Bar shoes and ambient temperature are risk factors for exercise-induced pulmonary haemorrhage in Thoroughbred racehorses

Reasons for performing study Ambient temperature has been identified as a risk factor for exercise-induced pulmonary haemorrhage (EIPH) in racing Thoroughbreds. This warranted a more expansive investigation of climatic conditions on the incidence and severity of EIPH. The impact of other variables such as the type of bit used, tongue ties and nonstandard shoes has not been reported and also warrant investigation. Objectives To examine the effect of various climatic variables as contributing risk factors for EIPH. Other previously uninvestigated variables as well as standard track and population factors will also be examined. Study design Cross-sectional study. Methods Thoroughbred racehorses competing at metropolitan racetracks in Perth, Western Australia were examined 30–200 min post race with tracheobronchoscopy. Examination took place at 48 race meetings over a 12 month period. Examinations were graded (0–4), independently by two experienced veterinarians. Univariable analyses were performed and variables with a P<0.25 were entered into a multivariable logistic regression analysis. The analysis was performed twice using the presence of blood (EIPH grade 0 vs. grades ≥1) and EIPH grades ≤1 vs. EIPH grades ≥2 as dependent variables. Results Exercise-induced pulmonary haemorrhage was diagnosed in 56.6% of observations. Lower ambient temperature was significantly associated with EIPH grades ≥1 (OR 0.95; 95% CI 0.93–0.98) and EIPH grades ≥2 (OR 0.97; 95% CI 0.94–1.0). Bar shoes were significantly associated with EIPH grades ≥1 (OR 6.35; 95% CI 2.17–18.54) and EIPH grades ≥2 (OR 2.72; 95% CI 1.3–5.68). Increasing race distance was significantly associated with EIPH grade ≥1 and increasing lifetime starts was significantly associated with EIPH grade ≥2. Conclusions Ambient temperature is a risk factor for EIPH in Thoroughbred racehorses, with lower temperatures associated with increased risk. Bar shoes are a novel risk factor for EIPH in this population

The effect of geographic location on circannual adrenocorticotropic hormone plasma concentrations in horses in Australia

Background: Longitudinal evaluation of plasma endogenous ACTH concentration in clinically normal horses has not been investigated in the Southern Hemisphere. Objectives: To longitudinally determine monthly upper reference limits for plasma ACTH in 2 disparate Australian geographic locations and to examine whether location affected the circannual rhythm of endogenous ACTH in the 2 groups of horses over a 12-month period. Animals: Clinically normal horses <20 years of age from 4 properties (institutional herd and client owned animals) in Perth (n = 40) and Townsville (n = 41) were included in the study. Methods: A prospective longitudinal descriptive study to determine the upper reference limit and confidence intervals for plasma ACTH in each geographic location using the ASVCP reference interval (RI) guidelines, for individual months and monthly groupings for 12 consecutive months. Results: Plasma endogenous ACTH concentrations demonstrated a circannual rhythm. The increase in endogenous ACTH was not confined to the autumnal months but was associated with changes in photoperiod. During the quiescent period, plasma ACTH concentrations were lower, ≤43 pg/mL (upper limit of the 90% confidence interval (CI)) in horses from Perth and ≤67 pg/mL (upper limit of the 90% CI) in horses from Townsville, than at the acrophase, ≤94 pg/mL (upper limit of the 90% CI) in horses from Perth, ≤101 pg/mL (upper limit of the 90% CI) in horses from Townsville. Conclusions and Clinical Importance: Circannual rhythms of endogenous ACTH concentrations vary between geographic locations, this could be due to changes in photoperiod or other unknown factors, and upper reference limits should be determined for specific locations

Thoracic Electrical Impedance Tomography—The 2022 Veterinary Consensus Statement

Electrical impedance tomography (EIT) is a non-invasive real-time non-ionising imaging modality that has many applications. Since the first recorded use in 1978, the technology has become more widely used especially in human adult and neonatal critical care monitoring. Recently, there has been an increase in research on thoracic EIT in veterinary medicine. Real-time imaging of the thorax allows evaluation of ventilation distribution in anesthetised and conscious animals. As the technology becomes recognised in the veterinary community there is a need to standardize approaches to data collection, analysis, interpretation and nomenclature, ensuring comparison and repeatability between researchers and studies. A group of nineteen veterinarians and two biomedical engineers experienced in veterinary EIT were consulted and contributed to the preparation of this statement. The aim of this consensus is to provide an introduction to this imaging modality, to highlight clinical relevance and to include recommendations on how to effectively use thoracic EIT in veterinary species. Based on this, the consensus statement aims to address the need for a streamlined approach to veterinary thoracic EIT and includes: an introduction to the use of EIT in veterinary species, the technical background to creation of the functional images, a consensus from all contributing authors on the practical application and use of the technology, descriptions and interpretation of current available variables including appropriate statistical analysis, nomenclature recommended for consistency and future developments in thoracic EIT. The information provided in this consensus statement may benefit researchers and clinicians working within the field of veterinary thoracic EIT. We endeavor to inform future users of the benefits of this imaging modality and provide opportunities to further explore applications of this technology with regards to perfusion imaging and pathology diagnosis

Clostridial myonecrosis, haemolytic anaemia, hepatopathy, osteitis and transient hypertrophic cardiomyopathy after intramuscular injection in a Thoroughbred gelding

A 9-year-old Thoroughbred gelding was presented for swelling over the left neck and inappetence. There was recent history of intramuscular administration of flunixin meglumine into the left neck. On examination, there was evidence of focal myositis, anaemia, haemolysis and pigmenturia. Culture of aspirated fluid from the left side of the neck produced a heavy growth of a Clostridium species. Complications of infection included haemolytic anaemia, hepatopathy, osteitis and transient hypertrophic cardiomyopathy. Treatment included intravenous fluid therapy, antibiotics, anti-inflammatory drugs, blood transfusion and surgical debridement. There was complete resolution of clinical, haematological, biochemical and echocardiographic abnormalities, and the horse returned to ridden work. This report highlights the complications that can arise from clostridial myonecrosis, including the effect on the myocardium

