Arterial blood gas parameters of normal foals born at 1500 metres elevation.

REASONS FOR PERFORMING STUDY: Arterial blood gas analysis is widely accepted as a diagnostic tool to assess respiratory function in neonates. To the authors' knowledge, there are no published reports of arterial blood gas parameters in normal neonatal foals at altitude. OBJECTIVE: To provide information on arterial blood gas parameters of normal foals born at 1500 m elevation (Fort Collins, Colorado) in the first 48 h post partum. HYPOTHESIS: Foals born at 1500 m will have lower PaO2 and PaCO2 than foals born at sea level due to low inspired oxygen and compensatory hyperventilation occurring at altitude. METHODS: Sixteen foals were studied. Arterial blood gas analysis was performed within 1 h of foaling and subsequent samples were evaluated at 3, 6, 12, 24 and 48 h post partum. Data were compared to those previously reported in healthy foals born near sea level. RESULTS: Mean PaO2 was 53.0 mmHg (7.06 kPa) within 1 h of foaling, rising to 67.5 mmHg (9.00 kPa) at 48 h post partum. PaCO2 was 44.1 mmHg (5.88 kPa) within one hour of foaling, falling to 38.3 mmHg (5.11 kPa) at 48 h. Both PaO2 and PaCO2 were significantly lower in foals born at 1500 m elevation than those near sea level at several time points during the first 48 h. CONCLUSIONS AND POTENTIAL RELEVANCE: Foals at 1500 m elevation undergo hypobaric hypoxia and compensatory hyperventilation in the first 48 h. Altitude specific normal arterial blood values are an important reference for veterinarians providing critical care to equine neonates.

Risk factors for owner-reported occurrence of equine protozoal myeloencephalitis in the US equine population.

BACKGROUND: Equine protozoal myeloencephalitis (EPM) is a serious and often fatal neurologic disease of horses, but few studies have investigated risk factors. OBJECTIVES: To evaluate operation- and individual-level factors associated with likelihood of the occurrence of EPM. ANIMALS: Data were collected as part of a study of the US equine industry from 1,178 operations representing 83.9% of horses and 51.6% of operations with > or =3 horses in 28 states. METHODS: Probability-based sampling was used to enroll representative operations in a cross-sectional study. Interviews were conducted to collect information regarding health and management of horses. A nested case-control study was used to investigate risk factors among individual horses. Interview data were combined with climate data, human population density, and opossum regional ecology categories. Data were analyzed using logistic regression to identify risk factors for the occurrence of EPM. RESULTS: Owners reported that 95% of EPM cases included in this study were diagnosed by veterinarians. Variables associated with EPM occurrence on premises included opossum regional ecology, reported exposure to small wildlife, climate, terrain, housing, choice of bedding material, method of storing feeds, equine stocking density, and primary use of horses. Among individual horses, age was most strongly associated with disease risk. Associations also were identified with sex, breed, primary use, and participation in competitions. CONCLUSIONS AND CLINICAL IMPORTANCE: Because the risk of EPM occurrence on operations is closely tied to factors that impact exposure to opossums, their feces, and their environment, controlling these exposures may be important in preventing the occurrence of EPM.

Parasite control strategies used by equine owners in the United States: A national survey.

The widespread occurrence of anthelmintic resistance in equine parasites across the world has led to recommendations of fecal egg count-based parasite programs to reduce treatment intensity and thereby delay further development of resistance as much as possible. The most recent study describing equine parasite control in the United States was conducted 20 years ago, and little is known about current strategies employed. This study was part of the National Animal Health Monitoring Systems (NAHMS) Equine 2015 Study, and aimed to describe equine parasite control strategies in the U.S. and evaluate to which extent respondents were in compliance with current guidelines. The study was carried out in 28 states, representing 70.9% of all equine operations with at least five equids present. Two questionnaires were administered, either by mail or delivered in person by veterinary medical officers. Participants provided specific details of their operation and were asked questions about strategies for anthelmintic therapy and diagnostic testing. A total of 380 operations provided data regarding their parasite control practices. Most respondents dewormed 2-3 times a year with ivermectin being the most commonly used anthelmintic. About 22% of respondents used fecal egg counts (FEC) in some form, with less than 10% using them on a regular basis. Less than 5% made use of fecal egg count reduction tests (FECRT). These results suggest little change since the last nationwide survey was conducted in 1998, as the majority of respondents did not report using FECs. This is in stark contrast to recent European surveys, where 50-60% of respondents were using FECs routinely. However, the anthelmintic treatment intensity appears to have been lowered compared to 1998. Taken together, these results suggest a continuing need for education and outreach regarding sustainable parasite control.

