Long-term assessment of horses and ponies post exposure to monensin sodium in commercial feed

Reasons for peforming 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 >= 6 weeks after ingestion of monensin-contaminated feed. Animals with evidence of monensin-induced cardiomyopathy were re-examined after a period of rest of >= 11 months. Follow-up information was obtained by owner telephone interview >= 52 months after exposure. Results: During resting echocardiography, It animals had reduced/low-normal left ventricullar fractional shortening (FS), an increase in FS in 8 of these animals was measured >= 11 months la(er. 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 under-went 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 possibl

Ecocardiografia de equinos Puro Sangue Árabe após exercício de enduro de diferentes intensidades Echocardiography in Arabian horses after endurance exercise of different intensities

A ecocardiografia é um método não invasivo e adequado para a avaliação das alterações cardíacas em equinos, identificando assim aqueles animais que apresentaram melhor adaptação e condicionamento ao exercício a que foram submetidos. O objetivo deste estudo foi verificar por meio de exames ecocardiográficos em modo-M e bidimensional os índices funcionais cardíacos de 15 equinos Puro Sangue Árabe, sendo nove machos e seis fêmeas, com idade variando de seis a 12 anos, submetidos a diferentes intensidades de exercício prolongado de enduro. Para tanto, foram divididos em três grupos, sendo que quatro animais percorreram 30km (GI), seis animais percorreram 90km (GII) e cinco animais percorreram 120km (GIII). As avaliações ocorreram antes do início de cada prova, sendo considerado o momento zero (M0) e 30 minutos após percorrerem o último anel da correspondente prova, caracterizando o momento final (Mf). Diante do tratamento estatístico, não se verificaram diferenças significantes entre os índices obtidos no M0 e Mf do GI. De outra forma, no GII para VS, FC, VEs e VEd, assim como no GIII para VS, FC, VEs, VEd e SIVd, observou-se diferença estatística. Portanto, em equinos de enduro a ecocardiografia revelou que o exercício físico permitiu o estabelecimento de índices funcionais cardíacos próprios, de acordo com a intensidade do exercício imposto.<br>Echocardiography is a noninvasive and accurate evaluation of cardiac abnormalities in horses, thereby determining those animals that show better adaptation to exercise and conditioning to which they were submitted. The aim of this study was to verify by echocardiographic M-mode and two-dimensional cardiac functional indices of 15 purebred Arabian horses, nine males and six females, ranging in age from 6 to 12 years, subjected to different intensities prolonged endurance exercise. Thus, both groups were divided into three, in which four animals traveled 30km (GI), six animals traveled 90km (GII) and five animals traveled 120km (GIII). Assessments occurred before the start of each test and was considered the time zero (M0); 30 minutes after running through the last ring of the race characterized the final moment (Mf). Before the treatment there were no statistically significant differences between the indexes obtained in the M0 and Mf of GI. Otherwise, it was observed statistical difference in GII for stroke volume, heart rate, left ventricular internal diameter in diastole and systole, and in GIII for stroke volume, heart rate, left ventricular internal diameter in diastole and systole and interventricular septal thickness in diastole. So endurance horses echocardiography revealed that the exercise enabled the assessment of cardiac functional indexes according to the intensity of the exercise tax

Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the \u201cDelirium Day\u201d study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors