The efficacy, safety and acceptability of emergency embedded Psychiatry Assessment and Planning Units: An evaluation of Psychiatry Assessment and Planning Units in close proximity to their associated emergency departments.

OBJECTIVE: To determine the efficacy, safety and acceptability as well as the patient demographics of three newly developed emergency department-embedded Psychiatric Assessment and Planning Units located in Metropolitan Melbourne at Austin, Peninsula and Eastern Health Services. METHODS: The evaluation reviewed a 12-month period of service activity from 1 September 2017 to 31 August 2018, when all three Psychiatric Assessment and Planning Units services were operational. A 12-month period from 1 September 2014 to 31 August 2015 was compared as the pre-Psychiatric Assessment and Planning Units period. Mixed qualitative and quantitative methods were used. This included semi-structured interviews of 30 Psychiatric Assessment and Planning Units patients and 30 emergency department staff (10 of each for all 3 sites), patient survey, statistical analysis of Client Management Interface data for the emergency department and related Psychiatric Assessment and Planning Units as well as audit of RISKMAN registers. RESULTS: There were 365 Austin, 567 Eastern and 791 Peninsula Psychiatric Assessment and Planning Units admissions. Psychiatric Assessment and Planning Units were generally well accepted by patients and emergency department staff, relatively safe, operating within the Key Performance Indicators with mixed effect on emergency department flow. Austin emergency department processing times improved post-Psychiatric Assessment and Planning Units (4 hours 57 minutes to 4 hours 19 minutes; p < 0.001) while deteriorating at Eastern and Peninsula. Adjustment Disorder and Depression and Borderline Personality Disorder were the most common admission diagnoses. While the Psychiatric Assessment and Planning Units had mixed utility on emergency department processing times, they appear to serve a demographic not previously accommodated in traditional emergency department psychiatry models. CONCLUSION: The emergency department-embedded Psychiatric Assessment and Planning Unit model of care appears effective on some measures, safe and acceptable to patients and staff. The Psychiatric Assessment and Planning Units seem to service a group not previously accommodated in traditional emergency psychiatry models.

Identification of modifiable factors associated with owner-reported equine laminitis in Britain using a web-based cohort study approach.

BACKGROUND: Equine laminitis is a complex disease that manifests as pain and lameness in the feet, often with debilitating consequences. There is a paucity of data that accounts for the multifactorial nature of laminitis and considers time-varying covariates that may be associated with disease development; particularly those that are modifiable and present potential interventions. A previous case-control study identified a number of novel, modifiable factors associated with laminitis which warranted further investigation and corroboration. The aim of this study was to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors previously identified in the case-control study. RESULTS: Self-selected horse/pony owners in GB submitted initial baseline and follow-up health and management questionnaires for 1070 horses/ponies between August 2014 and December 2016. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary-diagnosed episodes of active laminitis using a previously-validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with the previous case-control study, a prior history of laminitis (particularly non-veterinary-diagnosed episodes), soreness after shoeing/trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel, and require further investigation to explore their relationship with laminitis and their applicability as potential interventions. CONCLUSIONS: This study has demonstrated a temporal relationship between a number of horse- and management-level factors and laminitis, identifying potential interventions and important risk groups for which these interventions would be of particular importance. These results serve as a sound evidence-base towards the development of strategic recommendations for the horse/pony-owning population to reduce the rate of laminitis in GB.

Untangling the stranglehold through mathematical modelling of Streptococcus equi subspecies equi transmission.

Strangles, a disease caused by infection with Streptococccus equi subspecies equi (S. equi), is endemic worldwide and one of the most frequently diagnosed infectious diseases of horses. Recent work has improved our knowledge of key parameters of transmission dynamics, but important knowledge gaps remain. Our aim was to apply mathematical modelling of S. equi transmission dynamics to prioritise future research areas, and add precision to estimates of transmission parameters thereby improving understanding of S. equi epidemiology and quantifying the control effort required. A compartmental deterministic model was constructed. Parameter values were estimated from current literature wherever possible. We assessed the sensitivity of estimates for the basic reproduction number on the population scale to varying assumptions for the unknown or uncertain parameters of: (mean) duration of carriership (1∕γC), relative infectiousness of carriers (f), proportion of infections that result in carriership (p), and (mean) duration of immunity after natural infection (1∕γR). Available incidence and (sero-)prevalence data were compared to model outputs to improve point estimates and ranges for these currently unknown or uncertain transmission-related parameters. The required vaccination coverage of an ideal vaccine to prevent major outbreaks under a range of control scenarios was estimated, and compared available data on existing vaccines. The relative infectiousness of carriers (as compared to acutely ill horses) and the duration of carriership were identified as key knowledge gaps. Deterministic compartmental simulations, combined with seroprevalence data, suggest that 0.05

Effect of speed and water depth on limb and back kinematics in Thoroughbred horses walking on a water treadmill.