Risk factors associated with clinical signs of vesicular stomatitis and seroconversion without clinical disease in Colorado horses during the 2014 outbreak.

Vesicular stomatitis (VS) is caused by a contagious rhabdovirus that affects horses, cattle, and swine. Clinical signs of vesicular stomatitis virus (VSV) infection in pigs and cattle are indistinguishable from foot-and-mouth disease (FMD), a foreign animal disease and reportable disease in the United States (Rodriguez et al., 2000). A VS epidemic occurred in the Rocky Mountain region in 2014-15. A study was conducted in Colorado to evaluate horse- and management-level factors associated with VS. For a horse to be considered a clinical VS horse, there were two requirements. First, clinical VS horses had to have clinical signs consistent with VS, including one or more of the following: vesicles, ulcers, erosions or crusting on the muzzle, nares, lips, oral or nasal mucosa, ears, ventrum, udder or penile sheath, or coronary band lesions. Second, clinical VS horses had to have laboratory confirmation of VSV exposure via virus isolation from lesions or a positive complement fixation test performed on sera. All non-clinical horses residing on VSV-affected premises enrolled in the study were evaluated for exposure (i.e., seroconversion) to VSV. Overall, management and housing data were collected from 334 horses on 48 premises in Colorado. Approximately one-third (31.4%) of enrolled horses were clinical cases and two-thirds (68.6%) were controls. Three premises-matched logistic regression models were constructed in SAS using backward elimination (P-value < 0.05) after univariate screening of a priori-selected variables (P-value < 0.20). Model outcomes included differences in characteristics and management of 1) clinical and nonclinical horses, 2) exposed and unexposed horses, and 3) exposed nonclinical and unexposed nonclinical horses. Overall, factors most strongly associated with risk of being a VS clinical horse were access to pasture (P-value = 0.002), and pregnancy status (P-value = 0.001). Factors most strongly associated with VSV exposure among horses were access to pasture (P-value = 0.003) and lack of any insect control (P-value = 0.001). The only factor associated with VSV-exposed nonclinical horses compared with unexposed VSV horses was contact with clinical horses (P-value = 0.013). There were no associations identified regarding clinical horses compared with exposed nonclinical horses. With regard to severity of lesions (severe vs. moderate or mild), no variables met the criteria for inclusion in the multivariable model. Results of this study provide evidence that pasture access and fly control are important factors associated with VSV exposure.

Anthelmintic efficacy against equine strongyles in the United States.

Equine strongyle parasites are ubiquitous in grazing equids across the world. Anthelmintic resistance is widely developed in cyathostomin populations, but very few surveys have evaluated anthelmintic efficacy in equine populations in the United States, and most of these are over 15 years old. The present study was carried out as part of the National Animal Health Monitoring Systems (NAHMS) Equine 2015-2016 study. The aims were to investigate anthelmintic treatment efficacy by means of the fecal egg count reduction test (FECRT) and identify parameters associated with decreased efficacy. Data were collected from equine operations in 28 states via questionnaires and fecal samples submitted for fecal egg count analysis. Participants were instructed to collect samples from six equids at the day of anthelmintic treatments and 14 days later, and they were asked to include an empty syringe with a legible label of the anthelmintic product used in the shipment. Overall, dewormer treatment was effective for 76.3% of operations (84.6% of animals). Macrocyclic lactone use was effective for 88.7% of operations (95.0% of animals) while pyrimidine/benzimidazole use was effective for 21.4% of operations (43.5% of animals). Univariate analysis revealed that overall, macrocyclic lactones exhibited significantly higher efficacy than the pyrimidine and benzimidazole drug classes (p < 0.0001). There were no statistically significant differences observed between geographic regions (West, South Central, North East, and Southeast). Body weight (p = 0.0355), amount of anthelmintic administered (p = 0.0119), and operation size (p = 0.0162) were statistically associated with anthelmintic efficacy, while anthelmintic treatment frequency in the previous 12 months was not (p = 0.7081). Multiple, mixed-effect logistic regression revealed that anthelmintic drug class (p < 0.0001) was the most impactful factor in predicting anthelmintic efficacy, after accounting for operation size, region and clustering of equids at the operation level. Pasture rotation (p = 0.0129) also demonstrated a significant effect using this model. These data document widespread occurrence of reduced anthelmintic efficacy of benzimidazole and pyrimidine products against strongyle infections in equids in the United States. Anthelmintic efficacy patterns were relatively uniform between the four studied regions, and some epidemiological factors were identified to be associated with anthelmintic efficacy against strongyle infections. This information can be useful in devising sustainable parasite control strategies in the future.

