A de novo 2.3 kb structural variant in MITF explains a novel splashed white phenotype in a Thoroughbred family.

Splashed white in horses is characterized by extensive white patterning on the legs, face and abdomen and may be accompanied by deafness. To date, seven variants in microphthalmia-associated transcription factor (MITF) and two variants in Paired Box 3 (PAX3) have been identified to explain this phenotype. A splashed white Thoroughbred stallion, whose sire and dam were not patterned, was hypothesized to have a de novo variant leading to his white coat pattern. A whole-genome sequencing candidate gene approach identified two single nucleotide variants (SNVs) in SOX10, four SNVs in MITF and a 2.3 kb deletion in MITF with the alternative allele present in this stallion but absent in the other 18 horses analyzed. All six SNVs were annotated as modifiers and were not further considered. The deletion in MITF (NC_009159.3:g.21555811_21558139delinsAAAT) encompasses exon 9 encoding a part of the helix-loop-helix domain required for DNA binding. Sanger sequencing and parentage testing confirmed that this deletion was a de novo mutation of maternal origin. Consistent with the published nomenclature, we denote this likely causal variant as SW8. Genotyping three of this stallion's offspring identified SW8 only in the nearly all-white foal that was confirmed deaf by brainstem auditory evoked response testing. This foal was also a compound heterozygote for dominant white variants (W20/W22), but to date, W variants alone have not been connected to deafness. SW8 marks the fourth de novo MITF variant in horses reported to cause white patterning. The link between deafness and all MITF variants with and without other variants impacting melanocyte development and function needs to be further explored.

Pharmacokinetics of metronidazole in foals: influence of age within the neonatal period.

Neonatal foals have unique pharmacokinetics, which may lead to accumulation of certain drugs when adult horse dosage regimens are used. Given its lipophilic nature and requirement for hepatic metabolism, metronidazole may be one of these drugs. The purpose of this study was to determine the pharmacokinetic profiles of metronidazole in twelve healthy foals at 1-2.5 days of age when administered as a single intravenous (IV) and intragastric (IG) dose of 15 mg/kg. Foals in the intravenous group were studied a second time at 10-12 days of age to evaluate the influence of age on pharmacokinetics within the neonatal period. Blood samples were collected at serial time points after metronidazole administration. Metronidazole concentration in plasma was measured using LC-MS. Pharmacokinetic parameters were determined using noncompartmental analysis and compared between age groups. At 1-2.5 days of age, the mean peak plasma concentration after IV infusion was 18.79 ± 1.46 µg/mL, elimination half-life was 11.8 ± 1.77 h, clearance was 0.84 ± 0.13 mL/min/kg and the volume of distribution (steady-state) was 0.87 ± 0.07 L/kg. At 10-12 days of age, the mean peak plasma concentration after IV infusion was 18.17 ± 1.42 µg/mL, elimination half-life was 9.07 ± 2.84 h, clearance was 1.14 ± 0.21 mL/min/kg and the volume of distribution (steady-state) was 0.88 ± 0.06 L/kg. Oral approximated bioavailability was 100%. Cmax and Tmax after oral dosing were 14.85 ± 0.54 µg/mL and 1.75 (1-4) h, respectively. The elimination half-life was longer and clearance was reduced in neonatal foals at 1-2.5 days as compared to 10-12 days of age (P = 0.006, P = 0.001, respectively). This study warrants consideration for altered dosing recommendations in foals, especially a longer interval (12 h).

Comparison of hematologic variables among Warmbloods, Thoroughbreds, and Western stock horse breeds.

