Inter-observer agreement for clinical examinations of foot lesions of sheep.

In sheep, the diagnosis of foot lesions is routinely based on physical examination of the hoof. Correct diagnosis is important for the effective treatment, prevention and control of both infectious and non-infectious causes of lameness. Therefore, the aim of this study was to evaluate the level of inter-observer agreement for clinical examination of ovine foot lesions. Eight observers of varying experience, training and occupation performed foot examinations on a total of 1158 sheep from 38 farms across North England and Wales. On each farm, a group of two to four observers independently examined a sample of 24 to 30 sheep to diagnose the presence or absence of specific foot lesions including white line lesions (WL), contagious ovine digital dermatitis (CODD), footrot (FR), inter-digital dermatitis (ID) and toe granuloma (TG). The inter-observer agreement of foot lesion assessments was examined using Fleiss kappa (κ), and Cohen's κ examined the paired agreement between the test standard observer (TSO) and each observer. Scoring differences with the TSO were examined as the percentage of scoring errors and assessed for evidence of systematic scoring bias. With the exception of WL (maximum error rate 33.3%), few scoring differences with the TSO occurred (maximum error rate 3.3%). This suggests that observers can achieve good levels of reliability when diagnosing most of the commonly observed foot conditions associated with lameness in sheep.

Outcome of surgical treatment for umbilical swellings in bovine youngstock.

Umbilical swellings are commonly identified in calves and can be caused by hernia formation, infection of the remnants of umbilical vessels or a combination of both. Ninety-one cases with umbilical swellings were admitted to the Leahurst Farm Animal Practice (LFAP) between July 2004 and February 2012; 55 were simple hernias and 36 had associated infection. Eighty-seven cases underwent surgery of which 86 survived until discharge. Postoperative complications occurred in 65/86 animals (73 per cent). In 51 cases (81 per cent) this was classified as minor requiring no additional treatment. Placement of a prosthetic mesh was associated with a higher OR for developing severe postoperative complication when compared with those not receiving a mesh (OR=19.3; 95% CI 4.5 to 83.5). Long-term survival results were available for 49 animals, 22 of which were remaining in the herd with a median age of 1346 days (3.7 years). Of the 27 animals which had exited the herd, 16 were adult dairy cows, 7 were dairy heifers, 2 were beef animals and 2 exited at an unknown stage. Umbilical surgery in calves carries a good prognosis, although placement of a mesh increases the risk of complications occurring in the postoperative period.

Use of continuous positive airway pressure (CPAP) to optimise oxygenation in anaesthetised horses--a clinical study.

REASONS FOR PERFORMING STUDY: Hypoxaemia is a common problem during equine anaesthesia. Continuous positive airway pressure (CPAP) is a ventilation mode routinely employed in man to overcome hypoxaemia but has not been objectively assessed in horses. OBJECTIVES: To test the effects of CPAP on oxygenation and its indices in anaesthetised horses in a clinical setting. METHODS: Twenty-four healthy horses requiring anaesthesia in dorsal recumbency were anaesthetised using a standard protocol. Following orotracheal intubation and connection to an anaesthetic machine capable of applying CPAP, horses were randomly allocated to ventilate at physiological airway pressure measured at the airway opening (Group PAP) or to receive CPAP of 8 cmH2O (Group CPAP). Arterial blood gas analysis was performed as soon as arterial cannulation was achieved and 30, 60 and 90 min after induction. If PaCO2 increased above 9.31 kPa controlled ventilation was initiated. Groups were compared using a general linear model. RESULTS: Horses receiving CPAP had significantly higher PaO2 and calculated oxygen indices than horses receiving PAP. No significant differences in ventilation indices were observed between the 2 groups. Eight horses receiving PAP and 5 receiving CPAP required controlled ventilation. No differences in dobutamine requirements or mean arterial pressures were recorded. CONCLUSIONS: Continuous positive airway pressure of 8 cmH2O improved oxygenation indices in dorsally recumbent horses without significantly influencing ventilation. POTENTIAL RELEVANCE: Continuous positive airway pressure reduces the incidence of hypoxaemia in anaesthetised horses. Further research is warranted to elucidate the effects of CPAP on the cardiovascular system.

Intra-articular morphine, bupivacaine or no treatment for postoperative analgesia following unilateral elbow joint arthroscopy.

