Mandatory Intensivist Management Decreases Length of Stay, Facilitates an Increase in Admissions and Minimizes Closure of a Neurocritical Care Unit.

BACKGROUND: The primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando, an unacceptably high number of patients were being denied admission because of overcapacity. We compared length of stay (LOS), complications, outcomes, total admissions, and emergency transfer center closure rates before and after implementation of mandatory intensivist management. METHODS: A retrospective review comparing 1551 patients admitted to a 20 bed NCC unit from November 1, 2009 to October 31, 2010 (prior to mandatory intensivist management) with 1702 patients admitted from January 1, 2011 to December 31, 2011 (after the requirement) was performed. This included examining LOS, Acute Physiology and Chronic Health Evaluation III (APACHE) scores, service line closure rates, and mortality during both time periods. RESULTS: Analysis revealed that despite comparable APACHE scores, implementation of mandatory intensivist management reduced overall NCC LOS, 4.6 versus 3.7 days, (p < 0.01) and increased the number of monthly admissions, 129 versus 142, (p = 0.02). The percentage of patients declined admission because of a closed service line was reduced from 12.36 to 5.66 %, (p = 0.02). Mortality and infection rates remained unchanged. CONCLUSIONS: Implementation of mandatory intensivist management in the NCC unit decreased LOS, increased admissions, and decreased service line closure rates, while maintaining patient care.

Exercise-induced inhibition of remodelling is focally offset with fatigue fracture in racehorses.

UNLABELLED: Bone remodelling is inhibited by high repetitive loading. However, in subchondral bone of racehorses in training, eroded surface doubled in association with fatigue fracture and there was greater surrounding trabecular bone volume suggesting trabecular modelling unloads the bone focally, allowing damage repair by remodelling. INTRODUCTION: Remodelling replaces damaged bone with new bone but is suppressed during high magnitude repetitive loading when damage is most likely. However, in cortical bone of racehorses, at sites of fatigue fracture, focal porosity, consistent with remodelling, is observed in proportion to the extent of surrounding callus. Focal areas of porosity are also observed at sites of fatigue damage in subchondral bone. We hypothesised that fatigued subchondral bone, like damaged cortical bone, is remodelled focally in proportion to the modelling of surrounding trabecular bone. METHODS: Eroded and mineralizing surfaces and bone area were measured using backscattered scanning electron microscopy of post-mortem specimens of the distal third metacarpal bone in 11 racehorses with condylar fractures (cases) and eight racehorses in training without fractures (controls). RESULTS: Cases had a two-fold greater eroded surface per unit area at the fracture site than controls (0.81 ± 0.10 vs. 0.40 ± 0.12 mm(-1), P = 0.021) but not at an adjacent site (0.22 ± 0.09 vs. 0.30 ± 0.11 mm(-1), P = 0.59). Area fraction of surrounding trabecular bone was higher in cases than controls (81 ± 2 vs. 72 ± 2 %, P = 0.0020) and the eroded surface at the fracture site correlated with the surrounding trabecular area (adjusted R (2) = 0.63, P = 0.0010). CONCLUSION: In conclusion, exercise-induced inhibition of remodelling is offset at sites of fatigue fracture. Modelling of trabecular bone may contribute to unloading these regions, allowing repair by remodelling.

An automated walk-over weighing system as a tool for measuring liveweight change in lactating dairy cows.