Risk factors associated with strongylid egg count prevalence and abundance in the United States equine population.

Equine strongyle parasites are considered ubiquitous in grazing equids across the world, and cyathostomin parasites are known pathogens causing well-described disease complexes in horses. Decades of intensive anthelmintic treatments have led to anthelmintic resistance in cyathostomins, and current recommendations are to lower treatment intensity and base control strategies on fecal egg count surveillance. Little is known about risk factors associated with strongyle parasite egg shedding patterns in the United States equine population, as the most recent national survey was conducted 20 years ago. The present study was carried out as part of the National Animal Health Monitoring Systems (NAHMS) Equine 2015-2016 study. The aims were to describe strongyle parasite egg shedding patterns in the United States equine population and identify risk factors associated with prevalence and egg count magnitude. Data were collected from equine operations in 28 states via questionnaires and fecal samples submitted to a parasitology research laboratory for fecal egg count analysis and the data gathered underwent comprehensive statistical analyses. Though region and season were related, overall, the summer months and the fall in the southeast tended to have the greatest odds of presence of strongyles eggs on a FEC. Generally, equids resident in the Western region (Arizona, California, Colorado, Montana, Oregon, and Wyoming) had significantly lower strongyle prevalence, no matter the season, as well as a markedly different distribution between strongyle egg shedding levels (p = 0.0005). Overall, egg counts were over-dispersed with about 27% of equids (95% Confidence Interval (CI): 20-34%) contributing 80% of the egg output. Pasture history was significantly associated with strongyle egg prevalence (p = 0.0003) and egg shedding levels (p = 0.0063) with daily access in the previous 30 days being associated with higher odds of presence and greater median egg count levels. Equid gender was significantly associated with strongylid presence (p = 0.0081) and egg count level (p = 0.0008), with male equids having significantly lower odds and median egg counts than female equids, and age was significantly negatively associated with strongylid prevalence (p < 0.0001). Time since last deworming was significantly positively associated with prevalence of strongyle eggs, and this was dependent on the class of dewormer used (p = 0.0086), with equids treated with macrocyclic lactone class of drugs having lower odds of strongyle egg presence at 120 days since the last deworming. These data provide useful insights into strongylid egg shedding patterns in the United States equine population, and they can help refine parasite control recommendations depending on region, pasture access, and age distribution.

Isolation of piliated Escherichia coli from diarrheic foals.

Escherichia coli was isolated from the feces and intestines of foals with and without diarrhea. Piliation of isolates was demonstrated by electron microscopy and agglutination in antisera having specificity for K88, K99, P987 and F41 pili. Piliation was also demonstrated by electron microscopy on organisms which did not react with any of the antisera.

Operation-management factors associated with early-postnatal mortality of US foals.

Of 7320 equine foals reported born alive during 1997 on 1043 operations that had equids on 1 January 1997, and that participated in the United States National Animal Health Monitoring System (NAHMS) Equine 1998 Study, 120 foals were reported to have died (by either euthanasia or natural causes) within the first 2 days of a live birth. The weighted estimate was 1.7% mortality (standard error=0.5) within the first 2 days of live birth for all foals born on operations in the 28 states included in the study.A multivariable logistic-regression model revealed that foals born in the southern region were more likely to have been reported to have died within the first 2 days of live birth than in the western region. In addition, the following operation-level factors were associated with increased odds of a foal dying within the first 2 days of live birth: not routinely testing newborn foals for adequate absorption of colostral immunoglobulins during the first 2 days of life; adding new resident equids to the operation during 1997; having non-resident equids stay on the operation for 1-30 days during 1997; never requiring an official health certificate (for operations that had non-resident equids stay on the operation for 1-30 days); using something other than straw or hay as the predominant bedding type; and feeding equids a vitamin-mineral supplement/premix with forage and/or grain.

Foaling-management practices associated with the occurrence of enterocolitis attributed to Clostridium perfringens infection in the equine neonate.

