A comparison of the effects of a 4% modified fluid gelatin and a 6% hydroxyethyl starch on haemodilution, colloid osmotic pressure, haemostasis and renal parameters in healthy ponies.

REASONS FOR PERFORMING STUDY: Adverse effects on renal health and haemostasis have been documented in human patients administered hydroxyethyl starches (HESs). Gelatins may represent useful substitutes should similar adverse effects be identified in horses. OBJECTIVES: To compare the effects of a 4% modified fluid gelatin (MFG) with a 6% (130/0.4) HES on haemodilution, colloid osmotic pressure (COP), haemostasis and renal parameters in healthy ponies. STUDY DESIGN: Randomised crossover experiment. METHODS: Three treatments (Treatment A: 10 ml/kg bwt HES; Treatment B: 10 ml/kg bwt MFG; Treatment C: 20 ml/kg bwt MFG) were administered to 6 healthy ponies with a 1 week washout period between treatments. Haematocrit, platelet count, total serum protein, COP, thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration were measured at baseline and at multiple time points up to 24 h post-infusion. Serum creatinine concentration, urine specific gravity (USG), urine protein:creatinine ratio (UPC), urine γ-glutamyltransferase:creatinine ratio (UGC) and urine sediment examination (USE) were performed before and at 24 h after each treatment, as well as at 1 week after the final treatment. RESULTS: All treatments resulted in significant haemodilution and increases in COP. Treatment C had a significantly greater effect on haematocrit than the other treatments. The platelet count decreased with all treatments and was significantly lower following Treatment C compared with Treatment B. No clinically relevant differences were observed in any of the TEG parameters within or between treatments. No significant differences in PT, aPTT or fibrinogen concentration were observed among treatments. Serum creatinine concentration, UPC and UGC did not change significantly between pre- and post-study measurements. USG and USE remained within normal limits. CONCLUSIONS: Modified fluid gelatin could be considered as an alternative to HES for volume expansion and oncotic support. Neither MFG nor HES were associated with clinically significant adverse effects on haemostasis or renal parameters.

Risk factors for race-associated sudden death in Thoroughbred racehorses in the UK (2000-2007).

REASONS FOR PERFORMING STUDY: Sudden death adversely affects racehorse welfare, jockey safety and the public perception of horseracing. OBJECTIVE: To describe the risk of racing-associated sudden death in Thoroughbred racehorses in the UK from 2000 to 2007, to identify whether there were risk factors uniquely associated with sudden death and to improve the understanding of the pathogenesis of racing-associated sudden death by identification of risk factors for such cases. METHODS: A sudden death was defined as an acute collapse and death, in an apparently healthy Thoroughbred racehorse, during or immediately after racing, in the absence of clinical data indicative of a catastrophic orthopaedic injury. The retrospective study included 201 case race starts and 705,712 control race starts. Univariable and multivariable logistic regression were used to identify risk factors for sudden death at any one start. RESULTS: In the multivariable model, age, distance, race type, season and number of starts in the 60 days prior to the race were associated with sudden death. CONCLUSIONS: The risk factors identified in this study are not uniquely associated with sudden death and have been also been identified in studies using all causes of fatality as the outcome. These data suggest that a generic approach to reduce fatal musculoskeletal injury and sudden death may be possible. POTENTIAL RELEVANCE: The identification of risk factors allows speculation on the underlying mechanisms of sudden death in racing. This may stimulate hypothesis-led investigations into the pathogenesis of exercise-related arrhythmias, exercise-induced pulmonary haemorrhage and blood vessel rupture.

Sudden death in racing Thoroughbred horses: an international multicentre study of post mortem findings.

REASONS FOR PERFORMING STUDY: To improve the understanding of exercise related sudden death in Thoroughbred racehorses. OBJECTIVES: To describe the post mortem findings in cases of sudden death associated with exercise in 268 Thoroughbred racehorses. METHODS: Gross and histological post mortem findings of 268 cases of sudden death were collated and reviewed. Cases originated from 6 racing jurisdictions around the world. Sudden death was defined as acute collapse and death in a closely observed and previously apparently healthy Thoroughbred racehorse, during, or within one hour after, exercise. Cause of death as determined by the attending pathologist was categorised as definitive, presumptive or unexplained and compared between the different populations. Cardiopulmonary lesions recorded at post mortem examination were compared between different populations. RESULTS: Pathologists recorded a definitive cause of death in 53% (143/268) of cases. Major definitive causes of sudden death included cardiac failure, apparent pulmonary failure, pulmonary haemorrhage, haemorrhage associated with pelvic fractures or with idiopathic blood vessel rupture, and spinal cord injury. A presumptive cause of death was made in 25% (67/268) of cases and death remained unexplained in 22% (58/268) of cases. There were several statistically significant inter-population differences in the cause of death and in reporting of cardiopulmonary lesions. CONCLUSIONS: Sudden death can be attributed to a variety of causes. Causes of sudden death and the lesions found in cases of exercise-related sudden death are similar in different racing jurisdictions. However, the lesions are often not specific for the cause of death and determination of the cause of death is therefore affected by interpretation by the individual pathologist.

Retrospective evaluation of episodic collapse in the horse in a referred population: 25 cases (1995-2009).

BACKGROUND: Episodic collapse in horses has equine welfare and human safety implications. There are, however, no published case series describing this syndrome. OBJECTIVES: To characterize the cause and outcomes for horses referred for investigation of episodic collapse. ANIMALS: Twenty-five horses referred for investigation of single or multiple episodes of collapse. METHODS: Retrospective study. Clinical records from the Dick Vet Equine Hospital, University of Edinburgh from November 1995 to July 2009 were searched using the following keywords: collapse, collapsing, fall, syncope. Collapse was defined as an incident in which the horse lost postural tone with or without progression to recumbency and with or without loss of consciousness. Long-term follow-up information was obtained by telephone conversation with the owner. RESULTS: A final diagnosis was reached in 11 cases, namely cardiac arrhythmia (4), right-sided heart failure (1), hypoglycemia (2), generalized seizures (2), and sleep disorder (2). A presumptive diagnosis was reached in 8 cases, namely neurocardiogenic syncope (5), exercise-induced pulmonary hemorrhage (2), and generalized seizures (1). No diagnosis was reached in 6 cases despite comprehensive investigations. Three horses were euthanized at presentation. Treatment was attempted in 9 horses with 6 cases having successful outcome before discharge. Follow-up information was available for 14 of 19 horses discharged from the hospital. Only 1 of these horses was observed to collapse after discharge. CONCLUSIONS AND CLINICAL IMPORTANCE: Definitive diagnosis was more likely to be reached in cases with multiple episodes of collapse. Horses in which 1 episode of collapse occurred did not necessarily collapse again.