Automated walk-over weighing systems can be used to monitor liveweights of cattle. Minimal literature exists to describe agreement between automated and static scales, and no known studies describe repeatability when used for daily measurements of dairy cows. This study establishes the repeatability of an automated walk-over cattle-weighing system, and agreement with static electronic scales, when used in a commercial dairy herd to weigh lactating cows. Forty-six lactating dairy cows from a seasonal calving, pasture-based dairy herd in southwest Victoria, Australia, were weighed once using a set of static scales and repeatedly using an automated walk-over weighing system at the exit of a rotary dairy. Substantial agreement was observed between the automated and static scales when assessed using Lin's concordance correlation coefficient. Weights measured by the automated walkover scales were within 5% of those measured by the static scales in 96% of weighings. Bland and Altman's 95% limits of agreement were -23.3 to 43.6 kg, a range of 66.9 kg. The 95% repeatability coefficient for automated weighings was 46.3 kg. Removal of a single outlier from the data set increased Lin's concordance coefficient, narrowed Bland and Altman's 95% limits of agreement to a range of 32.5 kg, and reduced the 95% repeatability coefficient to 18.7 kg. Cow misbehavior during walk-over weighing accounted for many of the larger weight discrepancies. The automated walk-over weighing system showed substantial agreement with the static scales when assessed using Lin's concordance correlation coefficient. This contrasted with limited agreement when assessed using Bland and Altman's method, largely due to poor repeatability. This suggests the automated weighing system is inadequate for detecting small liveweight differences in individual cows based on comparisons of single weights. Misbehaviors and other factors can result in the recording of spurious values on walk-over scales. Excluding outlier weights and comparing means of 7 consecutive daily weights may improve agreement sufficiently to allow meaningful assessment of small short-term changes in automated weights in individuals and groups of cows.

Effect of simulated stages of the canine oestrous cycle on Escherichia coli binding to canine endometrium.

Pyometra, a prevalent infectious uterine disease that affects intact middle-aged bitches, is typically associated with Escherichia coli. Our hypotheses were (i) that bacterial adhesion to canine endometrium differs between different stages of the oestrous cycle and (ii) that the adhesin FimH facilitates this adhesion. Twelve post-pubertal, ovariectomized greyhound bitches were treated with exogenous hormones to simulate different stages of the oestrous cycle. Tissue samples from each uterus were incubated with a pathogenic E. coli strain carrying the fimH gene, but no other adhesin genes (P4-wt)--or an E. coli strain in which fimH was insertionally inactivated (P4-∆fimH::kan)--or with phosphate-buffered saline as a negative control. After washing, tissue samples were homogenized for quantification of adherent bacteria. The differences in binding to canine endometrium at different stages of the oestrous cycle were not significant. However, the mean difference in binding of the P4-wt and the P4-∆fimH::kan across all stages of the simulated oestrous cycle was significant (p < 0.001 by paired t-test on geometric means). Individual differences in numbers of P4-wt bacteria bound between dogs might suggest genetic variations or epigenetic differences in FimH receptor expression by the endometrium, unrelated to the stage of the oestrous cycle.

Isotope-specific detection of low-density materials with laser-based monoenergetic gamma-rays.

What we believe to be the first demonstration of isotope-specific detection of a low-Z and low density object shielded by a high-Z and high-density material using monoenergetic gamma rays is reported. The isotope-specific detection of LiH shielded by Pb and Al is accomplished using the nuclear resonance fluorescence line of L7i at 478 keV. Resonant photons are produced via laser-based Compton scattering. The detection techniques are general, and the confidence level obtained is shown to be superior to that yielded by conventional x-ray and gamma-ray techniques in these situations.

Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses.

REASONS FOR PERFORMING STUDY: The effectiveness and best method to manage dorsal cortical stress fractures is not clear. This study was performed to evaluate the success of lag screw fixation of such fractures in a population of Thoroughbred racehorses. HYPOTHESIS: Lag screw fixation of dorsal cortical stress fractures is an effective surgical procedure allowing racehorses to return to their preoperative level of performance. METHODS: The records of 116 racehorses (103 Thoroughbreds) admitted to Equine Medical Centre, California between 1986 and 2008 were assessed. Information obtained from medical records included subject details, limb(s) affected, fracture configuration, length of screw used in repair and presence of concurrent surgical procedures performed. Racing performance was evaluated relative to these factors using Fisher's exact test and nonparametric methods with a level of significance of P<0.05. RESULTS: Of 92 Thoroughbred horses, 83% raced preoperatively and 83% raced post operatively, with 63% having ≥5 starts. There was no statistically significant association between age, gender, limb affected, fracture configuration or presence of concurrent surgery and likelihood of racing post operatively or of having 5 or more starts. The mean earnings per start and the performance index for the 3 races following surgery were lower compared to the 3 races prior to surgery; however, 29 and 45% of horses either improved or did not change their earnings per start and performance index, respectively. CONCLUSIONS AND POTENTIAL RELEVANCE: Data show that lag screw fixation is successful at restoring ability to race in horses suffering from dorsal cortical stress fractures.