Enterocolitis associated with Clostridium perfringens (C. perfringens) infection in neonatal foals is often severe and has been associated with a high case-mortality risk. We designed a premises-based survey to evaluate the associations of regional foaling practices, premises environmental management, periparturient foal and brood-mare management, and periparturient brood-mare ration with the occurrence of neonatal enterocolitis attributed to C. perfringens infection. Potential risk factors individually associated with enterocolitis were breed type, housing type at foaling and in the first three days of life, ground/floor surface type at foaling and in the first three days of life, brood-mare ration before and after foaling, and the presence of livestock other than horses on the premises in the past. From the multivariable-logistic regression models, six variables were significantly associated with an increased risk of the outcome of interest (p<0.05): foals of the stock horse type, housing in a stall or drylot in the first three days of life, other livestock present on the premises in the past, foal born on dirt, sand or gravel surface, and low amounts of grass hay and grain fed post-partum. Low grain amounts fed pre-partum represented a decreased risk of the outcome of interest.

Occurrence of infectious upper respiratory tract disease and response to vaccination in horses on six sentinel premises in northern Colorado.

REASONS FOR PERFORMING STUDY: Horses vaccinated against common agents of infectious upper respiratory disease (IURD) may not have detectable serum antibody and may not be protected from clinical disease. OBJECTIVES: The objectives of this study were to 1) investigate the serological response of horses to vaccination against influenza virus (H3N8 and H7N7) and equine herpesviruses (EHV) in a field setting and 2) evaluate associations among vaccination status, serum antibody concentrations, and occurrences of IURD in monitored horses. METHODS: In this study, horses on 6 Colorado premises were vaccinated parenterally against influenza virus and EHV, and serological response evaluated. Horses were monitored, and biological samples collected from individuals with clinical IURD and control horses. RESULTS: Of 173 horses, 61 (35.3%), 21 (12.1%) and 4 (2.3%) seroconverted in response to vaccination against EHV, influenza virus H7N7 and influenza virus H3N8, respectively. CONCLUSIONS: Outbreaks of IURD in study horses were associated with influenza virus H3N8 and Streptococcus equi infection, and serological response to vaccination with conventional products was poor. POTENTIAL RELEVANCE: These results confirm that horses may not respond with detectable serological responses to conventional vaccination against common respiratory viruses and, therefore, suggest that alternate methods of protecting horses against common respiratory viruses should be sought.

A retrospective study of vein thrombosis in horses treated with intravenous fluids in a veterinary teaching hospital.

The medical records of 68 horses treated with IV fluids for 24 hours or more were reviewed to determine the risk of vein thrombosis and to determine which factors were associated with the occurrence of vein thrombosis in these horses. Three factors were positively associated with vein thrombosis including use of locally produced fluids and presence of fever and diarrhea. Two factors, having general anesthesia or having surgery, were negatively associated with vein thrombosis. One continuous variable, duration of treatment, was positively associated with vein thrombosis. Factors not associated with vein thrombosis included breed, age, sex, type of catheter, outcome (lived or died), laminitis, colic, other drugs via the catheter, and type of surgery. One type of catheter was used in the majority of horses (57) making it difficult to detect effect of catheter type. Preparation of the catheter site, the person placing the catheter, and technique of catheter maintenance were not evaluated. Like all retrospective studies, this study has limitations to the conclusions that can be made; however, the strong association between source of fluids, fever, diarrhea, anesthesia/surgery, and the occurrence of vein thrombosis merits consideration in the clinician's therapeutic plan.

Survey of the large animal diplomates of the American College of Veterinary Internal Medicine regarding percutaneous lung biopsy in the horse.

