Monitoring the Curriculum through the Student Perspective.

Student input was deliberately included as part of the curriculum implementation and assessment plan at the University of Minnesota College of Veterinary Medicine. The new curriculum included design features to encourage deeper learning such as a spiral curriculum with cross-course integration, increased open time, and more active learning. Student well-being was seen as a simultaneous need. To gather overall perceptions of workload and well-being, student volunteers from each cohort were surveyed weekly starting in 2013. Survey questions asked about out-of-class work time, level of integration, extracurricular activities, student well-being habits, paid employment, and other factors. Survey questions were combined with course data to get a full picture of week quality, total course work time, extracurricular activities, and the effects of integration. Many of our hypotheses about curricular and extracurricular impacts on week quality were disproven. Week quality was most positively affected by student factors of sleep and exercise, whereas the curricular factors of out-of-class work time, total course work time, and examination hours had the strongest negative effects. A surprising finding was that open time, in-class hours, and paid employment hours had a minimal effect on week quality. Students identified excessively heavy semesters and uneven semester workloads that resulted in early revisions to the new curriculum. Student feedback provided a view of the curriculum that was not otherwise available and resulted in early and significant impacts on the new curriculum, and they provided insight into whether planned changes had occurred and how effective various factors were in reaching the curricular goals.

The efficacy of imiquimod 5% cream (Aldara® in the treatment of aural plaque in horses: a pilot open-label clinical trial.

Aural plaques affect at least 22% of horses and can be asymptomatic or cause ear sensitivity. Immunohistochemical and electron microscopy studies have shown a strong association between aural plaques and papilloma virus. The purpose of this study was to investigate the efficacy of imiquimod 5% cream, an immune response modifier with potent antiviral activity, in the treatment of equine aural plaques. Twenty-one horses were enrolled and 16 completed the study. Imiquimod 5% cream was applied three times a week, every other week. When both ears were affected only the worst affected ear was treated. Adverse effects in all horses included marked local inflammation, exudation and thick crust formation at the site of treatment and the adjacent skin. Removal of the crust before treatment was painful and required sedation in most horses. Complete resolution of lesions was noted in all horses immediately post-treatment and the long-term resolution rate was 87.5%. Duration of therapy ranged from 1.5 to 8 months (median: 2.9 mean: 3.5). All horses were followed-up for 12-22 months after treatment was discontinued and only two horses had a recurrence of lesions. Clinical signs related to the aural plaques prior to treatment were reported in 11 of 16 (68.8%) horses and included resistance to touching the ears and bridling. Complete resolution of these signs was reported by the owners in all of the horses followed-up for at least 12 months. In conclusion, the topical application of imiquimod 5% cream is an efficacious treatment for aural plaques in horses.

Evaluation of diffusion of triamcinolone acetonide from the distal interphalangeal joint into the navicular bursa in horses.

OBJECTIVE: To determine whether triamcinolone acetonide diffuses from the distal interphalangeal joint (DIPJ) to the navicular bursa, diffusion is direct or systemic, and addition of sodium hyaluronan has an effect on diffusion in horses. ANIMALS: 11 adult horses without forelimb lameness. PROCEDURES: 1 randomly chosen forelimb DIPJ of each horse received an injection of 10 mg of triamcinolone acetonide plus 20 mg of sodium hyaluronan (group 1), and the contralateral forelimb DIPJ received an injection of 10 mg of triamcinolone acetonide plus 2 mL of lactated Ringer's solution (group 2). Synovial fluid samples were taken from both forelimb navicular bursae and 1 hind limb navicular bursa (systemic control group) at 6 hours. Triamcinolone acetonide concentrations in synovial fluid were quantified by use of high-performance liquid chromatography plus tandem mass spectrometry. Data were logarithmically transformed, and contrast analysis was performed on the 3 groups. RESULTS: Triamcinolone acetonide was detected in navicular bursal samples in all groups. Groups 1 and 2 had significantly greater concentrations of triamcinolone acetonide than the systemic control group. There was no significant difference between groups 1 and 2. CONCLUSIONS AND CLINICAL RELEVANCE: Triamcinolone acetonide diffused directly from the DIPJ into the navicular bursa in clinically normal horses, and diffusion was not affected by addition of hyaluronan. Injection into the DIPJ with triamcinolone acetonide or a triamcinolone acetonide-hyaluronan combination can potentially be used for treatment of navicular syndrome, but further studies are needed to determine whether triamcinolone acetonide diffuses similarly in horses with navicular syndrome.

Identification of normal parameters for ultrasonographic examination of the equine large colon and cecum.

Six healthy horses were examined by using transabdominal ultrasonography, as described (1-3), to evaluate activity and size of the large colon and cecum at various locations. Using size and number of sacculations, activity patterns and contractile frequency; significant differences that would allow ultrasonographic identification of dorsal versus ventral colons, if they were displaced, were not found. The cecum had significantly greater activity than the colon, and a trend was seen towards smaller sacculations in the cecum than in the large colon.