Influence of different exercise regimes on the proximal hoof circumference in young Thoroughbred horses.

REASONS FOR PERFORMING STUDY: Most lameness in horses relates to foot problems and may be associated with changes in hoof shape, but there is a lack of information on the influence of normal exercise on hoof shape. OBJECTIVES: To investigate the effect of training on proximal hoof circumference in young Thoroughbred racehorses being prepared for racing. METHODS: Thirty-seven young Thoroughbred racehorses were included in this study. Front hoof circumference immediately below the coronary band was measured weekly with a measuring tape in all horses present at the stable. Most horses accomplished a minimum of 2 training periods at the stable separated by periods of rest on a paddock. One sample t tests were used to evaluate if the mean change per week differed from zero. To estimate the repeatability coefficient, the left proximal hoof circumference of 25 horses was measured 3 times in a random order on one day. RESULTS: Most horses showed a similar pattern of change. The proximal hoof circumference decreased during the training periods (P < 0.0001) and increased when the horse was rested (P < 0.0001). The decrease of the circumference during the first training period was -0.66 mm/week on the left and -0.64 mm/week on the right. During the second training period, this was -0.58 mm/week on the left and -0.57 mm/ week on the right. During the rest period, the circumference increased by 1.03 mm/week on the left and 1.12 mm/week on the right. The repeatability coefficient for the left circumference was 1.8 mm. CONCLUSIONS: Horses showed a decrease in circumference during race training that reversed when they were rested. POTENTIAL RELEVANCE: Measurement of front hoof circumference is a simple method to assess change in hoof shape. It provides an opportunity to investigate the relationships between specific training, hoof shape and soundness.

Variation in plasma concentrations of insulin-like growth factor-I in pasture-fed Holstein cows.

The objective of this 5-wk study was to determine dietary effects on plasma concentrations of insulin-like growth factor-I (IGF-I), as well as milk production and milk components in pasture-fed dairy cows. Thirty-two Holstein cows 4 to 5 wk postpartum were randomly assigned to 4 dietary subgroups. Feed was provided twice daily ad libitum at 0900 and 1600 h composed of fresh-cut pasture, meadow hay, and pelleted cereal grain to achieve differing levels of DMI and ME density (LL: 16.6 kg of DMI and 174 MJ of ME; HL: 17.3 kg of DMI and 181.1 MJ of ME; LH: 15.4 kg of DMI and 183.1 MJ of ME; HH: 17.9 kg of DMI and 213.3 MJ of ME, with the first letter indicating DMI and the second ME, and with H indicating high and L indicating low, respectively). The first day cows were placed on their diets was designated d 0. Concentrations of IGF-I were measured in frozen-thawed samples of plasma using a verified ELISA. Dietary treatment had affected plasma concentrations of IGF-I by d 7 with cows on high ME diets having greater IGF-I concentrations at d 14 (83.7 vs. 45.6 ng/mL) than cows on the low ME diets. The level of DMI had less effect on plasma concentrations of IGF-I at d 14 (72.2 vs. 57.1 ng/mL). Dietary treatment effects on these concentrations had stabilized by d 21. Day-to-day variation in mean plasma concentrations of IGF-I within each dietary treatment was low during an intensive period of daily sampling for 14 d (from d 22 to 35). Within-cow day-to-day variation was also low compared with that among cows within the same dietary group and was associated with a high repeatability in the day-to-day concentration of IGF-I in individual cows. Intraclass correlation coefficients for IGF-I ranged from 0.56 (+/- 0.14) to 0.88 (+/- 0.06) with a combined (pooled) value for the 4 subgroups of 0.77 (+/- 0.05). The ME and DMI effects (H vs. L) at d 35 were 79.3 vs. 41.4 and 62.0 vs. 55.7 ng/mL, respectively. Although the ME and DMI differences also affected milk yield and compositional parameters, the effects were not as proportionately great as those measured for IGF-I. Altering the ME or DMI components of the pasture-based diets produced changes in plasma IGF-I concentrations that did not become stabilized for 3 wk, but were then highly repeatable for individual cows within each dietary group. Both observations have relevance to interpreting data related to plasma concentrations of IGF-I in lactating Holstein cows.

