Juvenile idiopathic epilepsy in Arabian horses is not a single-gene disorder.

Valued for their temperament, beauty, athletic ability, and exhibition in the show ring, Arabian horses are an important component of the horse industry. Juvenile idiopathic epilepsy (JIE), a seizure disorder, is most often reported in Arabian foals from birth to 6 months of age. Affected foals exhibit tonic-clonic seizures lasting as long as 5 min and risking secondary complications like temporary blindness and disorientation. Some foals outgrow this condition, while others die or suffer lifelong complications if not treated. Previous work suggested a strong genetic component to JIE and proposed JIE to be a single-gene trait. In this work, we conducted a genome wide association study (GWAS) in 60 cases of JIE and 120 genetically matched controls, identifying loci suggesting JIE is not caused by a single locus. Coat color (chestnut, gray) phenotypes were used as positive control traits to assess the efficacy of GWAS in this population. Future work will attempt to future define candidate regions and explore a polygenic mode of inheritance.

Ultrasound-guided injections of the equine head and neck: review and expert opinion.

Ultrasound-guided injections can be used for a wide variety of conditions in the horse, including both diagnostic and therapeutic applications. Benefits of ultrasound guidance include more accurate deposition of injectate compared with blind approaches. Improved identification of vital structures, including nerves and blood vessels, allows their avoidance and thus reduces procedure-associated complications. Validation of such ultrasound-guided techniques has shown that they can be easily learnt by inexperienced veterinarians, assuming a proper knowledge of the sonographic anatomy. In many cases they can be employed in the field with a high level of accuracy, using widely available equipment, and with complete adherence to the sterility principles. Many ultrasound-guided injection techniques of the axial skeleton in the horse have been described in past years, enabling the equine veterinarian to perform more accurate treatments of specific anatomical areas. The goal of this review is to discuss diagnostic and therapeutic ultrasound-guided injection techniques of the skull and cervical spine in the horse, including those for the retrobulbar space, maxillary and inferior alveolar nerves, atlanto-occipital and atlanto-axial junctions, and cervical articular process joints, as well as the 1st cervical nerve, the C2 and C3 nerve plexus, and the 6th, 7th, and 8th cervical nerve roots.

Effect of Presurgical Iodine-Based Disinfection on Bacterial Colonization of the Equine Peripodal Region.

OBJECTIVE: To compare bacterial colonization after diluted iodine tincture or povidone iodine solution for presurgical disinfection of the equine peripodal region. STUDY DESIGN: Complete block design. ANIMALS: Five horses. METHODS: Disinfection protocols using iodine tincture or povidone iodine solutions were tested on 5 pairs (n = 10) equine front feet. Iodine tincture was applied to the left feet and povidone iodine to the right feet. Fixed surfaces of the sole, frog, hoof wall, and peripodal skin were swabbed pre-preparation (T0), after a standard pre-disinfection step (T1), after short disinfection with a 4-minute application of 0.5% iodine tincture or povidone iodine (T2), and after long disinfection with 12-hour soaking in 0.25% iodine tincture or povidone iodine (T3). Quantitative bacteriology was performed on each swab. RESULTS: The frog and sole were the most contaminated sites compared to hoof wall and skin at T0. Bacterial counts were significantly decreased at T2 for both solutions. Bacterial counts did not change significantly with iodine tincture at T3 but increased with povidone iodine compared to T2. Skin abrasions were detected on almost all feet but were subjectively more severe on iodine tincture-treated feet. CONCLUSION: Soaking for 12 hours with either iodine tincture or povidone iodine is not recommended as these solutions damaged the skin and bacterial recolonization was noted with povidone iodine. Four-minute disinfection using either iodine tincture or povidone iodine (0.5% available iodine) is appropriate for presurgical preparation of the equine peripodal region.

Juvenile idiopathic epilepsy in Egyptian Arabian foals, a potential animal model of self-limited epilepsy in children.