BACKGROUND: Hematology is a diagnostic tool used to evaluate the health status of horses. However, breed differences are often not considered. OBJECTIVES: The objective was to compare complete blood count variables among Warmbloods, Thoroughbreds, and stock horses (SH). METHODS: Ninety-six healthy horses were grouped by breed (Warmbloods, Thoroughbreds, and SH). Samples were collected through venipuncture for complete blood count analysis. One-way ANOVA with Tukey's tests or Kruskal-Wallis with Dunn's post hoc tests were used to compare hematologic variables among groups. RESULTS: Warmbloods had a significantly lower total white blood cell (WBC) count (6.08 ± 1.11 × 109/L) and lymphocyte count (1.76 ± 0.41 × 109/L) than Thoroughbreds (7.28 ± 1.45; 2.28 ± 5.16 × 109/L, respectively; P < .001) and SH (7.21 ± 1.18 × 109/L, P < .01; 2.10 ± 5.17 × 109/L; P < .05). Warmbloods had a significantly lower red blood cell count (7.7 ± 0.8 × 1012/L) and higher mean corpuscular volume (MCV, 49.4 ± 2.2 fL) than Thoroughbreds (8.42 ± 1.2 × 1012/L, P < .01; 47.3 ± 3.0 fL). Warmbloods had lower MCVs than SH (49.4 ± 2.2 vs 51.2 ± 2.6 fL). The mean cell hemoglobin concentration (MCHC) was higher in Warmbloods (35.0, 33.8-36.2 g/dL) and Thoroughbreds (34.9, 33.4-35.7 g/dL) than in SH breeds (34.0, 33.4-35.4 g/dL; P < .001, both). Total protein concentrations were significantly lower in Thoroughbreds (67, 59-80 g/L) compared with SH (71, 64-83 g/dL) (P < .05). CONCLUSIONS: Warmbloods had decreased WBC and lymphocyte counts compared with Thoroughbreds and SH, and Thoroughbreds had increased red blood cell counts. Thoroughbreds had lower total protein concentrations than SH. Clinicians should consider breed differences when interpreting hematologic values.

Pharmacokinetics and preliminary safety evaluation of azithromycin in adult horses.

Azithromycin is widely used in foals but has not been studied in adult horses. The goals of this study were to determine the pharmacokinetic profile and to make a preliminary assessment of the safety of azithromycin in adult horses. Azithromycin was administered intravenously (5 mg/kg) and intragastrically (10 mg/kg) to six healthy mares in a crossover design. Serial plasma samples, blood neutrophils, and pulmonary macrophages were collected for the measurement of azithromycin concentrations. Azithromycin was also administered orally (10 mg/kg) once a day for 5 days to five healthy mares for preliminary evaluation of safety in adult horses. The bioavailability of azithromycin following intragastric administration was 45 ± 12%. Concentrations within peripheral neutrophils and bronchoalveolar macrophages were several fold higher than that of plasma. Mild decreases in appetite (n = 3) and alterations in fecal consistency (n = 3) were noted following repeated oral administration. The pharmacokinetic profiles of azithromycin in adult horses, especially the slow elimination rate and intraneutrophil and intrapulmonary macrophage accumulation, demonstrate that it is conducive to use in this age group. Because of the gastrointestinal alterations noted, further studies are warranted before azithromycin can be recommended for use in adult horses.

Congenital cardiac defects in neonatal foals: 18 cases (1992-2007).

BACKGROUND: Literature available regarding congenital cardiac defects in foals is limited to reports of individual cases or small case series. OBJECTIVE: To describe the clinical, echocardiographic, and necropsy findings and breed predilection of congenital cardiac defects in neonatal foals. ANIMALS: Eighteen foals < 15 days of age with 1 or more congenital cardiac defects. METHODS: Medical records of foals diagnosed with congenital cardiac defects at the William R. Pritchard Veterinary Medical Teaching Hospital were reviewed. Data collected included history, signalment, clinical signs, laboratory data, diagnostic and necropsy results, and outcome. RESULTS: Arabian foals represented 39% of cases with congenital cardiac defects and were significantly (P = .004) overrepresented (OR = 4.7 [CI: 1.8-12.4]) compared with the general hospital population. Ventricular septal defect (VSD) (14/18), tetralogy of Fallot (5/18), and tricuspid valve atresia (4/18) were the most common defects identified. A > or = 3/6 heart murmur (14/ 14) accompanied by tachycardia (14/17), tachypnea (17/17), and cyanosis of mucous membranes (7/16) were the most common clinical signs. Concurrent congenital defects were common (9/18). Two foals, both with VSD, survived for > or = 8 years after diagnosis and 1 was a successful performance horse. CONCLUSIONS AND CLINICAL RELEVANCE: Arabian horses appear to have a predisposition for cardiac defects. The presence of a loud murmur (> or = 3/6), cyanotic membranes, and tachycardia or tachypnea in a neonatal foal should warrant thorough evaluation of the heart for congenital defects. Foals with cardiac defects should be closely evaluated for concurrent congenital defects in other body systems.

Pharmacokinetics of multiple doses of chloramphenicol in fed adult horses.

To the authors' knowledge, there have been no studies evaluating the pharmacokinetics of chloramphenicol administered orally to horses at the currently recommended dose of 50 mg/kg PO q6 h for multiple days. The published antimicrobial susceptibility breakpoint is 8.0 ug/mL; it is unknown if this concentration is achievable at the recommended dose rate in horses. The aim of this prospective multi-dose pharmacokinetic study was to perform pharmacokinetic analysis of chloramphenicol after multiple doses. The authors hypothesize that the antimicrobial susceptibility breakpoint will not be reached. Seven healthy adult horses were administered 50 mg/kg chloramphenicol base tablets PO q6 h for 4 days. Blood was collected via venipuncture daily at 4 and 6 h after administration for the first 15 doses. After the 16th dose, an IV catheter was aseptically placed in the right jugular vein and blood was collected at regular intervals for pharmacokinetic analysis. Maximum chloramphenicol concentration was variable between horses (2.1-42.7 µg/mL). The highest average chloramphenicol concentration was just below the susceptibility breakpoint at 7.7 ug/mL while the lowest was well below the breakpoint at 1.5 ug/mL. On average, the time above 8.0 µg/mL was 75 min, considerably less than the recommended 50% of the dosing interval. When chloramphenicol is administered at a dose of 50 mg/kg PO q6 h in horses, the highest reliably achievable steady state concentration for at least half of the dosing interval is 2.0 µg/mL. The established susceptibility breakpoint of 8.0 ug/mL is not achievable in adult horses, and should be re-evaluated.

Diagnosis and treatment of confirmed and suspected primary hyperparathyroidism in equids: 17 cases (1999-2016).

BACKGROUND: Primary hyperparathyroidism is uncommon in equids. OBJECTIVES: To describe the diagnostic findings and efficacy of treatment in equids with primary hyperparathyroidism. STUDY DESIGN: Retrospective case series describing 16 horses and one mule. METHODS: Cases were identified by retrospective review of records at Cornell University and via an ACVIM listserv query. Inclusion criteria were an equid with hypercalcemia, normal renal function and high parathyroid hormone (PTH) or histopathological diagnosis of a parathyroid adenoma. Equids with normal PTH and PTH-related protein (PTHrP) in the face of hypercalcemia were included as suspect cases. RESULTS: The most common presenting complaints were weight loss (12/17) and hypercalcemia (10/17). PTH was above reference range in 12/17 cases. Suspected parathyroid tumours were localised in 12/14 equids imaged using ultrasonography alone (2/3), technetium 99m Tc sestamibi scintigraphy alone (1/1) or both modalities (9/10). Three horses did not have imaging performed. Surgical exploration successfully excised tumours in six of 10 cases. Five were located at the thoracic inlet, and surgery resulted in complete cure. One tumour was excised from the thyroid lobe, and the horse remained hypercalcemic. Four other cases explored surgically, four treated medically and three that were not treated also remained hypercalcemic. MAIN LIMITATIONS: The small study size prohibited statistical analysis. CONCLUSIONS: Parathyroid adenomas in equids can be successfully localised with ultrasonography and scintigraphy. Surgical excision appears more likely to be successful for single gland disease at the thoracic inlet.

Malignant hyperthermia associated with ryanodine receptor 1 (C7360G) mutation in Quarter Horses.

BACKGROUND: Anesthetic-induced malignant hyperthermia (MH) has been documented in Quarter Horses with a single point mutation in the ryanodine receptor 1 gene (RyR1) at nucleotide C7360G, generating a R2454G amino acid substitution. However, there have been no reports of nonanesthetic manifestations of MH in horses with the C7360G mutation. OBJECTIVE: To describe clinical manifestations of Quarter Horses with the C7360G mutation. ANIMALS: Eleven Quarter Horses with the RyR1 C7360G mutation. METHODS: This prospective study included horses with suspected MH, undetermined etiology of sudden death, death within hours of onset of rhabdomyolysis, muscle rigidity, stiffness, intermittent sweating, and persistent increases in serum muscle enzyme activities. Whole blood in EDTA and skeletal muscle were processed for genetic and histochemical analysis. Medical records and pedigrees were collected when available. RESULTS: Both anesthetic- and non-anesthetic-associated myopathic manifestations of MH occurred in halter Quarter Horses with mutation of RyR1. The disease is inherited as an autosomal dominant trait. Clinical and laboratory abnormalities were similar in both forms. Rhabdomyolysis was a common finding in both groups of horses. Skeletal muscle histochemical findings were nonspecific and compatible with a noninflammatory myopathic process. CONCLUSIONS AND CLINICAL IMPORTANCE: MH is a potentially fatal disease of Quarter Horses that could be triggered by halogenated anesthetics and other nonanesthetic factors that may include exercise, stress, breeding, illnesses, and concurrent myopathies.

Clinical presentation, diagnostic findings, and outcome of adult horses with equine coronavirus infection at a veterinary teaching hospital: 33 cases (2012-2018).

Equine coronavirus (ECoV) is a recently described enteric virus with worldwide outbreaks; however, there are little data available on clinical presentation, diagnosis, and outcome. The study objective was to document case management of ECoV in adult horses presented to a referral hospital and compare to a cohort of horses that tested negative for ECoV. A retrospective case series was performed based on positive real-time quantitative PCR results for ECoV on faeces from horses treated at the UC Davis Veterinary Medical Teaching Hospital from 1 March 2012 to 31 March 2018. Horses negative for ECoV were matched to the ECoV-positive group as controls. Data collected included signalment, history, exam findings, diagnostics, treatment, and follow-up. Thirty-three horses (median age, 11 years; range, 2-37 years) tested ECoV-positive, including three horses with co-infections. Presenting complaints for ECoV-infected horses included historic fevers (n = 25/30; 83%), anorexia (n = 14/30; 47%), and colic (n = 13/30; 43%). ECoV-positive horses had significantly lower white blood cell (median, 3.0 × 109/L; range, 0.68-16.2 × 109/L), neutrophil (median, 1.26 × 109/L; range, 0.15-14.4 × 109/L), and lymphocyte (median, 0.86 × 109/L; range, 0.42-3.47 × 109/L) counts than ECoV-negative horses. Electrolyte and metabolic derangements and scant faeces were common. Twenty-seven horses were hospitalised for a median of 5 days (range, 0.5-14 days), with 26/27 (96%) horses surviving to discharge. ECoV infection should be a differential diagnosis for adult horses with fever, colic, anorexia, and leukopenia. The disease has a low mortality rate, but horses may require intensive care to resolve severe leukopenia, systemic inflammation, and metabolic disturbances.

Effects of age on serum glucose and insulin concentrations and glucose/insulin ratios in neonatal foals and their dams during the first 2 weeks postpartum.

Maintaining serum glucose concentrations is critical in neonatal foals and is often dysregulated in illness; however, few studies have assessed the effects of age, or variation of glucose and insulin, in neonates and their postpartum dams. This study aimed to serially evaluate serum glucose and insulin concentrations and glucose/insulin (G/I) ratios in seven healthy foals and their dams immediately postpartum and at 1-2 and 10-12days of age. The hypotheses were that: (1) there would be wide temporal variation in hourly glucose and insulin measurements among foals; and (2) measured parameters in foals would differ from those of postpartum mares. Pre-suckle glucose concentrations were lower than post-suckle (5.15±1.61mmol/L and 7.16±3.13mmol/L, respectively, P=0.0377). Glucose remained >5mmol/L but varied hourly by up to 4.22mmol/L and 2.93mmol/L for individual foals 1-2 and 10-12days old, respectively. There were no significant changes in insulin over time (median 8.50 [4.32-18.4]µU/mL, 1-2days old) in foals. The maximum hourly variation of insulin for an individual foal was 7.53µU/mL and 14.78µU/mL (1-2days and 10-12days old, respectively). Glucose/insulin ratios increased from pre- and post-suckle to the 1-2days old period, with no significant changes thereafter. Mares had highest glucose and insulin concentrations and lowest G/I ratios immediately postpartum compared to later time points and to foals (median 7.37 [range, 4.34-8.78]mmol/L, median 30.94 [range, 20.35-49.20]µU/mL, 4.3 [2.43-7.04], respectively). In conclusion, neonatal foals exhibited wide variation in serum glucose and insulin concentrations but were not hypoglycemic. Mares developed transient insulin resistance in the immediate post-partum period.

Enterococcus infections in foals.

Enterococci have been increasing in prevalence in foal sepsis over the past three decades. There are no published studies in the peer-reviewed literature documenting common sites of infection, antimicrobial susceptibility, or outcome specifically associated with enterococcal infections in foals. Our objectives were to evaluate the sites of origin, antimicrobial susceptibility, and survival outcome to discharge in foals with enterococcal infections compared with foals with sepsis of another bacterial etiology. Seventy-five foals 0-30 days of age with cultures positive for Enterococcus and 170 control foals 0-30 days of age with cultures positive for other bacteria were included. Enterococcus was 2.67 times (95% confidence interval [CI], 1.49-4.80; P = 0.0012) more likely to be isolated from the lower urogenital tract of foals than were other bacteria. Enterococci were less likely to be isolated from blood cultures than other bacteria, with an odds ratio (OR) of 0.17 (95% CI 0.09-0.35; P < 0.0001). For Enterococcus isolates, 48% (n = 29/61) had a multiple antimicrobial resistance (MAR) index of ≥30% and 46% (n = 28/61) had a multiple drug resistance (MDR) index of ≥30%. Foals with enterococcal infections were less likely to survive to discharge (49.9% vs. 63.5%; P = 0.03). Enterococcus is commonly isolated from the lower urogenital tract of foals, is often multidrug resistant, and foals with enterococcal infections were less likely to survive. Multidrug resistance is common among enterococcal isolates, and therefore antimicrobial susceptibility testing of cultured isolates is warranted.

Blood glucose concentrations in critically ill neonatal foals.

REASONS FOR PERFORMING STUDY: Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with nonsurvival. Hypoglycemia is also seen in critically ill humans, and is associated with nonsurvival. This might also be true in the critically ill foal. OBJECTIVES: To investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS). METHODS: Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95), 48 hours (82), and 60 hours (45) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS. RESULTS: 29.1% of foals had blood glucose concentrations within the reference range (76-131 mg/dL) at admission, 36.5% were hyperglycemic, and 34.4% were hypoglycaemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the 1st 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations <2.8 mmol/L (50 mg/dL) or >10 mmol/L (180 mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS. CONCLUSIONS AND POTENTIAL RELEVANCE: Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation.

Actinomyces species as a cause of abscesses in nine horses.

The characteristics, history, clinical signs, treatment and outcome of nine horses with abscesses caused by Actinomyces species were reviewed. dna sequencing was used to determine the species of one of the isolates. The horses were one to 11 years of age, and the abscesses were most commonly located in the submandibular and retropharyngeal regions. The bacterium was usually cultured as the sole isolate and the horses were most often affected in the autumn. Most of the abscesses were treated with antimicrobials and drainage, but some of them recurred. The horses with submandibular abscesses had residual scar tissue that in some cases did not resolve.

Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates.

BACKGROUND: The original equine sepsis score provided a method of identifying foals with sepsis. New variables associated with sepsis have been evaluated, but the sepsis score has not been updated. OBJECTIVES: To evaluate the sensitivity and specificity of 2 updated sepsis scores and the systemic inflammatory response syndrome (SIRS) criteria in regard to detecting sepsis in foals. ANIMALS: Two-hundred and seventy-three ill foals and 25 healthy control foals. METHODS: Historical, physical examination, and clinicopathologic findings were used to calculate the original sepsis score and 2 updated sepsis scores. SIRS criteria were also evaluated. Sepsis scores and positive SIRS scores were statistically compared to foals with sepsis. RESULTS: One-hundred and twenty-six foals were septic and 147 sick-nonseptic. The original and updated sepsis scores were significantly higher in septic foals as compared to sick-nonseptic and healthy foals. The sensitivity and specificity of the updated sepsis scores to predict sepsis were not significantly better than those of the original sepsis score. One-hundred and twenty-seven of 273 (46.5%) foals met the original SIRS criteria and 88/273 (32%) foals met the equine neonatal SIRS criteria. The original SIRS criteria had similar sensitivity and specificity for predicting sepsis as did the 3 sepsis scores in our study. CONCLUSIONS AND CLINICAL IMPORTANCE: The updated sepsis scores did not provide improved ability in predicting sepsis. Fulfilling the original SIRS criteria provided similar sensitivity and specificity in predicting sepsis as the modified sepsis score and might serve as a diagnostic aid in identifying foals at risk for sepsis.

Bacteraemia in neonatal foals: clinicopathological differences between Gram-positive and Gram-negative infections, and single organism and mixed infections.