OBJECTIVES: To compare intra-articular morphine or bupivacaine against no treatment following unilateral elbow joint arthroscopy using force plate analysis and pain scoring. METHODS: Thirty-one dogs were randomly allocated to receive 0·1 mg/kg intra-articular morphine, 0·5 mg/kg bupivacaine or no treatment following elbow arthroscopy. Force plate analysis, pain scoring and kinematic evaluation were performed before anaesthesia, 4 and 24 hours after surgery. Peak vertical force index, symmetry index, rate of loading, rate of unloading, stance time and range of motion were obtained from gait analysis. Pain scoring was performed every 4 hours and interventional analgesia (0·3 mg/kg methadone) was administered if necessary. RESULTS: Of 29 dogs analysed, peak vertical force index (P<0·001), symmetry index (P=0·01) and rate of unloading (P=0·01) decreased significantly over time in each group; however, this was not affected by treatment. No significant differences were observed in stance time or rate of loading over time. Kinematic (range of motion) evaluation was not complete for all dogs. Pain scores increased significantly at both time points postoperatively in the no treatment group (P=0·007) and in morphine-treated dogs at 4 hours compared to baseline (P=0·03). For intra-articular bupivacaine significant increases in pain scores were not detected (P=0·28). CLINICAL SIGNIFICANCE: No benefit to intra-articular bupivacaine or morphine was detected using peak vertical force index from force plate analysis. Bupivacaine prevented increases in pain scores at both time points as did morphine at the 24-hour evaluation, compared to no treatment.

Effects of parenteral amoxicillin on recovery rates and new infection rates for contagious ovine digital dermatitis in sheep.

The present study is a randomised split-flock treatment trial, which compared the effect of foot bathing in a 1 per cent solution of chlortetracycline alone with a treatment protocol that added a single injection of a long-acting amoxicillin. Overall, the prevalence of contagious ovine digital dermatitis in the examined flock was 22 per cent, while 45.7 per cent of affected sheep had infections in two or more feet. Parenteral antibiotic treatment increased the odds of a recovery by 3.8 times (95 per cent confidence interval 1.05 to 14.0) (P=0.008). Moreover, the amoxicillin injection may also have had a preventative effect, reducing the rate of establishment of new infections from 2.5 per cent for foot bathing alone compared with 1.0 per cent with the addition of parenteral amoxicillin.

Molecular epidemiology and phylogeny reveal complex spatial dynamics in areas where canine parvovirus is endemic.

Canine parvovirus type 2 (CPV-2) is a severe enteric pathogen of dogs, causing high mortality in unvaccinated dogs. After emerging, CPV-2 spread rapidly worldwide. However, there is now some evidence to suggest that international transmission appears to be more restricted. In order to investigate the transmission and evolution of CPV-2 both nationally and in relation to the global situation, we have used a long-range PCR to amplify and sequence the full VP2 gene of 150 canine parvoviruses obtained from a large cross-sectional sample of dogs presenting with severe diarrhea to veterinarians in the United Kingdom, over a 2-year period. Among these 150 strains, 50 different DNA sequence types (S) were identified, and apart from one case, all appeared unique to the United Kingdom. Phylogenetic analysis provided clear evidence for spatial clustering at the international level and for the first time also at the national level, with the geographical range of some sequence types appearing to be highly restricted within the United Kingdom. Evolution of the VP2 gene in this data set was associated with a lack of positive selection. In addition, the majority of predicted amino acid sequences were identical to those found elsewhere in the world, suggesting that CPV VP2 has evolved a highly fit conformation. Based on typing systems using key amino acid mutations, 43% of viruses were CPV-2a, and 57% CPV-2b, with no type 2 or 2c found. However, phylogenetic analysis suggested complex antigenic evolution of this virus, with both type 2a and 2b viruses appearing polyphyletic. As such, typing based on specific amino acid mutations may not reflect the true epidemiology of this virus. The geographical restriction that we observed both within the United Kingdom and between the United Kingdom and other countries, together with the lack of CPV-2c in this population, strongly suggests the spread of CPV within its population may be heterogeneously subject to limiting factors. This cross-sectional study of national and global CPV phylogeographic segregation reveals a substantially more complex epidemic structure than previously described.

Bacterial flora and risk of infection of the ovine teat duct and mammary gland throughout lactation.