BACKGROUND: Juvenile idiopathic epilepsy (JIE) is categorized as a generalized epilepsy. Epilepsy classification entails electrocortical characterization and localization of epileptic discharges (ED) using electroencephalography (EEG). HYPOTHESIS/OBJECTIVES: Characterize epilepsy in Egyptian Arabian foals with JIE using EEG. ANIMALS: Sixty-nine foals (JIE, 48; controls, 21). METHODS: Retrospective study. Inclusion criteria consisted of Egyptian Arabian foals: (1) JIE group diagnosed based on witnessed or recorded seizures, and neurological and EEG findings, and (2) control group of healthy nonepileptic age-matched foals. Clinical data were obtained in 48 foals. Electroencephalography with photic stimulation was performed under standing sedation in 37 JIE foals and 21 controls. RESULTS: Abnormalities on EEG were found in 95% of epileptic foals (35 of 37) and in 3 of 21 control asymptomatic foals with affected siblings. Focal ED were detected predominantly in the central vertex with diffusion into the centroparietal or frontocentral regions (n = 35). Generalization of ED occurred in 14 JIE foals. Epileptic discharges commonly were seen during wakefulness (n = 27/37 JIE foals) and sedated sleep (n = 35/37 JIE foals; 3/21 controls). Photic stimulation triggered focal central ED in 15 of 21 JIE foals. CONCLUSIONS AND CLINICAL IMPORTANCE: Juvenile idiopathic epilepsy has a focal onset of ED at the central vertex with spread resulting in clinical generalized tonic-clonic seizures with facial motor activity and loss of consciousness. Electroencephalography with photic stimulation contributes to accurate phenotyping of epilepsy. Foals with this benign self-limiting disorder might serve as a naturally occurring animal model for self-limited epilepsy in children.

Piezoelectric device use in sinus osteotomy for equines is feasible but may extend time to accomplish frontonasal bone flap.

OBJECTIVE: Sinus osteotomy is currently performed in equine surgery with conventional surgical methods, such as trephines and oscillating bone saw, leading to subsequent trauma to the bone during cutting. Piezoelectric devices are now used in maxillofacial surgery in humans as a standard tool as it is less traumatic than the oscillating bone saw and shortens the healing period. The aim of this study was to show that the piezoelectric device can be used for equine sinus surgery, compare its use with the oscillating bone saw, and describe the outcome of cases involving osteotomy performed with a piezoelectric surgical device. ANIMALS: 10 horse specimens for cadaveric study and 11 client-owned equines for clinical evaluation. METHODS: Each cadaveric head underwent a frontonasal bone flap on a randomly assigned side with the piezotome and the oscillating bone saw on the opposite side. Surgical time was recorded for every procedure, and gross examination was performed. A Welch t test was used to compare the surgical time between piezoelectric and oscillating saw use. For the clinical study, animals presented for sinonasal surgery at the hospital from March through October 2023 were included. RESULTS: Osteotomy was possible with the piezotome in all animals. Surgical time was significantly increased when using the piezotome in comparison with the oscillating saw (P < .05). All clinical patients were treated adequately for the sinonasal disorder they were presented for using the piezotome instead of the oscillating saw. No adverse effects nor long-term complications related to its use have been noted, and preservation of the surrounding soft tissues was evident. CLINICAL RELEVANCE: The use of a piezoelectric device in equine surgery is feasible. However, the cadaveric study showed an increased surgical time to perform a frontonasal bone flap.

Radiological measurements of the feet of normal Straight Egyptian Arabian horses in Qatar.

The Arabian horse has been identified as carrying a risk locus for equine metabolic syndrome, predisposing this breed to development of laminitis. Radigraphy of the equine foot is widely considered the main diagnostic imaging technique for evaluation of the laminitic horse. Knowledge of 'normal' breed values allows assessment of the degree and severity of radiological changes associated with laminitis. The objective of this study was to investigate the normal values for radiological measurements of the feet of the Straight Egyptian Arabian horse in Qatar. The design was a clinical prospective study. Radiographs of the fore and hind feet of 10 clinically normal adult Straight Egyptian Arabian horses were taken. On the lateromedial views, 17 measurements were taken (13 distances and four angles). On the horizontal dorsopalmar/plantar views, two measurements were taken. On the dorsal 45 degree, proximo-palmarodistal oblique projections, four measurements were taken. Normal reference ranges were reported for radiological measurements of the feet of the Straight Egyptian Arabian horse. Several variables showed significant differences between fore and hind feet, including hoof angle, distal wall thickness, and two proximal inner layer measurements (p < 0.05). In addition, the Straight Egyptian Arabian horse was found to have a number of measurements which varied from previously published reports. The results reported within provide a useful reference for normal radiographic measurements of the Straight Egyptian Arabian horse with relevance for laminitis.