Water treadmill (WT) exercise may induce limb and back kinematics that meet specific training and rehabilitation goals. The study aimed to investigate the effects of walk speed, at different water depths (WDs), on limb and back kinematics of six Thoroughbreds exercising on a WT. Horses walked at 2.8/4.3/5.5/6.0 km/h (i.e. 0.8/1.2/1.5/1.7 m/s) at dry, metacarpophalangeal and carpal WD. Videography captured limb movement in the sagittal plane. Motion-capture measured thoracolumbosacral flexion-extension (FE), and lateral bend (LB) ranges of movement (ROM) using skin surface markers on the sixth, tenth, thirteenth, eighteenth thoracic, third and fifth lumbar, and third sacral spinous processes. Inertial-motion-sensors measured poll, withers and pelvic displacements. Following preliminary univariable analyses, multivariable mixed-effects linear-regression analyses were used to examine the relationship between speed, WD and each outcome variable (P < 0.05). Peak metacarpophalangeal, carpal and tarsal joint flexion increased with speed (P ≤ 0.002) and depth combined (P 0.001) while peak metatarsophalangeal flexion increased with WD only (P 0.001). Thoracolumbar FE-ROM between T10 and L3 and hindlimb retraction was increased by speed and WD combined (P 0.001). Hindlimb protraction was increased by speed (P 0.001) while hindlimb retraction was increased by speed and WD combined (P 0.001). Dorsoventral poll displacement was increased by speed (P 0.001) and carpal WD (P = 0.013), craniocaudal poll displacement was increased by speed and WD combined (P 0.001). Pelvic (tubera coxae and sacrum) dorsoventral displacements increased with speed and WD combined (P 0.001). Understanding the effects of speed and WD on limb, back and pelvic kinematics will improve decision making relating to dry and WT exercise within training.

The gene expression response of the catadromous perciform barramundi Lates calcarifer to an acute heat stress.

The acute heat-shock response of the tropical estuarine fish species barramundi Lates calcarifer as indicated by the expression of genes within stress (hsp 90AA, hsp 90AB, hsp 70 and hsc 70), metabolic (cisy, cco II and ldh) and growth (igf1 and mstn 1) related pathways was examined following an increase in water temperature from 28 to 36° C over 30 min. Lates calcarifer were maintained at the acute stress temperature of 36° C for 1 h before being returned to 28° C and allowed to recover at this temperature for a further 2 weeks. Muscle tissue sampling over the experimental period allowed for the expression quantification of stress, metabolic and growth-related genes via quantitative real-time polymerase chain reaction (qrt-PCR) where a robust and reliable normalization approach identified both α-tub and Rpl8 as appropriate genes for the analysis of gene expression in response to an acute heat stress. hsp90AA and hsp70 of the inducible heat-shock response pathway showed a massive up-regulation of gene expression in response to heat stress, whilst the constitutive heat-shock genes hsp90AB and hsp70 showed no change over the course of the experiment and a small increase after 2 weeks of recovery, respectively. Of the three genes representing the metabolic pathway (cisy, cco II and ldh) only cco II changed significantly showing a decrease in gene expression, which may suggest a small suppression of aerobic metabolism. igf1 of the growth pathway showed no significant differences in response to an acute heat stress, whilst mstn1 increased at the beginning of the heat stress but returned to basal levels soon after. Overall, the results demonstrate that an acute heat stress in L. calcarifer caused a significant increase in the expression of genes from the stress response pathway and a possible decrease in aerobic metabolism with only relatively minor changes to the growth pathway highlighting the hardy nature of L. calcarifer and its resilience in coping with sudden temperature changes routinely encountered within its natural environment.

Making use of equine population demography for disease control purposes: preliminary observations on the difficulties of counting and locating horses in Great Britain.

