gastric mucosa was studied by use of Ussing chambers. Short-circuit current (Isc) and potential difference (PD) were measured and electrical resistance (R) and conductance calculated for tissues after addition of HCl and VFAs (5, 10, 20, and 40 mM) in normal Ringer's solution (NRS)., Results: Mucosa exposed to HCl in NRS (pH of 1.5 and, to a lesser extent, 4.0) had a significant decrease in Isc, PD, and R, whereas tissues exposed to acetic acid at a pH of < 4.0, propionic and butyric acids at a pH of

The study was performed to evaluate the efficacy of omeprazole powder in sterile water, administered intravenously, on gastric juice pH in adult horses with naturally occurring gastric ulcers. Omeprazole (0.5 mg/kg, IV) was administered once daily for 5 days to 6 adult horses with gastric ulcers. Gastric juice was aspirated through the biopsy channel of an endoscope and pH was measured before and 1 hour after administration of omeprazole on day 1, and then before and after administration of omeprazole on day 5. Gastric ulcer scores were recorded on day 1 before administration of omeprazole and on day 5, 23 hours after the 4th daily dose. Gastric juice pH and ulcer scores were compared between the times. When compared with the pre-injection value (2.01 +/- 0.42), mean +/- SD gastric juice pH was significantly higher when measured 1 hour after administration of the initial dose (4.35 +/- 2.31), and before (5.27 +/- 1.74) and 1 hour after (7.00 +/- 0.25) administration of omeprazole on day 5. Nonglandular gastric ulcer number score significantly decreased from a mean +/- SD of 3.2 +/- 0.80 to 2.0 +/- 1.1, but nonglandular gastric ulcer severity score remained the same. Few glandular ulcers were seen in the study, and scores did not change. Because of its potent and long duration of action on gastric juice pH, this intravenous formulation of omeprazole may show promise for treatment of equine gastric ulcer syndrome (EGUS) in horses with dysphagia, gastric reflux, or other conditions that restrict oral intake of omeprazole paste. Aspiration of gastric juice and measurement of pH can be of use to determine whether the desired pH > 4.0 has been reached after omeprazole treatment.

Background: A combined dexamethasone (DEX) suppression/thyrotropin-releasing hormone (TRH) test (DEX/TRH test) has been developed to evaluate horses for presence of a pars intermedia pituitary adenoma (PIPA), but to the authors' knowledge, the accuracy of this test has not been previously determined., Hypothesis: The sensitivity and specificity of the DEX/TRH test can be determined by comparing test results with histopathologic examination findings., Animals: Age of 42 horses of various breeds ranged from 2 to 33 years., Methods: Plasma cortisol concentration was measured before and 24 hours after IV administration of 40 microg of DEX/kg of body weight, and before and 30 minutes after IV administration of 1 mg of TRH that had been given 3 hours after the injection of DEX. Results of the DEX/TRH test were considered positive if either the plasma cortisol concentration exceeded 10 ng/mL 24 hours after DEX administration, or if the change in plasma cortisol concentration 30 minutes after injection of TRH was > or = 66% above the 3-hour baseline. Diagnosis of PIPA was determined by histologic examination of the pituitary gland., Results: PIPA was detected in 17 of 42 (40%) horses. The DEX/TRH test had sensitivity, specificity, positive predictive value, and negative (NPV) predictive value of 88, 76, 71, and 90%, respectively., Conclusions and Clinical Importance: The combined DEX/TRH test was more sensitive than either of its component tests and had a high NPV, but was not as specific as the TRH component alone (92%). The DEX/TRH test should be used to screen older horses for PIPA.

Objective: To create a mathematical model to assist in early prediction of the probability of discharge in hospitalized foals < or= 7 days old., Study Design: Prospective study., Animals: 1,073 foals., Procedures: Medical records from 910 hospitalized foals < or = 7 days old for which outcome was recorded as died or discharged alive were reviewed. Thirty-four variables including historical information, physical examination findings, and laboratory results were examined for association with survival. Variables associated with being discharged alive were entered into a multivariable logistic regression model. Accuracy of the model was validated prospectively on data from 163 foals., Results: Factors in the final model included age group, ability to stand, presence of a suckle reflex, WBC count, serum creatinine concentration, and anion gap. Sensitivity and specificity of the model to predict live discharge were 92% and 74%, respectively, in the retrospective population and 90% and 46%, respectively, in the prospective population. Accuracy of an equine clinician's initial prediction of the foal being discharged alive was 83%, and accuracy of the model's prediction was 81%. Combining the clinician's prediction of probability of live discharge with that of the model significantly increased (median increase, 12%) the accuracy of the prediction for foals that were discharged and nonsignificantly decreased (median decrease, 9%) the accuracy of the predication for nonsurvivors., Conclusions and Clinical Relevance: Combining the clinician's initial predication of the probability of a foal being discharged alive with that of the model appeared to provide a more precise early estimate of the probability of live discharge for hospitalized foals.