Effect of pregnancy on isolation efficiency and in vitro proliferation of equine peripheral-blood derived mesenchymal stromal cells.

Mesenchymal stromal cells (MSCs) have regenerative and immunomodulatory potential and may be used to treat injured tissues. Pregnancy has been associated with increased MSCs in the peripheral circulation in multiple species, but to date, there are no reports on this matter in horses. This study aimed to evaluate the effect of pregnancy on isolation efficiency and proliferation capacity of equine MSCs derived from the peripheral blood (PB) of mares. Venous blood samples were collected at the 11th month of gestation and 1 month after delivery from clinically healthy Arabian mares that presented normal pregnancies. Blood samples were processed for in vitro cellular culture and hormonal and metabolic profiles. MSCs were isolated and characterized by trilineage differentiation potential, immunophenotyping, analyzed by gene sequencing and proliferation assays. The isolation of peripheral blood mononuclear cells (PBMCs) of pregnant mares were associated with higher isolation efficiency and proliferative capacity of MSCs derived from peripheral blood (PB-MSCs) recovered pre-partum than those isolated post-partum. Although fetal gender, parity, 5α-reduced pregnanes, insulin, and cortisol were shown to affect cellular proliferation, individual factors and the small population studied must be considered. This study suggests that PB-MSCs from pregnant mares could be a valuable alternative source of MSCs for therapeutic purposes.

Blood types and antibody profiles of Straight Egyptian Arabian horses in Qatar: Preliminary results.

The characterization of the blood groups, antibody profiles, and its distribution pattern among different horse breeds and geographic locations, can be very useful in life-threatening situations where a blood transfusion is needed, and compatibility tests are not readily available. This study estimated the distribution of blood types and antibody profiles in Straight Egyptian Arabian horses from Qatar. A total of 20 Straight Egyptian Arabian horses, from multiple origins and genetic background were included. Venous blood from each horse was typed and screened for anti-red blood cell (RBC) hemolytic and agglutinating antibodies. Descriptive statistical analysis and Fisher Exact test were applied, considering 95% confidence interval (95% CI). All included horses (100%) had Aa and Ca blood types (95% CI: 83.2%-100.0%). Other blood types found less frequently included Ua (50%), Qc (45%), Pa (40%), Qb (25%) and Qa (5%). Only horses with travel history developed anti-RBC antibodies (6 out of 9), however, no horse carried more than one type of anti-RBC antibodies, supporting the premise that environmental factors may influence the development of alloantibodies. Although pre-transfusion testing regardless the circumstances should be prioritized, even considering a small population of horses, our findings suggest that Straight Egyptian Arabian horses in Qatar could be safely used as blood donors, due to the apparent omnivalence of Aa and Ca blood types and lower incidence of alloantibodies, important in emergency situations where pre-transfusion testing is unavailable.

Electroencephalographic evaluation under standing sedation using sublingual detomidine hydrochloride in Egyptian Arabian foals for investigation of epilepsy.

BACKGROUND: A standardized protocol for electroencephalography (EEG) under standing sedation for the investigation of epilepsy in foals is needed. HYPOTHESIS/OBJECTIVES: To evaluate a modified standardized EEG protocol under standing sedation using sublingual detomidine hydrochloride in Egyptian Arabian foals. ANIMALS: Nineteen foals (controls, 9; juvenile idiopathic epilepsy [JIE], 10). METHODS: Descriptive clinical study. Foals were classified as controls or epileptic based on history or witnessed seizures and neurological examination. Foals were sedated using sublingual detomidine hydrochloride at a dosage of 0.08 mg/kg to avoid stress associated with injectable sedation. Once foals appeared sedated with their heads low to the ground and with wide base stance (30 minutes), topical lidocaine hydrochloride was applied at the determined locations of EEG electrodes. Fifteen minutes were allowed for absorption and electrodes were placed, protected, and EEG recording performed. RESULTS: Level of sedation was considered excellent with no need of redosing. The EEG recording lasted from 27 to 51 minutes and provided interpretable data. Epileptic discharges (ED) were noted predominantly in the central-parietal region in 9 of 10 epileptic foals. Photic stimulation triggered ED in 7 of 10 epileptic foals and in none of the controls. Foals were not oversedated and recovered uneventfully. CONCLUSIONS AND CLINICAL IMPORTANCE: Sublingual detomidine hydrochloride is a safe, painless, simple, and effective method of sedation for EEG recording in foals. Sublingual sedation allowed the investigation of cerebral electrical activity during states of sleep and arousal, and during photic stimulation for the investigation of epilepsy in foals.