Detailed knowledge of horse populations can better facilitate effective control of equine diseases. Preliminary studies were undertaken to ascertain the type of information held on the UK's National Equine Database (NED) and to determine the geographical resolution at which mandatorily recorded owner addresses might be a suitable proxy for predicting horse locations. Results indicated that relatively few UK passport-issuing organisations requested details of where horses were kept in addition to owner address details. Examination of data on 1440 horses held on an Animal Health Trust syndromic surveillance database showed that 90% of them were kept within 10 km of their owners. While owner location may provide an indication of where most horses are kept, further work is also needed to evaluate the usefulness of NED as an epidemiological resource in future equine disease control measures.

Molecular characterisation of 'strangles' outbreaks in the UK: the use of M-protein typing of Streptococcus equi ssp. equi.

REASONS FOR PERFORMING STUDY: Strangles is the most commonly diagnosed and important infectious disease of horses worldwide. Very little is known about the temporo-spatial and molecular epidemiology of strangles. The disease is not notifiable in the UK and there are few published data on the geographical locations of outbreaks. OBJECTIVE: To investigate whether typing of a surface protein (SeM) of Streptococcus equi ssp. equi (S. equi), the causative agent of strangles, is a useful epidemiological tool. METHODS: The variable region of the SeM gene was amplified from 145 isolates of S. equi by PCR and sequenced. Different SeM gene alleles were assigned based on the SeM database, grouped into phylogenetic clusters using split decomposition analysis and plotted against the submitting veterinary practices. RESULTS: In this study 21 S. equi SeM alleles were found, including 9 previously unidentified alleles and representing 4 phylogenetic groups. S. equi containing SeM alleles 9 and 7 were the most commonly isolated and there was a high number of low frequency alleles. The occurrence of an outbreak cluster in the north-west of the UK is also reported. CONCLUSIONS: Strangles outbreaks can be differentiated on the basis of their SeM allele sequences. The data provide further evidence of SeM mutation leading to the emergence of novel, but related SeM alleles that are geographically linked. Sequencing of the SeM gene is a useful tool for the elucidation of strangles epidemiology at a regional and a national level. POTENTIAL RELEVANCE: This technique may allow differentiation or linkage of strangles outbreaks and as such may be an effective tool for local as well as national and international disease surveillance.

Preliminary Investigation of the Dosimetric Properties of 'RadGel'

A preliminary investigation into the efficacy of a new 3D dosimetry material, RadGel™, for verification of radiation therapy dose distributions is presented. Small volumes of RadGel™ were found to exhibit a linear, reproducible response to dose. A gradual increase in optical-density (OD) with time was observed, suggesting scanning should be completed within 18 hours to keep a linear correlation of R(2) > 0.99. A larger 10 cm diameter volume of RadGel™ was irradiated with a rotationally symmetric "spoke" plan designed to rigorously evaluate scanner/dosimeter combined performance. The dosimeter was imaged with the Duke Mid-sized Optical-CT Scanner (DMOS). Promising OD and corresponding dose maps were obtained. Edge artefacts were observed and are suspected to be exacerbated by the particular container used in this early study. Further studies will evaluate new containers and methods for refractive matching at the gel-container-fluid interface.

Factors associated with euthanasia in horses and ponies enrolled in a laminitis cohort study in Great Britain.

Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis in GB. Self-selected horse/pony owners submitted regular management and health data over 29 months and reported dates and reasons for euthanasia during this period. The overall incidence of euthanasia was estimated and associated factors were identified using multivariable Cox regression modelling, adjusted for age, with variables retained in the final model if P ≤ 0.05. Data were available for 1070 horses/ponies contributing 1093 horse-years at risk (HYAR), with 80 owner-reported euthanasias. The incidence of euthanasia was 7.3 euthanasias per 100 HYAR (95 % confidence interval [CI] 5.9, 9.1). The most frequently reported health reasons contributing to euthanasia were laminitis-related consequences (25.0 % ; CI 16.8, 35.5 %), colic (21.3 % ; CI 13.7, 31.4 %), non-laminitic lameness (20.0 % ; CI 12.7, 30.1 %) and age-related deterioration, including owner-perceived compromised quality of life (20.0 % ; CI 12.7, 30.1 %). Health-related factors associated with significantly higher rates of euthanasia were colic (hazard ratio [HR] 26.4; CI 12.5, 55.8), pituitary pars intermedia dysfunction (HR 3.0; CI 1.7, 5.4) and lameness due to navicular syndrome (HR 5.9; CI 1.8, 20.0), soft tissue injury (HR 6.5; CI 2.7, 15.6) or laminitis (HR 2.7; CI 1.3, 5.7). Further factors included being pure bred (HR 1.7; CI 1.0, 2.8), female (HR 1.7; CI 1.0, 2.9), having poor owner-perceived hoof quality (HR 2.4; CI 1.1, 5.2), being entirely stabled (HR 5.0; HR 2.1, 12.0), being on loan or under temporary care of the study participant (HR 2.3; CI 1.2, 4.4) and participating in affiliated or professional competitions (HR 5.9; CI 2.4, 14.8). Euthanasia rates were significantly higher in the first two study years compared to the third (P < 0.001). Animals whose owners used the study's custom-designed weight tracker tool had significantly lower rates of euthanasia (HR 0.6; CI 0.3, 0.95). This study has identified a number of, arguably preventable, health-related factors associated with higher rates of euthanasia. Data on owners' decision-making process regarding euthanasia, including emotive and financial impacts, were not recorded but are important contributors to euthanasia that require better understanding.