We collected samples of teat duct material and mammary secretion from ewes in three farms (flock A, polyparous n=7; flock B, polyparous n=6, primiparous n=4; flock C, polyparous n=4): 14 samples immediately after lambing (before sucking of lambs), 244 samples during the suckling period and 156 samples during the milking period. Conventional bacteriological techniques were used. The results were modeled using survival analysis, initially by the Kaplan-Meier method and then by the Cox Proportional Hazards method. Then, we calculated the minimum true risk of an "at-risk" teat or mammary gland being infected and analyzed these data with STATA using the GLLAMM program for Generalised Linear Latent and Mixed Models. During the suckling period, bacteria were isolated from 52 (21%) duct material and 19 (8%) secretion samples; respective results for the milking period were 20 (13%) and 9 (6%). There was an increased risk of duct rather than secretion samples being infected (P<0.001). There was a significant difference among flocks in isolating bacteria from duct (P<0.01) or secretion (P<0.001) samples during suckling period, but not during hand-milking period (P>0.4 and 0.1, respectively). There were no differences between isolation of bacteria from duct (P>0.5) or secretion (P>0.7) samples among primiparous and polyparous animals. Most bacterial isolates were staphylococci. Persistent isolation of the same bacterial species from duct material samples obtained from a particular ewe was recorded with five Staphylococcus spp. and two Mannheimia haemolytica isolates. The results indicate that infections of the teat duct can take place easily; however, not all infections result to infection of the mammary gland. The results support experimental evidence that defence mechanisms of the healthy teat are able to limit the infection. Maintenance of healthy teats contributes to effective defence mechanisms, and coupled with minimal infections of the teat duct, would contribute to the prevention of mastitis in ewes.

Evaluation of the clinical efficacy of prokinetic drugs in the management of post-operative ileus: can retrospective data help us?

The objectives of the study were to determine whether retrospective data can be used to answer questions about the efficacy of prokinetic agents when used to treat horses with post-operative ileus (POI). We describe prevalence and mortality of POI with reference to treatment with four prokinetic agents. By combining data from two Hospitals a study population of 55 horses with POI following pedunculated lipoma obstruction (PLO) was established. Univariable and multivariable associations were determined between short term survival and potential explanatory variables. With death as outcome in multivariable models, breed and hospital were significantly associated with outcome but the use of prokinetic agents was not (P=0.15). However, sample size estimates indicate the low power of this study to detect differences in outcome. It was not possible definitively to evaluate the efficacy of prokinetics as treatment for POI following PLO using retrospective data. The data were suggestive of limited efficacy of prokinetics as treatment for POI. It is postulated that the identified association between hospital and survival reflects differences in clinician decision making. The study highlights the need for further prospective studies using randomised clinical trials to evaluate accurately the efficacy of prokinetic agents. This report illustrates difficulties with performing retrospective analysis of clinical data to determine the efficacy of treatment regimes.

Cytokine mRNA expression pattern in horses with large intestinal disease.

The aim of this study was to investigate cytokine expression patterns in the large intestinal mucosa of horses, particularly in diseases associated with inflammation. Many cases of equine colitis remain without a definitive diagnosis and survival rates are poor. In humans, colitis is associated with increased expression of pro-inflammatory cytokines. To examine if similar responses occur in horses, we investigated il -2, il -4, il -5, il -10, tnfalpha, ifngamma and tgfbeta messenger rna expression in large intestinal mucosa. Samples were obtained from animals with large intestinal disease (n=15) or from horses which had different levels of cyathostomin infection (n=9) and analysed by reverse transcription-polymerase chain reaction. il -2 was detected at all sites, whilst il -4 was detected at all but one site. The presence of il -10, il -5, ifngamma and tgfbeta varied with no significant differences amongst groups (P>0.4). Detection of tnfalpha was significantly different between the group of horses that had infiltrative inflammatory bowel disease and those with larval cyathostominosis (P=0.028) and those that were helminth negative (P=0.014). These results indicate a possible role for tnfalpha in the pathogenesis of equine infiltrative inflammatory bowel disease.

Hemostatic profiles in 39 dogs with congenital portosystemic shunts.