Plasma lipid concentrations, lipoprotein composition, and glucose dynamics were measured and compared between mares fed diets containing added water, corn oil (CO), refined rice bran oil (RR), or crude rice bran oil (CR) to test the hypothesis that rice bran oil lowers plasma lipid concentrations, alters lipoprotein composition, and improves insulin sensitivity in mares. Eight healthy adult mares received a basal diet fed at 1.5 times the DE requirement for maintenance and each of the four treatments according to a repeated 4 x 4 Latin square design consisting of four 5-wk feeding periods. Blood samples were collected for lipid analysis after mares were deprived of feed overnight at 0 and 5 wk. Glucose dynamics were assessed at 0 and 4 wk in fed mares by combined intravenous glucose-insulin tolerance tests. Plasma glucose and insulin concentrations were measured, and estimated values of insulin sensitivity (SI), glucose effectiveness, and net insulin response were obtained using the minimal model. Mean BW increased (P = 0.014) by 29 kg (range = 10 to 50 kg) over 5 wk. Mean plasma concentrations of NEFA, triglyceride (TG), and very low-density lipoprotein (VLDL) decreased (P < 0.001) by 55, 30, and 39%, respectively, and plasma high-density lipoprotein and total cholesterol (TC) concentrations increased (P < 0.001) by 15 and 12%, respectively, over 5 wk. Changes in plasma NEFA (r = 0.58; P < 0.001) and TC (r = 0.44; P = 0.013) concentrations were positively correlated with weight gain over 5 wk. Lipid components of VLDL decreased (P < 0.001) in abundance over 5 wk, whereas the relative protein content of VLDL increased by 39% (P < 0.001). Addition of oil to the basal diet instead of water lowered plasma NEFA and TG concentrations further (P = 0.002 and 0.020, respectively) and increased plasma TC concentrations by a greater magnitude (P = 0.072). However, only plasma TG concentrations and VLDL free cholesterol content were affected (P = 0.024 and 0.009, respectively) by the type of oil added to the diet. Mean plasma TG concentration decreased by 14.2 mg/dL over 5 wk in the CR group, which was a larger (P < 0.05) decrease than the one (-5.3 mg/dL) detected in mares that received water. Consumption of experimental diets lowered S(I), but glucose dynamics were not affected by oil supplementation. Addition of oil to the diet altered blood lipid concentrations, and supplementation with CR instead of water specifically affected plasma TG concentrations and VLDL free cholesterol content.

Objective: To assess antiulcerogenic properties of 3 dietary oils., Animals: 8 healthy adult mares., Procedure: A protocol to induce gastric ulcers was used and included 240 mL of water plus corn oil, refined rice bran oil, or crude rice bran oil administered each day for 6 weeks according to a 4 x 4 Latin square randomized crossover design with 5-week washout intervals. A 7-day alternating feed deprivation period was included between weeks 5 and 6. Omeprazole was administered daily for the last 14 days of each washout interval. Endoscopic examinations of the stomach were performed at 0, 5, and 6 weeks, and the number (0 to 4 scale) and severity (0 to 5 scale) of ulcers were scored. Gastric fluid was collected at 0 and 5 weeks., Results: Median body weight significantly increased by 29 kg (range, 10 to 50 kg). Mean +/- SE gastric fluid pH significantly decreased from 4.9 +/- 0.4 to 3.1 +/- 0.3 over 5 weeks, and total volatile fatty acid concentration significantly decreased over time. Mean +/- SE severity of nonglandular ulcers significantly increased from 0.4 +/- 0.1 to 1.2 +/- 0.2 over 5 weeks. Nonglandular ulcers significantly increased in number (mean +/- SE, 1.3 +/- 0.2 to 3.0 +/- 0.2) and severity (mean +/- SE, 1.2 +/- 0.2 to 2.6 +/- 0.2) during the 7-day alternating feed deprivation period. No effects of treatment were detected., Conclusions and Clinical Relevance: In this model dietary oils did not prevent gastric ulcers from forming in the nonglandular portion of the stomach of horses.

Objective: To determine the effects of a 24-hour infusion of an isotonic electrolyte replacement fluid (IERF) on weight, serum and urine electrolyte concentrations, and other clinicopathologic variables in healthy neonatal foals., Animals: 4 healthy 4-day-old foals., Design: Prospective study., Procedure: An IERF was administered to each foal at an estimated rate of 80 mL/kg/d (36.4 mL/lb/d) for 24 hours. Body weight was measured before and after the infusion period. Urine was collected via catheter during 4-hour periods; blood samples were collected at 4-hour intervals. Variables including urine production; urine and serum osmolalities; sodium, potassium, and chloride concentrations in urine and serum; urine and serum creatinine concentrations; urine osmolality-to-serum osmolality ratio (OsmR); transtubular potassium gradient (TTKG); and percentage creatinine clearance (Cr(cl)) of electrolytes were recorded at 0, 4, 8, 12, 16, 20, and 24 hours during the infusion period. Immediately after the study period, net fluid and whole-body electrolyte changes from baseline values were calculated., Results: Compared with baseline values, urine and serum sodium and chloride serum concentrations, urine and serum osmolalities, OsmR, and percentage Cr(cl) of sodium and chloride were significantly increased at various time points during the infusion; urine production did not change significantly. After 24 hours, weight, TTKG, serum creatinine concentration, and whole-body potassium had significantly decreased from baseline values., Conclusions and Clinical Relevance: Results suggest that administration of an IERF containing a physiologic concentration of sodium may not be appropriate for use in neonatal foals that require maintenance fluid therapy.