REASONS FOR PERFORMING STUDY: Treatment for bacteraemia in foals must be started before the identity of the causative organism is known. Information aiding selection of effective antimicrobials should improve outcome. OBJECTIVES: To describe differences in clinical and clinicopathological data and outcome in foals with bacteraemia due to different classes of bacteria. METHODS: Records of foals with a positive blood culture, age < 10 days and presenting to a university hospital 1995-2004, were reviewed. Bacterial culture results, subject details, historical information, physical examination findings at admission and clinicopathological data generated during the first 48 h of hospitalisation were analysed. Results from foals with Gram-positive or Gram-negative organisms, single or mixed organism bacteraemias, and with bacteraemia due to 3 commonly isolated organisms were compared. RESULTS: Eighty-five foals met the inclusion criteria. Gram-negative organisms (n = 59) Gram-positive organisms (n = 13) or multiple organisms (n = 19) were cultured from individual foals. Foals with Gram-negative bacteraemia had lower total white blood cell and lymphocyte counts at admission than did those from which only Gram-positive bacteria were cultured. Mixed organism bacteraemia was associated with tachycardia, increased serum concentrations of sodium, chloride and urea nitrogen, acidosis, respiratory distress, recumbency on admission and nonsurvival. Actinobacillus spp. infections were associated with leucopenia, neutropenia, lymphopenia and depression on hospital admission. CONCLUSIONS AND POTENTIAL RELEVANCE: Recognising particular patterns of clinical and clinicopathological findings associated with infection with specific groups of bacteria may, in the future, aid antimicrobial selection and influence prognosis in bacteraemic foals.

Triglyceride concentrations in neonatal foals: Serial measurement and effects of age and illness.

Few studies have evaluated the effects of age and illness on serum triglyceride concentrations in neonatal foals. The objectives of this study were to evaluate triglyceride concentrations in neonatal foals and their dams through serial measurement immediately postpartum and at 1-2 days and 10-12 days of age, as well as to measure them in sick foals. Serially measured serum triglycerides in seven healthy foals varied with age. Median (range) triglyceride concentrations were 28mg/dL (12-50mg/dL), 89mg/dL (51-264mg/dL), and 60mg/dL (28-135mg/dL) immediately postpartum, at 1-2 days of age, and 10-12 days of age, respectively (P<0.001). Triglyceride concentrations varied hourly by up to 117mg/dL in individual foals. The dams had lower triglycerides (median, 20mg/dL; range, 12-49mg/dL) than the foals, once foals were >24h old. Sick foals <24h old had lower triglycerides than sick foals aged 1-7 days (median, 41mg/dL [range, 16-116]; median, 110mg/dL [range, 24-379mg/dL]; P<0.001). Age and triglyceride concentration showed a non-linear association independent of foal health status (P=0.01). Sick foals with positive bacterial cultures had higher triglycerides than those with negative cultures (median, 111mg/dL [range, 10-379mg/dL] and median 53mg/dL [range, 17-271mg/dL], respectively; P=0.033). Nonsurvivors had higher triglycerides than survivors (median, 116mg/dL [range, 41-379mg/dL] and median, 55mg/dL [range, 10-311mg/dL], respectively; P=0.04). In conclusion, triglycerides were highest in healthy neonatal foals aged 1-2 days, and in nonsurviving sick foals and those with positive bacterial cultures. Age was associated with triglyceride concentration regardless of health status.

Assessment of quantitative polymerase chain reaction for equine herpesvirus-5 in blood, nasal secretions and bronchoalveolar lavage fluid for the laboratory diagnosis of equine multinodular pulmonary fibrosis.