OBJECTIVES: To determine if there were significant changes in prothrombin time (PT), partial thromboplastin time (PTT), and fibrinogen levels in dogs with naturally occurring congenital portosystemic shunts (CPSS) and to determine if there was any association between these values, serum albumin concentration, and the ability to attenuate the shunt vessel. STUDY DESIGN: Retrospective clinical study. ANIMALS: Thirty-nine client-owned dogs. METHODS: Medical records of 60 dogs with confirmed CPSS were retrospectively evaluated. Hemostatic profiles had been performed before surgery in 39 cases. RESULTS: Dogs with CPSS had significantly higher values for PTT (P < .001) when compared with normal dogs. Of the total number of dogs, 64.1% had a PTT greater than 16 seconds (25/39). PTT was prolonged by 25% or more in 51.3% of dogs (20/39). PT tended to be higher in dogs with CPSS (P = .036), although only 7.7% (3/39) of dogs had a PT greater than 12 seconds (the maximum reference value). Dogs with CPSS had significantly lower values for albumin and fibrinogen (P < .001). Platelet numbers were within the normal range in 87.2% of cases (34/39). Of the 5 dogs with platelet numbers outside the normal range, 3 were mildly thrombocytopenic. Fibrin degradation product concentrations were not elevated in any dogs tested (N = 22). There was no significant difference in any of the measured variables between dogs with extrahepatic shunts and those with intrahepatic shunts (P > .1). For PT, PTT, albumin, and fibrinogen, there was no significant difference between dogs that underwent total, partial, or no attenuation (P > .3). CONCLUSIONS: Dogs with CPSS have a tendency to have a prolonged PTT. There was no significant difference in hemostatic profile results between dogs with intrahepatic shunts versus extrahepatic shunts. Preoperative hemostatic profile abnormalities were not useful as predictors of ability to attenuate CPSS. CLINICAL RELEVANCE: Prolonged PTT was not associated with bleeding tendencies in any of the dogs. Assays of individual clotting factors may help to further characterize the abnormalities present in animals with CPSS and may identify specific factor deficiencies. This might enable identification of a noninvasive diagnostic or prognostic indicator.

Neospora caninum-associated abortion in cattle: the time of experimentally-induced parasitaemia during gestation determines foetal survival.

The parasite, Neospora caninum is an important cause of abortion in cattle. It is transmitted vertically or horizontally and infection may result in abortion or the birth of a live, healthy but infected calf at full-term. Only a proportion of infected cattle abort and the pathogenesis of abortion is not understood. Groups of cattle were infected with 10(7) N. caninum tachyzoites intravenously at different times relative to gestation. Intravenous inoculation was chosen to reproduce the putative haematogenous spread of N. caninum following either recrudescence of endogenous infection or de novo infection. In all cattle, infection was accompanied by high gamma-interferon and lymphoproliferative responses, and a biased IgG2 response indicating that N. caninum infection is accompanied by a profound Th1 helper T cell-like response. Infection at 10 weeks gestation resulted in foetopathy and resorption of foetal tissues 3 weeks after infection in 5 out of 6 cows. Infection at 30 weeks gestation resulted in the birth of asymptomatic, congenitally-infected calves at full term in all 6 cows, whereas the 6 cows infected before artificial insemination gave birth to live, uninfected calves. These results suggest that the reason some cows abort is related to the time during gestation when they become infected or an existing infection recrudesces.

Veterinary education, zoonoses and public health: a personal perspective.

Zoonotic disease poses an important threat to human public health and should therefore be taken seriously. A number of zoonoses also cause severe disease and loss of production in food producing animals. Many veterinarians are less aware of the importance of zoonoses than is desirable and medical clinicians who encounter zoonoses in human patients may either fail to recognise them or concentrate on treating the individual patient rather than disease control. This situation may be exacerbated where there is inadequate communication between veterinarians, the various health care professionals and public health organisations. Undergraduate and postgraduate training courses must promote a greater understanding of the importance of zoonoses and of how to investigate and control them. We also need to increase awareness amongst qualified veterinary personnel and human health care workers and to facilitate inter-disciplinary discussions and collaborative ventures. This paper suggests some ways to achieve these aims.

Efficacy and kinetics of carprofen, administered preoperatively or postoperatively, for the prevention of pain in dogs undergoing ovariohysterectomy.

OBJECTIVE: To determine what effect the timing of carprofen administration has on the severity of postoperative pain in dogs undergoing ovariohysterectomy and to investigate the pharmacokinetics of carprofen under these conditions. STUDY DESIGN: A prospective, randomized, double-blind, clinical trial. ANIMALS: Sixty-two adult bitches weighing between 10 and 25 kgs, undergoing elective ovariohysterectomy. METHODS: Examinations were performed for 20 hours postoperatively using subjective visual assessment scoring systems (DIVAS) and objective mechanical nociceptive threshold measurements. Forty dogs were assigned to one of three groups: (1) preoperative carprofen; (2) postoperative carprofen; and (3) no analgesics (saline injections). The dose of carprofen was 4.0 mg/kg subcutaneously. In another 22 bitches, the pharmacokinetics of carprofen given preoperatively or postoperatively at the same dose were examined. RESULTS: The dogs given carprofen preoperatively had lower pain scores than the other groups, significantly so at 2 hours postextubation (P < .01 and P < .05, Kruskal-Wallis and post hoc Dunn's). Mechanical pain thresholds measured at the distal tibia showed the development of hyperalgesia at 12 and 20 hours postextubation; this was prevented by both the preoperative (P < .05 at 12 and 20 hours, Kruskal-Wallis) and postoperative (P < .05 at 20 hours, Kruskal-Wallis) administration of carprofen. Mechanical pain threshold testing at the wound showed a significant analgesic effect of carprofen. Plasma concentrations of carprofen were not directly related to analgesia; maximum plasma concentration, the area under the curve to the last data point, and area under the first moment curve up to the last data point were all significantly higher in the dogs given carprofen postoperatively (P < .05, Mann-Whitney). CONCLUSION: Preoperative administration of carprofen has a greater analgesic effect than postoperative administration in the early postoperative period in dogs undergoing ovariohysterectomy. Plasma levels of carprofen are not related to the degree of analgesia achieved. CLINICAL RELEVANCE: Carprofen provides effective analgesia after canine ovariohysterectomy. The timing of analgesic administration is important to optimize the control of postoperative pain.