A survey designed to obtain information on the indications, contraindications, complications, and methodology of percutaneous lung biopsy in the horse was sent to large animal diplomates of the American College of Veterinary Internal Medicine. Sixty-five of 190 diplomates returned the survey (response rate: 34%) and 59 of these 65 respondents (91%) indicated that they worked with horses. Forty-four diplomates had performed a percutaneous lung biopsy in 1 or more horses (i.e. 75% of those diplomates working with horses and 68% of total respondents). Clinical and radiologic diagnoses that prompted diplomates to perform percutaneous lung biopsy in the horse included a pulmonary miliary pattern (93%), suspicion of pulmonary infiltrative disease (91%), suspicion of pulmonary neoplasia (91%), suspicion of chronic obstructive pulmonary disease (COPD) (20%), and suspicion of exercise-induced pulmonary hemorrhage (EIPH) (7%). Only one of the respondents reported the use of percutaneous lung biopsy in the diagnostic workup if pneumonia was suspected, but 11% of respondents reported that suspicion of pulmonary abscessation would prompt them to perform a percutaneous lung biopsy. In contrast, a variable percentage of respondents felt there were contraindications to performance of this technique, which included neonatal septicemia (68%), pulmonary abscessation (65%), pleuropneumonia (55%) and pneumonia (42%), EIPH (41%), and COPD (26%). No respondent indicated that suspicion of neoplasia was a contraindication to percutaneous biopsy. Most common complications observed by respondents were epistaxis (68% of respondents), putative pulmonary hemorrhage (52%), tachypnea (39%), and respiratory distress (32%). Ten of 44 respondents (23%) had not seen any complications with percutaneous lung biopsy. Forty-two of 44 respondents (96%) warned owners about possible complications before performing percutaneous lung biopsy. All respondents to this question reported that they would perform percutaneous lung biopsies in horses in the future, but 4 of 41 would use the procedure only as a last resort.

A comparison of dobutamine infusion to exercise as a cardiac stress test in healthy horses.

This study was done to determine whether administration of dobutamine would produce echocardiographic and electrocardiographic alterations comparable to those induced by treadmill exercise in healthy horses. Fourteen horses received maximal treadmill exercise and, separately, intravenous dobutamine infusion up to a maximum rate of 50 microg/kg/min. Ten of the 14 horses were euthanized, and the myocardial tissues were examined grossly and histopathologically. No significant differences were found in the chronotropic effects of dobutamine and exercise (P = .905). Dobutamine induced greater interventricular septal thickening during systole (dobutamine = 4.78 cm, exercise = 4.03 cm; P = .004). and greater left ventricular diameters during diastole (dobutamine = 9.73 cm, exercise = 9.26 cm; P = .037), than did exercise treatment. Horses exhibited transient signs of sweating and restlessness during infusion of moderate to maximum doses of dobutamine. Ventricular ectopy seen in 11 of 14 horses was attributed to the arrhythmogenic properties of dobutamine, as well as to increased vagal tone present at low dobutamine doses. Myocardial lesions characteristic of catecholamine myotoxicity were present in 2 of the 10 horses examined. Although dobutamine induces chronotropic and inotropic changes similar to those induced by exercise, the use of high-dose dobutamine as a cardiac stressor in horses cannot be advocated because of potential development of arrhythmias or myotoxicity.

Evaluation of clinical signs of disease, bronchoalveolar and tracheal wash analysis, and arterial blood gas tensions in 13 horses with chronic obstructive pulmonary disease treated with prednisone, methyl sulfonmethane, and clenbuterol hydrochloride.

We evaluated the efficacy of 3 treatments for chronic obstructive pulmonary disease in horses: prednisone (400 mg/horse, PO, daily; n = 7), methyl sulfonmethane (10 g/horse, PO, q 12 h; n = 6), and clenbuterol hydrochloride (0.4 mg/horse, PO, q 12 h; n = 7). A fourth group acted as controls (n = 6) and was not treated. The treatment period lasted 10 days. Each horse was a member of 2 different groups for 10 days, separated by an 18-day interval of no treatment. All horses were housed together in an outdoor pen without bedding. Horses were fed alfalfa/grass hay mix ad libitum from a large feeder. The same batch of hay was fed throughout the study. Multiple physical and laboratory variables were monitored prior to, during, and at the end of each 10-day trial period. Changes in lung sounds, respiratory effort, degree of anal movement, nasal discharge, temperature, respiratory rate, or heart rate were not significant. Changes in arterial blood gas tensions, tracheal wash or bronchoalveolar lavage cytologic findings, or phagocyte function were not significant. All horses were tachypneic and most were tachycardic. The median value for PaO2 was below normal for all horses. All tracheal wash and most bronchoalveolar lavage cytologic findings represented a suppurative response. Negative linear correlation was observed between PaO2 and degree of respiratory effort in these horses (eg, as PaO2 decreased, the degree of respiratory effort increased).

Chronic flunixin meglumine therapy in foals.