Chronology and sequence of emergence of permanent premolar teeth in the horse: study of deciduous premolar 'cap' removal in Thoroughbred racehorses.

REASONS FOR PERFORMING STUDY: There are few published data to support the ages of emergence of permanent dentition widely reported in horses. OBJECTIVES: To clarify the chronology and sequence of permanent premolar (PM) tooth emergence in Thoroughbred racehorses. METHODS: A prospective study was undertaken in which records were kept of deciduous PM 'cap' extractions performed during routine dental examinations in Thoroughbred racehorses. Mixed effects multiple regression analysis was used to relate the observed ages, measured in days, for PM 'cap' extractions simultaneously with different predictive variables. Care was taken to account for clustering of multiple observed outcomes within individual horses. RESULTS: A total of 508 deciduous premolar 'caps' were removed from 207 horses, mean ages at removal from PM2, PM3 and PM4 were 35.1, 37.7 and 45.1 months, respectively. Age at which deciduous 'cap' removal occurred was associated significantly with tooth row, upper or lower jaw and gender of the horse concerned. There was a significant trend for later 'cap' extraction age with more caudal teeth, teeth in the upper jaw and female gender. CONCLUSIONS: Age at removal of deciduous premolar 'caps' in this population differed considerably from the ages of emergence of permanent dentition reported widely in equine publications. The results provide the first evidence of sexual dimorphism in the eruption of the permanent premolar dentition in horses. These findings strongly support a model of cheek tooth eruption in the horse in which chronology and sequence of emergence are more complex than previously thought, but which is consistent with understanding of tooth eruption in species that have been studied in greater detail. POTENTIAL RELEVANCE: Abnormalities of cheek tooth eruption are thought to be a factor in the pathogenesis of a variety of dental conditions, and a thorough understanding of the process of eruption is fundamental to the development of rational strategies for prevention and treatment.

Incidence and clinical signs of owner-reported equine laminitis in a cohort of horses and ponies in Great Britain.

BACKGROUND: Previous robust epidemiological studies of equine laminitis have utilised only veterinary-diagnosed episodes of disease, potentially underestimating true disease frequency. OBJECTIVES: To estimate the incidence of, and describe clinical signs associated with, owner-reported active laminitis in horses/ponies, using both veterinary-diagnosed and nonveterinary-diagnosed episodes. STUDY DESIGN: Prospective cohort. METHODS: Data were collected from horse/pony owners in Great Britain between August 2014 and December 2016 using a web-based application. The incidence of owner-reported laminitis was estimated using both first incident and repeat episodes reported during the study period via a previously validated laminitis reporting form. Owner-reported clinical signs present in these episodes were recorded. RESULTS: A total of 1070 horses/ponies contributed 1068 horse-years at risk (HYAR) and 123 active laminitis episodes were reported in 97 animals. Sixty-two of these episodes (50.4%, 95% confidence interval [CI] 41.6, 59.2%) were veterinary-diagnosed and 75.3% (CI 66.7, 83.8%; n = 73) of horses/ponies reported to have laminitis during the study had a previous laminitis history. Overall owner-reported first episode incidence was 9.6 episodes (CI 7.8, 11.7)/100 HYAR, whereas incidence including repeat episodes was 11.5 episodes (CI 9.7, 13.7)/100 HYAR. Laminitis occurred throughout the year with no significant differences between seasonal incidence estimates. Incidence was highest in Connemara and New Forest and lowest in Draught and Cob breed categories. The most prevalent owner-reported clinical signs (≥70%) were difficulty turning and a short/stilted or lame walk. Laminitis was reported in all limbs, however; both forelimbs were most commonly affected (62.9%, CI 54.1, 71.7%; n = 73/116). MAIN LIMITATIONS: Self-selection enrolment of participants may limit generalisability of the findings. CONCLUSIONS: Laminitis remains a considerable year-round welfare issue of horses and ponies, with frequency estimates utilising owner-reported data more representative of the true impact of the disease. The clinical signs reported by horse/pony owners were reflective of those previously described by veterinary surgeons.