A retrospective study of mortality associated with general anaesthesia in horses: elective procedures.

A retrospective analysis examined mortality associated with all procedures requiring general anaesthetic, performed at the Philip Leverhulme Large Animal Teaching Hospital, during the five-year period from February 1991 to December 1995. The study involved details relating to 2276 equine general anaesthetics and a variety of patient variables were examined. Within a group of 1279 animals undergoing anaesthesia for elective procedures, 46 (3.6 per cent) died or were euthanased owing to a poor prognosis or financial implications. Mortality relating directly to the surgery or anaesthesia occurred in eight of these cases. Therefore, the surgical/anaesthetic death rate was 0.63 per cent. Death which was apparently attributable directly to the anaesthesia (no organic cause of death found at postmortem examination) occurred only once, giving an anaesthetic death rate of 0.08 per cent.

Central sensitization as a result of surgical pain: investigation of the pre-emptive value of pethidine for ovariohysterectomy in the rat.

The development of central hypersensitivity as a result of a routine surgical procedure, midline ovariohysterectomy, was investigated in rats using the paw pressure test (PPT) and tail-flick latency (TFL) tests of spinal reflex activity. In addition, the modulating effect of pre-emptive versus post-operative administration of pethidine (a short-acting pure mu-opioid agonist) on the development of central hypersensitivity was studied. Initial experiments indicated that pethidine (15 mg/kg, i.m.) gave sub-maximal increases in thresholds for 60 min, and also that the administration of an anaesthetic did not unduly prolong the action of pethidine. Subsequently, 24 female Wistar rats were allocated to 1 of 4 treatment protocols: (1) anaesthesia without analgesics; (2) anaesthesia and surgery (midline ovariohysterectomy) without analgesics; (3) anaesthesia and surgery with pre-operative administration of pethidine; (4) anaesthesia and surgery with post-operative administration of pethidine. Thirty-five minutes after the end of anaesthesia thermal and mechanical nociceptive thresholds were measured at stepwise increasing intervals for 480 min. Changes were expressed as percentage changes from baseline (PPT) or deviation from expected values (TFL). Area under the threshold versus time response curves (AUCs) were also calculated for the following time sectors: 30-90, 90-150, 150-270, 270-390 and 390-510 min post-anaesthetic. Results of the TFL testing did not indicate the development of any significant hyperalgesia in any groups, but the results of the PPT did. In the time sectors 150-270 and 270-390 min post-anaesthetic, the AUCs in rats subjected to anaesthesia and surgery with either post-operative administration of pethidine or surgery with no analgesic drug administration, were significantly lower than the AUCs in rats given analgesics pre-operatively or those subjected to general anaesthesia alone (P < 0.01), Mann-Whitney). In summary, it appears that pethidine, in this protocol, prevented the development of surgically induced hyperalgesia when it was given pre-emptively.

Fate and uptake of soluble and particulate antigens in the preparturient bovine mammary gland.

Pregnant heifers were infused intramammarily with ovalbumin in one quarter and killed S. uberis in another quarter. The animals were slaughtered at time intervals after infusion, and tissues were collected from different parts of the gland and from the local lymph nodes. Ovalbumin and bacteria reached the lymph nodes as early as 1 and 3 h after infusion respectively. Ovalbumin was also present in blood 5-10 min after infusion and in non-infused quarters. Both ovalbumin and bacteria were phagocytosed by the epithelium of the mammary gland. However, bacteria were seen in the tissues in small numbers at all stages after infusion. Larger numbers were phagocytosed by neutrophils in the lumen of ducts, 18 h after infusion. Phagocytosis of both ovalbumin and bacteria was not present in the connective tissue of the gland. The results indicate increased permeability of the preparturient gland to soluble proteins, but limited uptake of bacteria. Furthermore, a mechanism of transfer of antigens among quarters has been suggested.