An investigation into environmental variables influencing post-race exertional heat illness in thoroughbred racehorses in temperate eastern Australia.

Exertional heat illness (EHI) is a syndrome that occurs when metabolic heat production from muscular contraction exceeds the rate at which it can be dissipated. Core body temperature rises to critical levels, causing hyperthermia and central nervous system dysfunction. Best practice for the prevention of EHI centres around early detection, rapid response and aggressive cooling. Advance planning enables risk mitigation measures. The more that is known about EHI in horses, the better prepared those in the positions of responsibility can be to anticipate events in which the risk of EHI may be elevated. This prospective, observational study investigated environmental risk factors associated with the occurrence of EHI. From 2014 to 2018, the number of horses exhibiting the symptoms of post-race EHI was recorded at 73 convenience sampled race meetings. Of the 4809 starters, the signs of EHI were recorded for 457. Thermal environmental data were measured and included ambient temperature, radiant heat, vapor pressure (humidity) and wind speed (WS). Mixed linear regression models were computed to assess the associations between the occurrence and incidence of post-race EHI and the four thermal environmental variables. The analysis showed that vapor pressure and WS had the largest effects on the occurrence of post-race EHI. The major limitations were that the race meetings selected were convenience sampled according to attendance by the first author and individual horse data were not available. EHI is influenced by a complex interaction of independently acting environmental variables, but warm, windless, humid days are most likely to result in the cases of EHI.

Exertional heat illness: a review of the syndrome affecting racing Thoroughbreds in hot and humid climates.

Metabolic heat produced by Thoroughbred racehorses during racing can rapidly elevate core body temperature (1°C/min). When environmental conditions are hot and humid, the normal physiological cooling mechanisms become ineffective. The heat accumulated may exceed a critical thermal maximum (estimated to be 42°C), which may trigger a complex pathophysiological cascade with potentially lethal consequences. This syndrome has been labelled exertional heat illness (EHI). EHI is described in humans, but has not been well documented in Thoroughbred racehorses. The clinical signs described in racehorses would suggest that the pathophysiological events affecting the central nervous (CNS) and gastrointestinal systems are similar to those described in humans. Clinical signs are progressive and include signs of endotoxaemia and increasing levels of CNS dysfunction. Initially, horses that may be mildly irritable (agitated, randomly kicking out) may progress to unmanageable (disorientation, severe ataxia, falling) and ultimately convulsions, coma and death. Currently, the approach to treatment is largely empirical and involves rapid and effective cooling, administration of drugs to provide sedation, administration of non-steroidal anti-inflammatory drugs to ameliorate the effects of endotoxaemia and glucocorticoids to stabilise cell membranes and reduce the effects of inflammation on the CNS. This review provides an overview of the current knowledge about EHI in Thoroughbred racehorses, suggests a likely pathophysiology of the syndrome in horses based on the current literature on heat illness in humans and horses, and outlines current treatment strategies being used to treat racehorses with clinical signs of EHI.

Peritonitis associated with Actinobacillus equuli in horses: 15 cases (1982-1992).

Peritonitis attributable to Actinobacillus equuli was diagnosed in 15 horses examined at the veterinary center between 1982 and 1992. In 13 horses, historical findings included acute onset of mild to severe signs of abdominal pain, lethargy, and inappetence. Two other horses had a history of weight loss for 3 to 6 weeks prior to examination. Diagnosis was based on the physical signs and laboratory findings, including results of peritoneal fluid analysis (gross characteristics, total protein, total and differential nucleated cell counts, and morphologic findings) and culture of A equuli. Actinobacillus equuli was consistently susceptible in vitro to penicillin, trimethoprim/sulfadiazine, and aminoglycosides. All horses in the study had marked clinical improvement within 24 to 48 hours of commencing antibiotic and supportive treatment. Antibiotic treatment was continued for variable periods, depending on the horse, but ranged from 5 to 21 days. In 11 horses for which follow-up information was available, long-term response to treatment was excellent, with horses returning to original activity.

Indices of renal function: values in eight normal foals from birth to 56 days.