Molecular epidemiology of Streptococcus zooepidemicus infection in naturally occurring equine respiratory disease.

The objective of the study was to characterise the molecular epidemiology of Streptococcus zooepidemicus infection among isolates collected sequentially from recently weaned, pasture maintained Welsh mountain ponies with naturally occurring respiratory disease. Weekly nasopharyngeal and tracheal lavage samplings over a 10-week period were conducted in 29 ponies. Two PCR typing methods based on characterisation of the M-protein hypervariable (HV) region and the 16S-23S rRNA gene intergenic spacer were then applied to isolates of S. zooepidemicus recovered from nasopharyngeal swab and tracheal wash samples. S. zooepidemicus infection was highly prevalent during the study, being isolated from 94% of tracheal washes and 88% of nasopharyngeal swabs. Among 39 different S. zooepidemicus types isolated, more were isolated from the trachea (n=33) than the nasopharynx (n=27). There was evidence from temporal patterns of infection for clonal succession over time by the more prevalent S. zooepidemicus types. Novel S. zooepidemicus types were identified, including previously untyped HV regions and intra-strain multiples of both the HV region and intergenic spacer types.

Patients' satisfaction with the nurse-led aural care clinic.

BACKGROUND: The necessity of decreasing costs while maintaining a high standard of clinical care has led to the expansion of the role of nurses in recent years. To this end, nurse-led clinics are becoming increasingly common in otolaryngology. The aims of this cross sectional survey were to assess patients' satisfaction with this nurse-led aural care clinic. METHOD: Patients attending this clinic were requested to fill in an anonymous questionnaire. Data was collected for 12 weeks between January and April, 2007. RESULTS: Forty-four questionnaires were completed satisfactorily (44/50 = 88%). In response to the presenting complaint, the nurse gave verbal advice (25), discussed with a doctor (10) or arranged a doctor review (9). Forty patients were very satisfied and 4 patients were satisfied with the overall care in the clinic. CONCLUSION: Combining medical and nursing efforts can provide efficient use of limited time resource in NHS. Nurse-led clinics are cost effective and help reduce the waiting time, for outpatient clinics.

A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

BACKGROUND: Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. OBJECTIVES: To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. STUDY DESIGN: Systematic literature search. METHODS: The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. RESULTS: In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. MAIN LIMITATIONS: The search strategies may not have identified all relevant papers, introducing bias to the review. CONCLUSIONS: Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome.

Streptococcus equi Infections in Horses: Guidelines for Treatment, Control, and Prevention of Strangles-Revised Consensus Statement.

This consensus statement update reflects our current published knowledge and opinion about clinical signs, pathogenesis, epidemiology, treatment, complications, and control of strangles. This updated statement emphasizes varying presentations in the context of existing underlying immunity and carrier states of strangles in the transmission of disease. The statement redefines the "gold standard" for detection of possible infection and reviews the new technologies available in polymerase chain reaction diagnosis and serology and their use in outbreak control and prevention. We reiterate the importance of judicious use of antibiotics in horses with strangles. This updated consensus statement reviews current vaccine technology and the importance of linking vaccination with currently advocated disease control and prevention programs to facilitate the eradication of endemic infections while safely maintaining herd immunity. Differentiation between immune responses to primary and repeated exposure of subclinically infected animals and responses induced by vaccination is also addressed.

Localization of the angiotensin II and its receptor subtype expression in human endometrium and identification of a novel high-affinity angiotensin II binding site.

