Elapid snake envenomation in horses: 52 cases (2006-2016)

Background: Snake envenomation is a cause of morbidity and mortality in domestic animals worldwide. The clinical features of crotalid snake (pit viper) envenomation are widely reported and well described in horses but elapid snake envenomation is poorly characterised. Objectives: To describe the presentation, clinical and laboratory findings, treatment and outcome of horses with a diagnosis of elapid snake envenomation in Australia. Study design: Retrospective case series. Methods: Medical records of horses with a diagnosis of elapid snake envenomation (2006-2016) at several university and private veterinary practices were reviewed. Inclusion criteria comprised one or more of the following: 1) observed snakebite, 2) positive snake venom detection kit (SVDK) result, 3) appropriate clinical response to treatment with antivenom or 4) supportive post-mortem findings. Results: Fifty-two cases met the inclusion criteria. Most cases (94%) demonstrated clinical signs of neurotoxicity, characterised by generalised neuromuscular weakness. Associated neurologic signs included staggering gait, muscle fasciculations, recumbency, mydriasis, ptosis and tongue paresis. Concurrent clinically important conditions included rhabdomyolysis (50%) and haemolysis (19%). Of 18 urine samples evaluated with a SVDK, only three (17%) were positive. Overall survival was favourable (86%) among 49 horses who received antivenom. Eighteen surviving horses (43%) required more than one vial of antivenom. Main limitations: Possible cases within the searchable database were not included if horses died acutely or responded to symptomatic treatment without receiving antivenom. Conclusions: Elapid snake envenomation is primarily a syndrome of neuromuscular weakness. Supportive anamnesis or an obvious bite site is rarely encountered. In endemic areas, this diagnosis should be considered for horses with generalised neuromuscular weakness, altered mentation, rhabdomyolysis and/or haemolysis; especially during spring and summer months. Diagnostic suspicion is best confirmed by response to treatment with antivenom

Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia

Background: Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. Objectives: To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). Study design: Cross-sectional. Methods: Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1–9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms. Results: Among 167 ponies tested, median (range) age was 9 (4–21) years and BCS was 6 (4–8). Prevalence (95% confidence interval [CI]) of ID was 61 (53–68)%. Factors associated with insulin concentrations (estimate [95% CI]; μIU/mL) 60 min post-OST were: age (1.07 [1.02–1.11]), CNS (≥3/5, 1.52 [1.04–2.23]) and VASo (≥7/9, 1.75 [1.09–2.79]); and 90 min post-OST were: age (1.08 [1.03–1.12]), CNS (≥3/5, 1.80 [1.22–2.64]), VASo (≥7/9, 2.49 [1.52–4.08]) and sex (male, 0.64 [0.45–0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (−1.34 [−2.01 to −0.67]), sex (female, −6.21 [−11.68 to −0.74]) and VASo (≥7/9, −1.74 [−18.89 to −4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68–12.58]), IR (3.66 [1.26–10.61]) and PPID (11.75 [1.54–89.40]). Main limitations: Single time-point sampling, laminitis definition and diet analysis. Conclusions: Ageing, being female and owner-perceived obesity were associated with ID. © 2024 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Implementación de un sistema de control de citas médicas integrado con una aplicación móvil que facilite la gestión de búsqueda y reservas en clínicas

TesisCuando queremos sacar una cita médica con algún doctor en particular, normalmente debemos limitarnos a ir a la clínica para conseguir un cupo, o a lo mucho hacer una llamada. Este proceso, si bien funciona hoy en día, no es el más óptimo por ciertos puntos, como por ejemplo, demoras en la gestión, pocas opciones de horarios, entre otros. De igual forma, los pacientes no cuentan con una guía completa de los médicos con los que pueden atenderse. De esta forma no siempre se atienden con el doctor que cubre mejor sus requerimientos, como tiempo, distancia, precio, y otros indicadores. El contar con un consolidado de información sobre todos los médicos del Perú y ver su disponibilidad generaría ciertos beneficios. El siguiente proyecto de fin de carrera tiene como finalidad crear una solución informática ante este problema mencionado, con la creación de una aplicación móvil que pueda funcionar como un motor de búsqueda personalizado y que permita realizar reservas de citas médicas desde cualquier lugar y a cualquier momento. A su vez, la integración con un sistema web que permita recibir las peticiones de citas. De esta forma las clínicas podrían estar integradas al sistema que se propone, dándole facilidades en su gestión de reservas y que de esta forma funcione como una posible nueva alternativa de negocio