Equine pulmonary Cryptococcosis: A comparative literature review and evaluation of fluconazole monotherapy

Cryptococcus is the most common fungal respiratory pathogen in Australian horses, manifesting primarily as pulmonary granulomas. Disease severity at presentation is dependent on the athletic use of the horse. The diagnosis and estimation of disease severity are centred around clinical findings, cytological evaluation of respiratory tract secretions, diagnostic imaging, and antigen titre testing. Both the lateral flow assay and the latex cryptococcal antigen titre are used, and important similarities and differences between species are discussed. Cryptococcus gattii occurs with greater frequency than Cryptococcus neoformans in equine pulmonic cryptococcosis and can be successfully treated with enteral fluconazole monotherapy, with disease severity determining treatment length

Temporohyoid osteoarthropathy in two young horses

Two cases of temporohyoid osteoarthropathy (THO) in young Australian horses are described. The pathogenesis of THO is yet to be fully elucidated, but current theories include extension of infection from otitis media or interna to the temporohyoid joint or a primary but non-infectious degenerative condition within the temporohyoid joint. The young age of the horses and the unilateral distribution suggested an infectious aetiology. Both horses partially responded to treatment with broad-spectrum antimicrobial and anti-inflammatory drugs with concurrent management of ulcerative keratitis. The management of violent head shaking in one horse included the administration of gabapentin, an anticonvulsant known to have antihyperalgesic effects and reduce neuropathic pain

The effect of dobutamine and bolus crystalloid fluids on the cardiovascular function of isoflurane anaesthetised horses

Reasons for performing study Hypotension is the most common cardiovascular complication encountered during equine inhalational anaesthesia, for which a dobutamine intravenous constant rate infusion (DCRI) is often the sole treatment. There is limited literature available on the combined use of crystalloid boluses and inotropic agents during equine hypotensive episodes

Hypertrophic cardiomyopathy in a Clydesdale gelding

Case report: A 7-year-old Clydesdale gelding was referred with a history of progressive lethargy and ventral oedema. The horse developed diarrhoea after treatment with antibiotics by the referring veterinarian. History, clinical signs, imaging and laboratory findings were consistent with hypertrophic cardiomyopathy complicated by antibiotic-associated colitis. Progression of clinical signs prompted euthanasia and the antemortem diagnosis of hypertrophic cardiomyopathy was confirmed at postmortem examination. Conclusion: Primary HCM is reported as rare in horses, but specific descriptions are lacking. The history, clinical, laboratory and postmortem findings in this case supported a diagnosis of HCM, complicated by antibiotic-associated colitis

Bronchoalveolar lavage fluid cytology and airway hyper-reactivity in clinically normal horses

Objective To characterise the relationship between bronchoalveolar lavage fluid (BALF) cytology and pulmonary function testing with histamine bronchoprovocation (HBP) methods in a population of clinically normal horses. Design Cross‐sectional study Methods Clinically normal adult horses (n = 33) underwent pulmonary function testing and HBP with a commercial flowmetric plethysmography system. BAL was performed 1–5 days later. Statistical analysis was used to assess associations between BALF cell concentration, relative inflammatory cell percentages and categorisation, and airway hyper‐reactivity (AHR). Results AHR (PC35 ≤ 8 mg/mL) was demonstrated in 17 (52%) of the horses. Using current definitions, BALF cytology was consistent with inflammatory airway disease in 14 (42%) of the horses and 7 of those demonstrated either mastocytic and/or eosinophilic responses. There was no correlation between total inflammatory cell counts or relative percentage and AHR. No statistical association was found between BALF inflammatory cell categories and AHR. Conclusion A direct association between cytological evidence of airway inflammation and AHR was not identified in this population of clinically normal horses. Determining the presence and measuring inflammatory cell mediators in BALF may more accurately reflect AHR. In addition, normal values for cell proportions in BALF may vary between different populations of horses and more appropriate regional reference ranges should be established

Pathophysiology and diagnosis of third carpal bone disease in horses: A review

Third carpal bone (C3) disease is a significant cause of lameness in Standardbred and Thoroughbred horses. The bone density of C3 increases as a result of exercise, reducing the compliance of the bone and predisposing it to injury. Currently, the most widely used method of diagnosis is subjective radiography using the tangential view. Radiographically, increases in bone mineral density (BMD) appear as sclerosis but it is not known at what point increases in sclerosis indicate the onset of disease or increased risk of C3 fracture. A quantitative assessment of the BMD of C3 in horses would improve understanding of the changes that occur within this bone and guide athletic management, as it is thought that BMD changes precede articular cartilage damage. Methods of non-invasive bone-mineral analysis used for the detection of osteoporosis in humans include single photon absorptiometry (SPA), dual x-ray absorptiometry (DXA), computed tomography (CT), radioabsorptiometry (RA), quantitative ultrasonography (QU) and magnetic resonance imaging (MRI). To date, DXA and RA are the most commonly used methods of quantitative non-invasive bone-mineral analysis in horses. The cost of equipment and difficulties in performing DXA in live animals preclude the routine use of this technique for diagnostic purposes. RA may become clinically applicable to C3 analysis in horses, but small variations in x-ray beam angle when taking the tangential view significantly affect results, making this technique clinically inapplicable at this time. Currently, methods of quantitative non-invasive bone-mineral analysis of C3 in horses are not suited to clinical application