Angiotensin (ANG) II is not only a potent vasoconstrictor but may also be involved in the regeneration of new blood vessels. In proliferative endometrium, ANG II-like immunoreactivity was detected in glandular epithelium and stroma with negligible staining around the vascular endothelium. In contrast, in secretory endometrium intense immunostaining was seen in the perivascular stromal cells around the endometrial spiral arterioles with negligible staining of the other cell types. Quantitative receptor autoradiography using the nonselective radioligand [125I]-ANG II and subtype selective competing compounds showed that endometrium contained predominantly AT2 receptors, with relatively low expression of AT1 receptors and a novel non-AT1/non-AT2 angiotensin II recognition site that was insensitive to AT1 or AT2 selective ligands. Levels of specific [125I]-ANG II receptor binding displayed cyclic changes during the menstrual cycle, reaching a maximum in early secretory endometrium and then decreasing in mid to late secretory endometrium to levels seen in early to mid proliferative endometrium. In situ hybridization showed AT1 receptor mRNA expression in the glands and in the endometrial blood vessels. The cyclic changes in ANG II-like immunoreactivity together with expression of both the known and the novel AT receptor subtypes imply that this octopeptide may play a dual role both in the control of the uterine vascular bed and also in the regeneration of the endometrium after endometrial shedding, acting as an angiogenic and mitogenic mediator.

Evidence for transferrin allele as a host-level risk factor in naturally occurring equine respiratory disease: a preliminary study.

REASONS FOR PERFORMING STUDY: Recurring respiratory infections can contribute to prolonged burdens of disease, especially in younger horses and better knowledge of factors and effective interventions, such as vaccines, should improve therapeutic and preventive strategies. OBJECTIVES: To identify factors and infections associated with naturally occurring respiratory disease in recently weaned Welsh Mountain ponies maintained at pasture and to determine whether ponies vaccinated with an experimental inactivated bacterial vaccine had lower burdens of disease and infection compared to nonvaccinated controls. Transferrin allele, which may influence the ability of pathogenic bacteria to acquire iron, was examined specifically as a host-level risk factor. METHODS: Twice weekly clinical evaluations and weekly microbiological samplings over a 10 week period were conducted in 29 ponies, of which 12 received an experimental bacterial vaccine, 12 received placebo and 5 were untreated. A multilevel modelling approach suitable for analysing longitudinal data containing repeated observations was used to identify factors associated with disease and to evaluate any effect from vaccination. RESULTS: Analyses demonstrated significant variation in clinical disease between ponies that possessed different alleles of iron binding transferrin protein but no significant effect from vaccination. Of the 29 ponies monitored, 14 possessing homozygote or non-F2 heterozygote transferrin D alleles demonstrated significantly less clinical disease (P < 0.001), whereas 14 possessing the F2 transferrin allele demonstrated significantly more clinical disease (P < 0.001). These effects remained apparent even after the significant effects of tracheal bacterial isolates, clinical score the previous week and repeated observations from the same ponies were accounted for. CONCLUSIONS AND POTENTIAL RELEVANCE: Results provide evidence for a potential genetic basis for variation in susceptibility to clinical equine respiratory disease of bacterial origin, although more work is required to corroborate this conclusion.

Electrosurgery as the sole means of haemostasis during the laparoscopic removal of pathologically enlarged ovaries in mares: a report of 55 cases.

REASONS FOR PERFORMING STUDY: There is little published clinical evidence on the use of a laparoscopic approach for the removal of pathologically enlarged ovaries in standing mares. OBJECTIVES: To show the orders of success and complication rates that can be expected if pathologically enlarged ovaries are removed from standing, sedated mares under laparoscopic guidance using only electrosurgical means of haemostasis. METHODS: A retrospective analysis was made of 55 mares in which the removal of an enlarged ovary was attempted by applying a standard laparoscopic procedure for routine ovariectomy in standing mares including a reliance solely on one of 2 types of electrosurgical bipolar forceps with an integrated guillotine for haemostasis and transection of the ovarian pedicle. The outcomes and complications encountered were recorded. Logistic regression analysis was performed to identify the risk of any complications associated with the size of the ovary removed and the instrument used. RESULTS: In 54 of the 55 mares, the surgery was successfully accomplished by the planned approach. In one mare there was significant intraoperative haemorrhage and this necessitated the additional use of a prosthetic haemostatic device. The only other complications encountered were post operative abdominal discomfort (n = 9), delayed incisional wound healing (n = 6) and iatrogenic uterine puncture (n = 2). One mare developed a rectal tear, but not as a direct complication of the surgical procedure. None of these prevented a long-term successful outcome. CONCLUSIONS: The removal of pathologically enlarged ovaries (up to 30 cm diameter) from mares under standing sedation can be accomplished predictably and safely by applying the standard laparoscopic approach that is established for routine laparoscopic ovariectomy, including a reliance solely on endoscopic electrosurgery instruments for haemostasis of the ovarian pedicle. POTENTIAL RELEVANCE: This study shows that the simple standing laparoscopic technique now favoured for routine ovariectomy can be used safely and reliably for the removal of pathologically enlarged ovaries. This promises to be of significant clinical advantage to mares so affected.