Use of postpartum vaginoscopic (visual vaginal) examination of dairy cows for the diagnosis of endometritis and the association of endrometritis with reduced reproductive performance.

OBJECTIVE: To assess the association between the findings from vaginoscopic examination of postpartum dairy cows with peripartum reproductive disease and their subsequent reproductive performance, and to determine the factors that might be associated with a positive vaginoscopic examination (VV). METHODS: Cows (n=1325) from 17 seasonal calving dairy herds were enrolled if they had been calved at least 7 days and had at least one of the following conditions that placed them at risk of endometritis: retained fetal membranes (RFM), dystocia, a dead calf, hypocalcaemia, twin birth, calving induction or an observed vulval discharge (VD). Examination was undertaken 28-37 days before mating start date (MSD) within each herd. All cows were body condition scored (BCS) and were VV scored on a scale of 0 (clear) to 3 (purulent). The uterus and ovaries were assessed by rectal palpation. RESULTS: Cows with a positive VV score (1-3) were less likely to conceive to first service and had a lower pregnancy proportion than cows that had a negative VV score (score 0). Mean MSD to conception interval was longer in VV-positive cows. A positive VV score was associated with a low BCS, primiparity, intrapelvic uterus, poor uterine tone, large uterus, RFM, VD, dystocia, dead calf and twins. CONCLUSION: In the present study a positive VV score was associated with reduced reproductive performance and was more common in primiparous and low BCS cows. Of the at-risk cows, those with RFM, VD, dystocia, dead calf or twins were more likely to have a positive VV score.

Effect of intrauterine treatment with cephapirin on the reproductive performance of seasonally calving dairy cows at risk of endometritis following periparturient disease.

OBJECTIVE: To determine the effect of intrauterine cephapirin (0.5 g) treatment on the reproductive performance of cows diagnosed as at risk of developing endometritis. METHODS: Cows (n = 1325) from 17 seasonal calving dairy herds were enrolled if they had been calved for more than 6 days and had a condition that placed them at risk of endometritis. Half were treated with intrauterine cephapirin at an examination performed 28-37 days prior to mating start date (MSD). Cows were scored for body condition, their vaginal discharge was scored using vaginoscopy (VV), and the uterus and ovaries were assessed by rectal palpation. RESULTS: Overall, there was no significant treatment effect on reproductive performance. In 945 modified at risk (MAR) cows the effect of treatment varied with the calving to treatment interval (CTI) and VV status. For the subset of 229 MAR cows with CTI < or = 28 days, treatment improved the proportions of first-service conception (OR 3.1; P < 0.01) and 6-week in-calf (OR 2.1; P < 0.05), and reduced the mean MSD to conception interval by 20 days (P < 0.05). The difference was greater in cows with a positive VV score (1-3). Treated VV-negative cows with CTI > 48 days had a reduced proportion of cows in-calf by 6 weeks (OR 0.58; P = 0.056) compared with untreated cows. CONCLUSION: Intrauterine cephapirin infusion of MAR cows improved reproductive performance, depending on CTI. The greater treatment effect in VV-positive cows suggests that VV scoring is a useful tool for the diagnosis of endometritis.

Prevalence and risk factors for medical events following exercise at Australian Greyhound race meetings.

AIM: A prospective, observational study to determine the prevalence of post-exercise conditions at Australian Greyhound race meetings and to assess association with race performance and other environmental, race- and dog-related factors was undertaken. METHODS: A total of 4020 starters were observed (2813 Greyhounds, 1009 trainers, 536 races, 52 race meets, 48 race dates and 11 race tracks) following a race. The presence of diaphragmatic flutter (DF), ataxia, seizure, collapse or sudden death was recorded. Risk factors were screened by univariable logistic regression prior to multivariable backward stepwise model building. RESULTS: In this study, 962 starters (n = 768 dogs) had DF (23.9%), 16 starters were ataxic (0.4%) and there were no observed cases of collapse, seizure or sudden death. Race track location, increasing race distance, race grade based on increasing 1st place prize value, lower (earlier) race number at the meeting, age, a previous observation of DF at the last start, females, colour (white) and better finishing position were all associated with an increased risk of a Greyhound being observed with DF. However, when logistic regression assessing the random effect of dog was performed, the presence of previous DF was not significant. In this cohort, DF was common following strenuous exercise in Greyhounds and on its own does not appear to result in reduced performance or distress to the animal. CONCLUSION: The incidence of ataxia was low and collapse, seizure and sudden death were not observed. However, even though uncommon, ataxia has welfare concerns for racing Greyhounds that warrants further investigation.