Free Swimming and Exercise-Induced Pulmonary Hemorrhage in Endurance Horses: A Preliminary Study.

Swimming is used for rehabilitation of musculoskeletal injuries and for conditioning to improve equine fitness. However, there are anecdotal reports that suggest that tethered swimming can induce epistaxis, likely secondary to exercise-induced pulmonary hemorrhage (EIPH). The objective of this observational, prospective study was to investigate if EIPH occurs during intensive free-swimming training sessions (5 × 70m) using 15 endurance horses. On tracheo-bronchoscopic evaluations following swimming, low grade mucus scores were observed, but no tracheal blood was observed. Bronchoalveolar lavage fluid analysis revealed a low cellularity, and the median red blood cell count (RBCs) was 271 cells/µL (interquartile range 150-363 cells/µL), which is much lower than the threshold of RBCs >1,000 cells/µL for horses to be considered positive for EIPH. Therefore, free swimming does not seem to predispose endurance horses to EIPH following a typical free-swimming training session.

Characterization of exercise-induced hemolysis in endurance horses.

Exercise-induced hemolysis occurs as the result of intense physical exercise and is caused by metabolic and mechanical factors including repeated muscle contractions leading to capillary vessels compression, vasoconstriction of internal organs and foot strike among others. We hypothesized that exercise-induced hemolysis occurred in endurance racehorses and its severity was associated with the intensity of exercise. To provide further insight into the hemolysis of endurance horses, the aim of the study was to deployed a strategy for small molecules (metabolites) profiling, beyond standard molecular methods. The study included 47 Arabian endurance horses competing for either 80, 100, or 120 km distances. Blood plasma was collected before and after the competition and analyzed macroscopically, by ELISA and non-targeted metabolomics with liquid chromatography-mass spectrometry. A significant increase in all hemolysis parameters was observed after the race, and an association was found between the measured parameters, average speed, and distance completed. Levels of hemolysis markers were highest in horses eliminated for metabolic reasons in comparison to finishers and horses eliminated for lameness (gait abnormality), which may suggest a connection between the intensity of exercise, metabolic challenges, and hemolysis. Utilization of omics methods alongside conventional methods revealed a broader insight into the exercise-induced hemolysis process by displaying, apart from commonly measured hemoglobin and haptoglobin, levels of hemoglobin degradation metabolites. Obtained results emphasized the importance of respecting horse limitations in regard to speed and distance which, if underestimated, may lead to severe damages.

A case-control study of atypical guttural pouch empyema in Arabian foals.

BACKGROUND: Upper respiratory disease was reported over many seasons in Arabian foals on a single stud farm in the Middle East. Affected foals were noted to have mucopurulent nasal discharge, cough, fever and tachypnea. All affected foals had been empirically treated with a macrolide and rifampicin, by the referring veterinarian without improvement. On endoscopic examination, all affected foals had significant guttural pouch empyema (GPE). OBJECTIVES: (1) To document a previously unreported presentation of guttural pouch empyema (GPE) in a family of juvenile Arabian foals; (2) To document the cytological and microbial composition of the empyema; (3) To identify clinical signs significantly correlated with the presence of GPE, as predictors for the need for guttural pouch (GP) endoscopy; (4) To demonstrate successful resolution of the identified syndrome with mechanical GP lavage and evidence based antimicrobial use, improving antibiotic stewardship and the one-health approach to respiratory disease in this demographic of foals. METHODS: Evaluation and scoring of clinical signs, upper airway endoscopy and thoracic ultrasound were performed in 14 affected foals and 10 age-matched controls, followed by comparative tracheal and guttural pouch sputum culture and cytological evaluation. Therapeutic GP lavage was performed and response to therapy monitored. RESULTS: GPE, cranioventrally distributed ultrasonographic lesions and opportunistic pathogen infection suggested a primary lesion of GPE with aspiration of GP discharge into the lungs. GP lavage resolved the empyema and associated clinical signs in all cases. CONCLUSIONS: Cytological examination of tracheal and guttural pouch aspirates revealed a neutrophilic exudate with lipid-laden phagocytes, suggestive of engulfed milk. Bacteriology revealed a high prevalence of Streptococcus equi ssp. zooepidemicus admixed with other opportunistic pathogens. Streptococcus equi ssp. equi was not isolated in any case.