A series of blood and urine samples was collected from each of eight normal foals between birth and eight weeks. Blood chemistry relating to renal function was evaluated as well as physical and chemical characteristics of urine. During the first 4d of life it was impractical to suggest meaningful normal values due to wide variation among foals and with time. Serum urea and plasma creatinine fell markedly to levels less than those previously reported for normal adult horses, while urine, mildly hypersthenuric at birth, rapidly became hyposthenuric. There was also a marked proteinuria during the first 48h. After 4d clinicopathological values stabilised. Urea and creatinine remained at subadult levels and hyposthenuria was maintained. While there was some variation with time, generally the urinary activity of gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (AP) was greater in foals than in adults; plasma potassium, the creatinine clearance ratio of potassium (% Cr K), serum inorganic phosphate and the creatinine clearance ratio of phosphate (% Cr PO4) were greater than in adults while plasma chloride and the creatinine clearance ratio of chloride (% Cr Cl) were lower in foals than in adults. Urinary pH was acidic and epithelial cells and calcium oxalate crystals more prevalent in the urine of foals than in that of adults. The information presented here will be useful in the diagnosis and management of renal disease and azotaemia in foals.

Indices of renal function: reference values in normal horses.

Urine and blood samples were taken at the same time from normal adult horses presented for routine investigations to establish reference values for a variety of parameters reported to be useful in the clinical evaluation of renal function. Blood biochemical values were consistent with previous studies and had well-defined normal ranges. Parameters representing urine concentration and electrolyte excretion however, varied widely reflecting the ability of the healthy kidney to change the composition of urine in response to differences in environment and management. Percent creatinine clearance ratios for potassium in particular were lower than those reported in normal horses in previous studies. Rational interpretation of these latter measurements should accept a wide range of normal values and management conditions must be considered in this interpretation.

Studies on the optimal temperature of flotation tanks in the management of skeletal injuries in the horse.

In order to determine optimum tank temperature, nine horses were allocated randomly to three groups and placed in a flotation tank at temperatures of 28 degrees C, 32 degrees C and 36 degrees C. Their progress was monitored by subjective and objective clinical measurements and a variety of laboratory parameters. A 'reacclimatisation crisis' following removal from the tank was observed in most horses after immersion for 21 days and it was concluded that a tank temperature of 36 degrees C provided maximum patient comfort and minimum homoeostatic disturbance.

Pulmonary changes associated with flotation techniques in the treatment of skeletal injuries in the horse.

Six adult horses with normal blood gas values, normal thoracic radiographs and free from overt signs of respiratory disease were confined in flotation tanks for periods from one to seven weeks. With one exception, they all coughed, had a variable amount of nasal discharge and, at autopsy, showed cranio-ventral alterations to their lungs which were characterised by patchy irregular areas of absorption atelectasis with or without an inflammatory reaction and an accompanying alveolar emphysema.

The 'Turner' circle absorber: an anaesthetic breathing system for the horse.

An inhalation anaesthetic apparatus for the horse is described and the physiological concepts pertaining to its design presented. The internal diameter of all breathing components is 6.2 cm with no change in cross sectional area throughout the circle system. The soda lime capacity is 25 litres (approximately 20 kg). In the horse, which is apparently predisposed to alveolar hypoventilation during inhalation anaesthesia, it is apparent that adequate anaesthetic apparatus design should be directed towards minimising resistance and dead space and providing maximal and efficient carbon dioxide elimination.

Polymorphonuclear neutrophil leucocytes of peritoneal fluid.

Cells in the peritoneal fluid from 179 horses were examined in Giemsa stained preparations using light microscopy. Neutrophils were found in all samples whether transudative or exudative although their proportions varied enormously. They were well preserved in "normal" or sterile effusions and hardly differed morphologically from those seen on a peripheral blood film although hypersegmentation was commonly observed. In purulent effusions a reliable correlation was found between degenerative changes in neutrophils such as karyolysis and karyorrhexsis and the presence of toxin-producing microorganisms. On most occasions these degenerative changes enabled a confident judgement to be made as to whether the likelihood of a bacterial aetiology did or did not exist even in the absence of demonstrable microorganisms.

Mononuclear phagocytes of peritoneal fluid.