Risk factors for Thoroughbred racehorse fatality in jump starts in Victoria, Australia (1989-2004).

REASONS FOR PERFORMING STUDY: The risk of fatality is greater in jump than in flat racing in Victoria, Australia. This is the first study to identify risk factors specific to jump starts in Victoria. OBJECTIVE: To identify risk factors for fatality of Thoroughbred racehorses in jump starts on all racecourses in Victoria, Australia between 1989 and 2004. METHODS: Fatalities comprised all horses that died during or immediately after a jump (hurdle or steeplechase) race or official jump trial and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 191 case starts and 2324 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. A multiple level model was used with racecourse included as a random effect. RESULTS: In the final multivariable model, the duration of the racing career of the horse, the number of flat, hurdle and steeple starts accumulated in the 60 days prior to the case or control start, the number of flat and jump starts accumulated over the racing career, if the horse had had a start between 1 and 14 days prior to the case or control start, the type of jump race (hurdle or steeple), the calendar year of the start and the location of the racecourse were associated with fatality. CONCLUSIONS: The findings highlight the need to investigate further the differences between hurdle and steeplechase events and the adverse effect of prolonged prior flat racing careers on the risk of fatality in jump starts. POTENTIAL RELEVANCE: This is the first study to examine risk factors for fatality in jump starts in Victoria. The results should shape the development of interventions to reduce the risk in jump starts in the future.

Risk factors for Thoroughbred racehorse fatality in flat starts in Victoria, Australia (1989-2004).

REASONS FOR PERFORMING STUDY: Research into risk factors specific for fatality in flat racing should be focused at a regional level as the risk factors may differ among countries and even regions within countries. OBJECTIVE: To identify risk factors for fatality of Thoroughbred racehorses in flat starts on all racecourses in Victoria, Australia between 1989 and 2004. METHODS: Fatalities comprised all horses that died during or immediately after a flat race or official flat trial, and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 283 case starts and 3307 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. RESULTS: In the final multivariable model, horse gender, prior racing history, race length, racing year, racecourse location and track rating were associated with fatality. CONCLUSIONS: This study identified specific risk factors for fatality. The findings are consistent with the hypothesis that horses accumulating high speed exercise are predisposed to catastrophic injury. The study has also highlighted the need to investigate further the adverse effects of different track ratings on the incidence of injury and subsequent fatality. RELEVANCE: The results will facilitate the development of effective strategies to improve overall safety of horses and jockeys in flat racing in Victoria, Australia.

The influence of the full moon on the number of accessions to an animal emergency centre.

OBJECTIVE: To test the hypothesis that the number of animal emergency centre accessions is associated with the time of the full moon. DESIGN AND PROCEDURE: Retrospective study. A comparison was made of the number of accessions to the University of Melbourne Animal Emergency Centre in the period February 2003 to January 2006 on full moon and non-full moon days, adjusted for day of the week and public holiday. A three day period with the day of the full moon as the middle day was taken to be a full moon period. RESULTS: A total of 12,102 animals were presented to the Centre in this time. An adjusted count ratio of 1.048 (95% CI 0.97 to 1.14; P = 0.26) for accessions on full moon days compared with those on non-full moon days indicated that there was no significant association between the full moon and the number of accessions per day. CONCLUSION: There was no significant difference between the number of animals presented to the University of Melbourne Animal Emergency Centre on full moon days and non-full moon days.

Augmented hamate replacement arthroplasty for fracture-dislocations of the proximal interphalangeal joints in 12 patients.