Hydrostatic pressure acts to stabilise a chondrogenic phenotype in porcine joint tissue derived stem cells.

Hydrostatic pressure (HP) is a key component of the in vivo joint environment and has been shown to enhance chondrogenesis of stem cells. The objective of this study was to investigate the interaction between HP and TGF-ß3 on both the initiation and maintenance of a chondrogenic phenotype for joint tissue derived stem cells. Pellets generated from porcine chondrocytes (CCs), synovial membrane derived stem cells (SDSCs) and infrapatellar fat pad derived stem cells (FPSCs) were subjected to 10 MPa of cyclic HP (4 h/day) and different concentrations of TGF-ß3 (0, 1 and 10 ng/mL) for 14 days. CCs and stem cells were observed to respond differentially to both HP and TGF-ß3 stimulation. HP in the absence of TGF-ß3 did not induce robust chondrogenic differentiation of stem cells. At low concentrations of TGF-ß3 (1 ng/mL), HP acted to enhance chondrogenesis of both SDSCs and FPSCs, as evident by a 3-fold increase in Sox9 expression and a significant increase in glycosaminoglycan accumulation. In contrast, HP had no effect on cartilage-specific matrix synthesis at higher concentrations of TGF-ß3 (10 ng/mL). Critically, HP appears to play a key role in the maintenance of a chondrogenic phenotype, as evident by a down-regulation of the hypertrophic markers type X collagen and Indian hedgehog in SDSCs irrespective of the cytokine concentration. In the context of stem cell based therapies for cartilage repair, this study demonstrates the importance of considering how joint specific environmental factors interact to regulate not only the initiation of chondrogenesis, but also the development of a stable hyaline-like repair tissue.

Novel engineered nanobodies specific for N-terminal region of alpha-synuclein recognize Lewy-body pathology and inhibit in-vitro seeded aggregation and toxicity.

Nanobodies (Nbs), the single-domain antigen-binding fragments of dromedary heavy-chain antibodies (HCAb), are excellent candidates as therapeutic and diagnostic tools in synucleinopathies because of their small size, solubility and stability. Here, we constructed an immune nanobody library specific to the monomeric form of alpha-synuclein (α-syn). Phage display screening of the library allowed the identification of a nanobody, Nbα-syn01, specific for α-syn. Unlike previously developed nanobodies, Nbα-syn01 recognized the N-terminal region which is critical for in vitro and in vivo aggregation and contains many point mutations involved in early PD cases. The affinity of the monovalent Nbα-syn01 and the engineered bivalent format BivNbα-syn01 measured by isothermal titration calorimetry revealed unexpected results where Nbα-syn01 and its bivalent format recognized preferentially α-syn fibrils compared to the monomeric form. Nbα-syn01 and BivNbα-syn01 were also able to inhibit α-syn-seeded aggregation in vitro and reduced α-syn-seeded aggregation and toxicity in cells showing their potential to reduce α-syn pathology. Moreover, both nanobody formats were able to recognize Lewy-body pathology in human post-mortem brain tissue from PD and DLB cases. Additionally, we present evidence through structural docking that Nbα-syn01 binds the N-terminal region of the α-syn aggregated form. Overall, these results highlight the potential of Nbα-syn01 and BivNbα-syn01 in developing into a diagnostic or a therapeutic tool for PD and related disorders.

Kinematic Analysis During Straight Line Free Swimming in Horses: Part 2 - Hindlimbs.