Cells in the peritoneal fluid from 179 horses were examined in Giemsa stained preparations using light microscopy. Mononuclear phagocytes were a common cell type observed in normal fluids. In the absence of stimulation they were morphologically similar to the peripheral blood monocyte and the unstimulated mesothelial cell. In acute inflammatory effusions their proportion decreased significantly but, as the condition resolved, monocytes began to migrate into the cavity gradually becoming more numerous, transforming into larger macrophages and assuming an increasing phagocytic role. They were often strikingly enlarged and actively phagocytic of degenerate neutrophils and aged red cells.

The concept of osmolality: its use in the evaluation of "dehydration" in the horse.

Osmolality is an indication of the osmotic pressure of plasma and depends on the amount of solute and solvent (water) present. The mean (+sd) plasma osmolality of 100 clinically normal animals was 282 (+6) mOsm/kg using lithium heparin as anticoagulant. The equation, osmolality=1.86 (sodium + potassium) +glucose +blood urea nitrogen + 9, was found to predict only crudely plasma osmolality. The plasma sodium: osmolality ratio was 0.49. Water and electrolyte disorders are classified into 3 types based on the measurement of electrolytes and osmolality: (1) Hypertonic dehydration (true dehydration desiccation), osmolality greater than 300 mOsm/kg, associated with water deprivation, some gastrointestinal emergencies and some types of diarrhoea; (2) hypotonic dehydration (acute desalting water loss), osmolalities less than 260 mOsm/kg, associated with acute diarrhoea, particularly salmonellosis; (3) isotonic dehydration (normal electrolyte and osmolality levels), in horses losing electrolytes and water in almost equal proportions. The importance of these observations and their significance in rational clinical management are discussed.

Mesothelial cells of peritoneal fluid.

Cells in the peritoneal fluid from 159 horses were examined in Giemsa stained preparations using light microscopy. Normal mesothelial cells showed an oval nucleus with finely reticular chromatin and pale blue cytoplasm. Activated mesothelial cells occurred in fluids derived from mesothelium under acute or subacute, non-septic stimulus and were remarkable for their pleomorphism and intense basophilia which may mimic neoplasia. Transformed mesothelial cells seen in chronic inflammatory fluids were sometimes phagocytic and showed conspicuous cytoplasmic vacuolation.

Reference values for equine peritoneal fluid.

Twenty horses, aged one to 17 years (mean age 6 years), presented for elective destruction and subsequently found at autopsy to have no significant peritoneal alterations, were used to determine a variety of reference values for peritoneal fluid. Samples were collected ante mortem or within 1 h post mortem. Each cavity contained 100 to 300 ml of usually clear, pale yellow fluid which in a clinical refractometer showed a mean specific gravity 1.010 (range 1.0081-1.0116) and mean (+/- standard deviation) total protein 7.7 +/- 3.6 g/litre. The mean total nucleated cell count (+/- sd) was 4.33 +/- 2.5 x 10(9)/litre (range 1.5-10.1 x 10(9)/litre) and, proportionally, polymorphonuclear leucocytes averaged 45.2 per cent, mononuclear phagocytes 47 per cent, lymphocytes 7.8 per cent, eosinophils 0.7 per cent and basophils and mast cells zero. Eosinophils were not usually seen but 6 samples had 1 to 5 per cent. The peritoneal fluid chemical profile (mean +/- sd) was: Aspartate aminotransferase (AST) 118.9 +/- 46.9 iu/litre; alkaline phosphatase (AP) 56.0 +/- 52.7 iu/litre; lactate dehydrogenase (LDH) 143.0 +/- 106.1 iu/litre; total bilirubin (TB) 8.0 +/- 6.2 mumol/litre; total protein (TP) (biuret method) 14.2 +/- 6.8 g/litre; urea nitrogen (BUN) 6.1 +/- 1.1 mmol/litre; glucose 7.7 +/- 1.8 mmol/litre; inorganic phosphate (IP) 1.4 +/- 0.5 mmol/litre; calcium 2.0 +/- 0.2 mmol/litre. TP, BUN, glucose and IP were closely correlated with levels in paired serum samples.