We report clinical outcomes in 12 patients with hemi-hamate replacement arthroplasty combined with volar plate arthroplasty. The volar plate was reattached using trans-osseous sutures to reconstruct the ligament-box complex after hamate grafting to augment the stability of the proximal interphalangeal joint. Ten patients had improved joint movement from a mean of 14° before surgery to a mean of 77° at a minimum follow-up of 2 years. Grip strength and pain of the affected hand and patient-rated hand and wrist scores were improved in these 10 patients. Two patients had poor results. One patient developed ankylosis, and one patient had resorption of the grafted bone. We conclude that the augmented hamate replacement arthroplasty is useful in treating chronic proximal interphalangeal joint fracture-dislocations. LEVEL OF EVIDENCE: IV.

Scintigraphic Assessment of Deposition of Radiolabeled Fluticasone Delivered from a Nebulizer and Metered Dose Inhaler in 10 Healthy Dogs.

BACKGROUND: Aerosolized medications are increasingly being used to treat respiratory diseases in dogs. No previous studies assessing respiratory tract deposition of radiolabeled aerosols have been performed in conscious dogs. HYPOTHESIS/OBJECTIVES: Assess respiratory tract deposition of radiolabeled, inhalant corticosteroid (fluticasone propionate labeled with 99m Tc) delivered from a nebulizer and metered dose inhaler (MDI) to healthy dogs. ANIMALS: Ten healthy Foxhounds. METHODS: Prospective, randomized, cross-over pilot study. Initial inhalation method (nebulizer or MDI) was randomly assigned. Treatments were crossed over after a 7-day washout period. Treatments initially were performed using sedation. Dogs were imaged using 2-dimensional planar scintigraphy, with respiratory tract deposition quantified by manual region-of-interest analysis. Deposition calculated as percentage of delivered dose. Six of 10 dogs were randomly selected and reassessed without sedation. RESULTS: Inhalation method had significant effect on respiratory tract deposition (P = 0.027). Higher deposition was achieved by nebulization with mean deposition of 4.2% (standard deviation [SD], 1.4%; range, 1.9-6.1%); whereas MDI treatment achieved a mean of 2.3% (SD, 1.4%; range, 0.2-4.2%). Nebulization achieved higher respiratory tract deposition than MDI in 7 of 10 dogs. No statistical difference (P = 0.68) was found between mean respiratory tract deposition achieved in dogs when unsedated (3.8%; SD, 1.5%) or sedated (3.6%; SD, 1.7%). CONCLUSIONS AND CLINICAL IMPORTANCE: Study confirms respiratory tract deposition of inhalant medications delivered from a nebulizer and MDI in healthy dogs, breathing tidally with and without sedation. Respiratory tract deposition in these dogs was low compared to reported deposition in adult humans, but similar to reported deposition in children.

Risk of fatality and causes of death of Thoroughbred horses associated with racing in Victoria, Australia: 1989-2004.

REASONS FOR PERFORMING STUDY: Determining the risk of fatality of Thoroughbred horses while racing is essential to assess the impact of intervention measures designed to minimise such fatalities. OBJECTIVES: To measure the risk of racehorse fatality in jump and flat starts on racecourses in Victoria, Australia, over a 15 year period and to determine proportional mortality rates for specific causes of death. METHODS: All fatalities of Thoroughbred horses that occurred during or within 24 h of a race were identified from a database. The risk of a start resulting in a racehorse fatality in all races and within flat and jump races, proportional mortality rates, population attributable risk, population attributable fraction and risk ratios were calculated along with 95% confidence intervals. Poisson regression was also performed to estimate risk ratios. RESULTS: There were 514 fatalities over the 15 year period; 316 in flat races and 198 in jump races. The risk of fatality was 0.44 per 1000 flat starts and 8.3 per 1000 jump starts (18.9 x greater). The risk of fatality on city tracks was 1.1 per 1000 starts whereas on country tracks it was 0.57 per 1000 starts. Of the 316 fatalities in flat races, 73.4% were due to limb injury, 2.5% to cranial or vertebral injury and 19.0% were sudden deaths. Of the 198 fatalities in jump races, 68.7% were due to limb injury, 16.2% to cranial or vertebral injury and 3.5% were sudden deaths. The risk of fatality in flat starts increased between 1989 and 2004 but the risk in jump starts remained unchanged over the 15 year period. CONCLUSIONS: The risk of fatality in flat starts was lower in Victoria than North America and the UK but the risk in jump starts was greater. Catastrophic limb injury was the major reason for racehorse fatality in Victoria but there was a larger percentage of sudden deaths than has been reported overseas. The risk of fatality in jump starts remained constant over the study period despite jump racing reviews that recommended changes to hurdle and steeple races to improve safety. POTENTIAL RELEVANCE: This study provides important benchmarks for the racing industry to monitor racetrack fatalities and evaluate intervention strategies.