Effects of a therapeutic dose of flunixin meglumine on gastric mucosa of horse foals were determined by endoscopy, double-contrast radiography, and gross and histologic examinations. Foals were administered 1.1 mg of flunixin meglumine/kg of body weight, PO/day for 30 days in an encapsulated form that was divided into 2 doses/day (group 1; n = 3) or by IM injection once a day (group 2; n = 7). Three control foals (group 3; n = 3) were administered capsules (n = 1) containing dextrose powder or IM injections (n = 2) of vehicle solution without flunixin meglumine. All 3 groups-1 foals given flunixin meglumine PO developed oral ulcers. Group-2 foals given flunixin meglumine IM did not develop oral ulcers. One control foal (group 3) developed 1 oral ulcer that healed during the study. Endoscopic examination revealed linear crease-like mucosal lesions in the glandular portion of the stomach in 2 group-2 foals. Radiographic evidence of gastric ulcers was observed in only 1 gastrogram of a group-1 foal. Foals were euthanatized, and necropsy revealed erosions and/or ulcers of the glandular portion of the stomach. Oral ulcers were observed in all 3 group-1 foals. Erosions of the glandular portion of the stomach developed in all 10 foals given flunixin meglumine, but did not develop in group-3 foals. Ulceration of the glandular portion of the stomach was present in 1 group-2 foal.

Effect of transportation stress on bronchoalveolar lavage fluid analysis in female horses.

Four bronchoalveolar lavages were performed sequentially on 9 control and 8 transport-stressed female horses. Alterations in results of fluid cytologic analyses, microbial content, and phagocyte function of recovered pulmonary macrophages in all horses were determined. Seemingly, absolute and relative increase in the number of inflammatory cells detected in the second bronchoalveolar lavage fluid of control horses was the result of irritation of the first lavage. This increased response was not observed in transport-stressed horses until 5 days after transport (third lavage; 10 days after initial lavage). Seemingly, delayed inflammatory response was the result of the transport stress. Microbial content and macrophage function were not significantly different between the 2 groups (P greater than 0.05).

Medical problems of adult horses, as ranked by equine practitioners.

This paper reports the results of a survey conducted among members of the American Association of Equine Practitioners, concerning medical problems of adult horses. A one-page questionnaire listing 36 medical problems grouped by body system was completed by 1,149 veterinarians. The top-ranked disease was colic, followed by viral respiratory tract disease, endometritis, dermatitis, and parasitism. When responses were evaluated by type of practice, location of practice, and number of veterinarians in the practice, ranking of the top 2 diseases was the same for the total respondents. Ranking of diseases 3 through 5 varied when these criteria were taken into consideration.

Bilateral hypoplasia of the soft palate and aryepiglottic entrapment in a horse.

Endoscopic examination of a 7-year-old gelding with weight loss indicated a palatal defect with a prominent tissue mass at the caudomedial margin of the defect. At necropsy, the condition was determined to be bilateral hypoplasia of the soft palate.

Epidemiologic study of salmonellae shedding in the feces of horses and potential risk factors for development of the infection in hospitalized horses.

A study was designed to identify epidemiologic factors associated with the development and spread of salmonellae in horses in a veterinary teaching hospital, through a case-control study and a longitudinal follow-up prospective study. In the case-control study, 44 horses shedding salmonellae in feces were compared with 99 control horses not shedding salmonellae in feces; regarding breed, sex, age and initial diagnosis, none of the odds ratios for study factors was significant. The factors found to be associated with fecal shedding of salmonellae in the prospective study included diarrhea at the time of admission to the hospital, fever while hospitalized, and a change in diet while hospitalized. Horses identified to be shedding salmonellae in feces were not limited to those with clinical signs of salmonellosis; however, spread of salmonellae from a shedder without clinical signs of disease to other hospitalized horses was not identified. The most common serovars of Salmonella isolated were oranienburg and newport.

Atrial fibrillation in a pregnant mare: treatment with quinidine sulfate.

Atrial fibrillation in a pregnant, lactating, 15-year-old mare nursing a 70-day-old foal was converted to normal sinus rhythm, using quinidine sulfate. The maximum concentration of quinidine was 4.3 mg/L in the mare's milk and was 2.6 mg/L in the mare's serum. Treatment with quinidine did not interrupt the pregnancy. Six months after treatment, the mare developed acute volvulus of the large colon and died. At necropsy, the mare did not have macroscopic or microscopic cardiac lesions. The fetus was macroscopically and histologically normal.