BACKGROUND: Swimming is used for rehabilitation and conditioning purposes in equine sports medicine. We described the swimming kinematics of the equine forelimbs in Part 1. The aim of Part 2 is to assess stifle, tarsus, and hind fetlock joints kinematics in swimming horses. The objectives were 1- to calculate and compare joint angles during swimming against passive mobilizations (PM), 2- to determine joints angular velocities during a swimming stride cycle. METHODS: Eleven elite endurance horses were used to swim in a 100-meter straight pool. Underwater (swimming) and overground PM videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metatarsal epicondyle, lateral aspect of the talus, lateral femoral epicondyle, and great trochanter of the femur. As a reference, maximal fetlock, tarsus, and stifle flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities, and range of motion (ROM) were statistically compared. RESULTS: The tarsus ROM was similar during PM and swimming. The stifle and fetlock ROM were greater during PM, although the stifle flexion was greater during swimming. The stifle and tarsus had the greatest hindlimb angular velocity during the swimming cycle. Greater angular velocities were observed during the retraction phase for all the hindlimb joints. CONCLUSION: A short retraction phase with great angular velocity for the joints of interest characterized the swimming pattern observed. Swimming may be beneficial in horses when an increased ROM of the tarsus and stifle or a reduced fetlock extension is indicated for rehabilitation purposes.

Kinematic Analysis During Straight Line Free Swimming in Horses: Part 1 - Forelimbs.

Background: Swimming is used for rehabilitation and conditioning purposes in equine sports medicine despite the lack of understanding of equine swimming kinematics. The aim of this study was to assess forelimb joints kinematics (elbow, carpus, and fetlock) in swimming horses. The specific objectives were 1- to calculate and compare joint angles in swimming vs. passive mobilizations (PM), 2- to determine joint angular velocities during a swimming stride cycle. Methods: Eleven elite endurance horses swam in a 100-m straight pool. Underwater (swimming) and overground (PM) videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metacarpal epicondyle, ulnar carpal bone, lateral humeral epicondyle, and the greater tubercle of humerus, from which elbow, carpus and fetlock angles, and angular velocities were obtained. As a reference, maximal fetlock, carpus, and elbow flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities and range of motion (ROM) were compared. Results: Carpus and fetlock ROM were significantly smaller (p < 0.001) during swimming when compared with PM, while there was no difference in elbow ROM between both situations. The carpus had the greatest ROM of all joints during swimming. Absolute angular velocities values of all joints during swimming were greater during retraction than protraction (p < 0.001). When compared to other joints during protraction, the carpus joint reached the highest angular velocity. Conclusion: Swimming, as a rehabilitation exercise, has the potential to benefit horses where great elbow ROM with a moderate carpus and fetlock extension are wanted.

Metabolic Predictors of Equine Performance in Endurance Racing.

Equine performance in endurance racing depends on the interplay between physiological and metabolic processes. However, there is currently no parameter for estimating the readiness of animals for competition. Our objectives were to provide an in-depth characterization of metabolic consequences of endurance racing and to establish a metabolic performance profile for those animals. We monitored metabolite composition, using a broad non-targeted metabolomics approach, in blood plasma samples from 47 Arabian horses participating in endurance races. The samples were collected before and after the competition and a total of 792 metabolites were measured. We found significant alterations between before and after the race in 417 molecules involved in lipids and amino acid metabolism. Further, even before the race starts, we found metabolic differences between animals who completed the race and those who did not. We identified a set of six metabolite predictors (imidazole propionate, pipecolate, ethylmalonate, 2R-3R-dihydroxybutyrate, ß-hydroxy-isovalerate and X-25455) of animal performance in endurance competition; the resulting model had an area under a receiver operating characteristic (AUC) of 0.92 (95% CI: 0.85-0.98). This study provides an in-depth characterization of metabolic alterations driven by endurance races in equines. Furthermore, we showed the feasibility of identifying potential metabolic signatures as predictors of animal performance in endurance competition.

Doppler indices of the equine fetal carotid artery throughout gestation.