Efficacy of imiquimod 5% cream in the treatment of equine sarcoids: a pilot study.

Imiquimod is an immune response modifier with potent antiviral and antitumour activity. The objective of this pilot study was to evaluate the efficacy of an imiquimod 5% cream (Aldaratrade mark: 3M, Saint Paul, MN, USA) as a topical treatment for equine sarcoids. Fifteen horses with a total of 19 tumours were enrolled, including mixed (7), fibroblastic (5), flat (3), verrucous (2), and nodular (2) types. Baseline data included history, physical examination, tumour location, measurement and digital photography. Imiquimod was applied by the owners three times a week until complete resolution of the tumour or 32 weeks, whichever occurred first. Tumours were measured and photographed every 4 weeks. Treatment efficacy was defined as 75% or greater reduction of tumour size by the end of the trial. Four sarcoids were withdrawn from the study. Twelve of the remaining 15 tumours (80%) showed more than 75% reduction in size and nine (60%) totally resolved between 8 and 32 weeks. The most common adverse effects of exudation, erythema, erosions, depigmentation and alopecia were limited to the tumour and adjacent areas. The results suggest that topical imiquimod is a therapeutic option for the treatment of equine sarcoids, although more detailed studies are required to corroborate these initial findings.

Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder.

A 6-month-old female alpaca was presented for stranguria. Based on the history, physical examination findings, and radiographic studies, the alpaca was diagnosed with bladder outlet obstruction, secondary to pelvic displacement of the bladder, a condition previously unreported in camelids. Cystopexy was performed and the alpaca recovered unremarkably.

Evaluation of gastrointestinal activity patterns in healthy horses using B mode and Doppler ultrasonography.

Healthy adult horses were examined by using transabdominal ultrasonography to quantitatively and qualitatively evaluate activity of the jejunum, cecum, and colon with B mode and Doppler techniques. Doppler ultrasound was used to assess jejunal peristaltic activity. Examinations were performed on multiple occasions under imposed colic evaluation conditions, including fasting, nasogastric intubation, and xylazine sedation. In fasted horses, jejunal visibility was increased and jejunal, cecal, and colonic activity was decreased. The stomach was displaced ventrally and was visualized ventral to the costochondral junction. Xylazine sedation in fed horses had minimal effects; however, in fasted horses, xylazine significantly decreased jejunal and cecal activity. Nasogastric intubation in fasted horses had no observable effects on activity, but moved the stomach dorsally. B mode and Doppler jejunal activity were strongly correlated. Prior feeding and sedation status need to be considered when interpreting the results of equine abdominal ultrasound examinations. Doppler techniques may be useful for assessing jejunal activity.

Severe carpometacarpal osteoarthritis in older Arabian horses.

OBJECTIVE: To report a severe form of carpometacarpal osteoarthritis (CMC-OA) affecting primarily older Arabian horses. STUDY DESIGN: Retrospective study. ANIMALS: Thirty-one horses with CMC-OA. METHODS: Carpal radiographs (405 sets) from 3 hospitals were evaluated to identify horses with marked osteoproliferative reaction across the medial aspect of the CMC joint. Owners were contacted to obtain detailed histories and status updates. Necropsy specimens of the CMC joint were evaluated at 2 hospitals to determine the prevalence of 2 variations in the articulation between the proximal second and third metacarpal bones. RESULTS: Thirty-one horses were identified as having marked osteoproliferative reaction at the CMC joint. Twenty-three (74%) were Arabian horses. Of the Arabian horses, the average age at admission was 14.4 years. Eight (34.8%) Arabian horses had a known history of trauma. Most were no longer rideable at presentation. Ten of the horses were subsequently euthanatized because of lameness. The dorsal and palmar articulations between the second and third metacarpal bones were examined in 177 horses. The palmar articulation was absent in 48% of Arabian horses and 12.5% of non-Arabian horses at 1 center, including 4 horses with CMC-OA. At the second center, the palmar articulation was present in 8 of 8 Arabian horses but was absent in 22 of 92 (24%) non-Arabian horses. CONCLUSIONS: An increased frequency of this crippling form of OA was observed in Arabian horses. It may reflect an increased prevalence, in some geographical regions, of an absent palmar articulation between the second and third metacarpal bones. CLINICAL RELEVANCE: Carpal trauma in some Arabian horses may result in unexpectedly severe carpometacarpal osteoarthritis.

Managing chronic arthritis.

Many compounds are being investigated for the control of symptoms of osteoarthritis in people and animals. Ideally, treatment should include analgesia, inflammation control, and chondroprotection. With further progress in this area, combination therapies tailored to the needs of the individual animal should enable us to maximize efficacy and minimize side effects. Only a few of the newer therapies and pharmaceutic agents have been investigated in the horse, however. With more rigorous investigation, they may be determined to be ineffective or unsafe. Meanwhile, as much information should be gathered from manufacturers as possible so as to ensure that appropriate recommendations are made.