REASONS FOR PERFORMING STUDY: The ante mortem diagnosis of equine multinodular pulmonary fibrosis (EMPF) relies on histopathological results and polymerase chain reaction (PCR)-positive equine herpesvirus (EHV)-5 testing of lung tissue. Polymerase chain reaction detection of EHV-5 in bronchoalveolar lavage fluid (BALF) is commonly used to support a diagnosis of EMPF. However, the diagnostic power of EHV-5 testing on BALF and other biological samples such as blood and nasal secretions has yet to be shown to support a diagnosis of EMPF. OBJECTIVES: To determine the frequency of detection and the viral loads of EHV-5 by quantitative PCR (qPCR) in blood, nasal secretions and BALF from horses confirmed with EMPF, healthy horses and horses with non-EMPF pulmonary diseases. STUDY DESIGN: Prospective study. METHODS: The study population consisted of 70 adult horses divided into 4 groups based on a combination of clinical findings, cytology of BALF, imaging studies of the thoracic cavity and histopathology of pulmonary tissue: control group (n = 14), EMPF group (n = 11); inflammatory airway disease group (n = 32); and non-EMPF interstitial lung disease group (n = 13). For each horse, whole blood, nasal secretions and BALF were available for EHV-5 qPCR testing. Sensitivities, specificities and their respective 95% confidence intervals were calculated for viral loads from blood, nasal secretions and BALF. In addition, these measures were calculated for combined use of blood and nasal secretions. RESULTS: The detection of EHV-5 in BALF was strongly associated with EMPF (sensitivity 91%, specificity 98.3%). Detection of EHV-5 in blood was, independent of the viral loads, strongly associated with EMPF with a sensitivity of 91% and specificity of 83.1%. The detection of EHV-5 in nasal secretions displayed the highest sensitivity (72.7%) and specificity (83.1%) at a level of >245,890 glycoprotein B target genes/million cells to support a diagnosis of EMPF. Dually positive blood and nasal secretions at any viral loads in support of EMPF yielded a sensitivity and specificity of 90% and 89.8%, respectively. CONCLUSIONS: Although histopathological confirmation (lung biopsy) is considered the gold standard for EMPF diagnosis, results of qPCR testing of BALF or a combination of whole blood and nasal secretions should be regarded as clinically useful in support of this diagnosis. The latter testing may be relevant when dealing with horses in respiratory distress, for which invasive procedures such as BALF collection or lung biopsies may be detrimental to their health.

Multicentric T-cell lymphosarcoma in an alpaca.

A two-year-old female alpaca with multicentric lymphosarcoma presented because of progressive weakness and recumbency. The diagnosis of lymphosarcoma was based on the detection of immature and atypical lymphocytes in a lumbosacral CSF sample. Post mortem examination confirmed multicentric lymphosarcoma involving multiple organs. Immunophenotyping using cross reactive T- and B-cell antibodies characterized the tumour as a T-cell lymphosarcoma.

Idiopathic immune-mediated polysynovitis in three horses.

This paper describes the clinical, laboratory and histological findings in three horses with immune-mediated polysynovitis; they had lost weight, suffered intermittent fever, were lethargic and stiff, and had effusions in several joints. Laboratory abnormalities included anaemia, leucocytosis, hyperfibrinogenaemia and hyperglobulinaemia. The diagnosis was based on the presence of a suppurative, non-septic inflammation in at least two different joints in each of the horses and the presence of immunoglobulins in the synovial membrane of one of them. The horses were treated with a combination of dexamethasone and azathioprine, and responded well to the initial treatment. Twenty months after its last re-evaluation, the first horse was being maintained on azathioprine because similar clinical signs had recurred after the cytotoxic drug was discontinued; the second horse was finishing a tapering course of prednisolone 15 months after its first examination, and the third horse was euthanased five months after it was first examined as a result of an unrelated injury.

Atrial Fibrillation in Eight New World Camelids.

BACKGROUND: There is limited information on the incidence of clinical signs, concurrent illness and treatment options for atrial fibrillation (AF) in New World Camelids (NWC). OBJECTIVE: Describe clinical signs and outcome of AF in NWC. ANIMALS: Eight New World Camelids admitted with AF. METHODS: A retrospective observational study of camelids diagnosed with AF based on characteristic findings on electrocardiogram (ECG). RESULTS: All animals had an irregularly irregular heart rhythm detected on physical examination and 4 cases had obtunded mentation on admission. Three camelids were diagnosed with AF secondary to oleander intoxication, 3 animals had underlying cardiovascular disease, 1 was diagnosed with lone AF and 1 had AF diagnosed on examination for a urethral obstruction. Five of eight animals survived to discharge and nonsurvivors consisted of animals which died or were euthanized as a result of cardiovascular disease (2/8) or extra-cardiac disease unrelated to the AF (1/8). CONCLUSIONS AND CLINICAL IMPORTANCE: Atrial fibrillation occurs in NWC in association with cardiovascular disease, extra-cardiac disease or as lone AF. Amiodarone and transthoracic cardioversion were attempted in one llama with lone AF, but were unsuccessful. Atrial fibrillation was recorded in 0.1% of admissions.