Equine influenza vaccine containing older H3N8 strains offers protection against A/eq/South Africa/4/03 (H3N8) strain in a short-term vaccine efficacy study.

REASONS FOR PERFORMING STUDY: Surveillance of equine influenza viruses has suggested that strains included in currently licensed vaccines are a poor match for those predominantly circulating in the field. OBJECTIVE: To assess the ability of Duvaxyn IE-T Plus to provide cross protection against the newly evolved South Africa/4/03 (H3N8) strain of equine influenza virus. METHODS: The vaccine efficacy was evaluated by challenge infection with influenza strain A/eq/South Africa/4/03 (H3N8) 2 weeks after a primary course of 2 vaccinations with Duvaxyn IE-T Plus given at a 4-week interval. The outcome of challenge in vaccinated ponies was compared with that in unvaccinated animals. RESULTS: At the time of challenge, all vaccinated ponies had high levels of antibody to Newmarket/1/93, Newmarket/2/93 and South Africa/4/03 strains measured by single radial haemolysis. After challenge infection, there were statistically significantly decreased clinical scores and virus shedding was significantly lower in the vaccinated ponies compared to unvaccinated controls. CONCLUSION: Two doses of Duvaxyn IE-T Plus provides good clinical and virological protection against challenge with a variant virus 2 weeks after the 2 doses of vaccine. POTENTIAL RELEVANCE: When variant strains of equine influenza virus first emerge, booster immunisations with currently available vaccines may limit infection provided sufficiently high antibody levels are achieved, suggesting that vaccination in the face of an outbreak may be beneficial.

Assessment of horse owners' ability to recognise equine laminitis: A cross-sectional study of 93 veterinary diagnosed cases in Great Britain.

BACKGROUND: Use of owner-reported data could further epidemiological knowledge of equine laminitis. However, owner recognition of laminitis has not previously been assessed. OBJECTIVES: The primary objective was to establish whether cases of owner-suspected laminitis would be confirmed as laminitis by the attending veterinary surgeon. Secondary objectives were to compare owner- and veterinary-reported information from veterinary-confirmed cases of equine laminitis. STUDY DESIGN: Cross-sectional study. METHODS: Twenty-five British veterinary practices were invited to submit laminitis reporting forms (LRFs) for active laminitis cases attended between January 2014 and October 2015; detailing 27 clinical signs, 5 underlying conditions and 7 risk factors associated with laminitis. Owners were invited to independently complete a modified LRF if reason for the veterinary visit was suspicion of laminitis. Differences between paired veterinary and owner LRFs, and between cases where owners did and did not recognise laminitis, were assessed using McNemar's and Fisher's Exact tests, respectively. RESULTS: Veterinary LRFs were received for 93 veterinary-diagnosed laminitis cases. All 51 owner-suspected cases were confirmed by veterinary diagnosis, with the remaining 42 (45.2%) not recognised as laminitis by owners. Undefined lameness, foot abscesses, colic and stiffness were common reasons for owner-requested veterinary visits in owner-unrecognised cases. 'Divergent growth rings' (prevalence difference: +27.3%, P = 0.01) and 'breed type' (prevalence difference: +21.2%, P = 0.04) were more commonly reported by veterinary surgeons in owner-recognised compared to owner-unrecognised cases. 'Difficulty turning', 'shifting weight' and risk factor 'body condition' were more frequently reported by veterinary surgeons whilst 'increased hoof temperature' was reported more frequently by owners. MAIN LIMITATIONS: The limited clinical data restricted statistical inferences regarding the secondary objectives. CONCLUSIONS: All owner-suspected laminitis cases were confirmed upon veterinary examination, showing validity for the inclusion of owner-reported cases in future epidemiological studies. However, failure of laminitis recognition by owners highlights further need for evidence-based education to ensure early disease detection.