Reference limits for urinary fractional excretion of electrolytes in adult non-racing Greyhound dogs.

OBJECTIVE: To determine reference limits for urinary fractional excretion of electrolytes in Greyhound dogs. METHODS: Urinary fractional excretion was calculated using a spot clearance method preceded by a 16 to 20 hour fast in 48 Greyhound dogs. Raw data analysed using the bootstrap estimate was used to calculate the reference limits. RESULTS: The observed range for urinary fractional excretion in Greyhound dogs was 0.0 to 0.77% for sodium, 0.9 to 14.7% for potassium, 0 to 0.66% for chloride, 0.03 to 0.22% for calcium and 0.4 to 20.1% for phosphate. Expressed as percentages, the suggested reference limits for fractional excretion in Greyhound dogs are as follows: sodium < or = 0.72, potassium < or = 12.2, chloride < or = 0.55, calcium < or = 0.13 and phosphate < or = 16.5. CLINICAL SIGNIFICANCE: Veterinary practitioners may use these reference limits for urinary electrolyte fractional excretion when investigating renal tubular disease in Greyhound dogs.

Importance of secondary damage in downer cows.

OBJECTIVE: To investigate the relative importance in downer cows of the primary cause of recumbency in comparison with secondary complications. METHODS: Downer dairy cows were monitored during their recumbency under field conditions in South Gippsland, Victoria, Australia. The cause of the original recumbency of the 218 cows was determined and secondary damage, status on day 7 and final outcome were recorded. RESULTS: Some type of secondary damage was found in 183/218 (84%) cows, of which 173/218 (79%) had damage deemed to be clinically important. By day 7, 52 (24%) had recovered and 69 (32%) eventually recovered. Of the 149 (68%) cows that were euthanased or died, 23 (15%) were deemed to have been lost solely from the primary cause, 107 (72%) from secondary damage and 19 (13%) from a combination of both. CONCLUSION: There was no difference in recovery among the five broad groups of causes of primary recumbency. Secondary damage was very common and presented in a large variety of ways, with many cows having multiple types of secondary damage concurrently. For most cows the secondary damage was more important than the initial primary damage in determining their fate.

High-quality care improves outcome in recumbent dairy cattle.

OBJECTIVE: To investigate the influence of the quality of care on outcome and occurrence of secondary damage in recumbent dairy cows. METHODS: Recumbent dairy cows were monitored during their recumbency under field conditions in South Gippsland, Victoria, Australia. The cause of the original recumbency of 218 downer cows was determined and any secondary damage, day 7 status, final outcome and the nursing conditions of the cows were recorded. A four-tiered grading system describing nursing quality was developed to allow analysis of its influence on outcome and on the occurrence of secondary damage. RESULTS: Day 7 outcome, final outcome and occurrence of important secondary damage were very strongly associated with the level of overall care provided to the recumbent cows. There was a decrease in the percentage of cows recovering by day 7 from 33% to 0%, a decrease from 45% to 0% of cows eventually recovering and an increase from 68% to 100% of cows with clinically important secondary damage as overall care decreased. CONCLUSION: Management of recumbent cattle is potentially a significant animal welfare issue for the dairy industry and their care is a very important but often under-appreciated aspect of their management. Recovery is positively influenced by high-quality care by improving the chances of recovery from the initial cause of recumbency and by reducing the occurrence of secondary damage. Recumbent cows must either be nursed at a high level of care or euthanased promptly.