Assessment of pregnancy viability in the equine patient is currently based on gestational profiles of limited prognostic value. In recent years Doppler technology has been applied to uterine and umbilical arteries of pregnant mares to monitor fetal responsive haemodynamics, suggestive of compromise. To date, uterine artery Doppler indices failed to provide sufficient evidence of pregnancy viability and the umbilical cord of the equine fetus is inconsistently visualized past 250 days gestation. The objectives of this study were to: i) evaluate intracranial blood flow impedance by Doppler examination of the fetal carotid artery and ii) establish reference values for healthy, uncomplicated pregnancies. The middle cerebral artery (MCA), a branch of the carotid artery, is commonly employed to assess intracranial hemodynamics in the human fetus, exhibiting high resistance to circulation to the fetal brain in uncomplicated pregnancies. For the purpose of this study, 12 pregnant mares were examined at 2-3 weeks interval by B mode and Doppler ultrasonography until delivery and a novel technique was developed for Doppler evaluation of the carotid artery in the equine fetus, in order to provide objective evidence of the hemodynamic status of the equine fetus. Additional biophysical and biochemical parameters were collected to demonstrate appropriate pregnancy development. In this study Doppler waveform analysis of fetal intracranial vasculature demonstrated an elevated blood flow impedance, showing a significant correlation of carotid Doppler indices with gestational age. Results were comparable to human fetal trends for the middle cerebral artery (MCA) from mid gestation to term. Biochemical data showed expected patterns of uncomplicated pregnancies.

Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment.

Synovial fluid analysis is utilized to diagnose septic synovitis. However, not all cases are clearly and rapidly discernible with the diagnostic tools available in the laboratory. Serum amyloid A (SAA), an acute phase protein, has been shown to be elevated in synovial fluid from inflamed synovial structures. The goal of this study is to describe the correlation between two diagnostic tests measuring equine SAA levels in septic and non-septic synovial structures and to understand the correlation between an elevated SAA result and synovial sepsis. Prospective estimation of sensitivity (Se) and specificity (Sp) of two tests, handheld and ELISA, measuring SAA in synovial fluid was completed in 62 horses presented with injured synovial structures. The comparison was made to a reference diagnosis based on white cell count, percentage of neutrophils, intracellular bacteria and bacterial culture on synovial fluid. Handheld test levels were classified as: 4 lines visible-SAA level negative; 3 lines visible-SAA level mild; 2 lines visible-SAA level moderate; and 1 line visible-SAA level severe and compared to the numerical value obtained with ELISA test. The ELISA SAA test had an area under the curve of 0.88 (0.78-0.98). An ELISA cut-off of 23.95 µg/mL maximized Se and Sp. This cutoff gave a Se of 0.93 (0.66-1.00) and Sp of 0.77 (0.63-0.88). The handheld test was highly correlated with the ELISA SAA test (Spearman rank correlation 0.96) and at a cutoff of moderate or higher for positive results gave identical Se and Sp. Se and Sp of synovial fluid SAA are very reliable when clinical signs of synovitis are present for >6 h. This test, in conjunction with traditional methods, can assist practitioners to rapidly diagnose and expedite appropriate intervention of synovial sepsis.

Arthroscopic surgical approach and intra-articular anatomy of the equine suprapatellar pouch.

OBJECTIVE: To describe a direct arthroscopic approach to the suprapatellar pouch (SPP), its intra-articular anatomy, and report our clinical experience with SPP arthroscopy. STUDY DESIGN: (1) Experimental study and (2) retrospective clinical study. ANIMALS: (1) Cadaveric equine hind limbs (n=24; 14 horses) and (2) 5 horses. METHODS: Four femoropatellar joints (FPJ) were dissected or injected with latex to document surface landmarks and topographic anatomy. (1) Arthroscopic exploration of 20 SPP (10 equine cadavers) was performed and described, followed by dissection. (2) Medical records of horses that had FPJ arthroscopy were reviewed for cases where SPP portals were required. RESULTS: (1) The optimal arthroscopic portal was located approximately 10 cm lateral to the longitudinal patellar axis and 2 cm proximal to the patellar base in the intermuscular septum between the biceps femoris and vastus lateralis muscles. This approach allowed arthroscopic observation of the proximal aspect of the lateral and medial femoral trochlear ridges, the intertrochlear groove, the patellar base, and the synovial recess of the SPP. (2) Additional arthroscopic and instrument suprapatellar portals were used in 5 of 25 horses to complete lavage/debridement in osteochondritis dissecans (OCD) and septic arthritis. CONCLUSION: Suprapatellar arthroscopy improved arthroscopic observation of structures located proximally in the FPJ and facilitated surgical access to the SPP. CLINICAL RELEVANCE: SPP arthroscopy is a safe and complementary approach to traditional distal FPJ arthroscopy that could be helpful for inspection and removal of free fragments/debris/fibrin located in the SPP, for OCD lesions extending proximally, and fracture(s) involving the proximal aspect of the patella.