The lipopolysaccharide model for the experimental induction of transient lameness and synovitis in Standardbred horses.

An established lipopolysaccharide (LPS) model previously described in Warmbloods, was inconsistent in Standardbred horses, where lameness was not detected despite the presence of synovitis. The present study aimed to determine the dose of LPS from E. coli O55:B5 required to induce mild to moderate lameness following middle carpal joint injection in Standardbred horses and to quantitate the induced lameness over time, with and without anti-inflammatory pre-treatment. In a baseline trial, eight healthy, clinically sound Standardbred horses were used in a rule-based dose-escalation design trial, starting at a dose of 10 endotoxin units (EU). Lameness at trot was evaluated visually and quantitatively (using an inertial-sensor system and pressure plate analysis). Synovial fluid aspirates were analysed for total nucleated cell counts, total protein and prostaglandin E2 (PGE2). Following 2 months wash-out, the effective LPS-dose determined in the baseline trial was used to evaluate the effect of anti-inflammatory treatment. A mixed model for repeated measures with horse as random effect was used for analysis. After injection of 10 EU LPS, the desired degree of lameness was observed in the baseline trial, with maximal lameness at post-injection hour (PIH) 4, followed by a rapid decline and return to baseline by PIH 48. No lameness was observed following pre-treatment with meloxicam. In synovial fluid, PGE2 was significantly higher at PIH 8 and PIH 24 in the baseline trial compared with following meloxicam pre-treatment. In conclusion, injection of the middle carpal joint with 10 EU LPS consistently induces a transient lameness and synovitis in Standardbred horses.

Dynamic evaluation of toe-heel and medio-lateral load distribution and hoof landing patterns in sound, unshod Standardbred horses with toed-in, toed-out and normal hoof conformation.

Dynamic load distribution and landing patterns play an important role in equine orthopaedics. The aim of this study was to analyse dynamic load distribution and hoof landing patterns of sound Standardbreds. Twenty-four sound, unshod Standardbreds were walked and trotted over a pressure plate to obtain the peak vertical force (PVF), vertical impulse (VI) and stance time (ST) of both forelimbs. Asymmetry indices between both forelimbs were calculated and the dynamic medio-lateral and toe-heel load distribution of the forelimbs were compared between normal, toed-in and toed-out horses. The hoof landing patterns were determined on the first loaded zone. Linear mixed models and Chi-square analysis were used for statistical analysis (α = 0.05). At walk and trot, there were no significant differences in asymmetry of PVF, VI and ST between normal (n = 9/24 horses), toed-in (n = 6/24 horses), and toed-out horses (n = 9/24 horses). In both forelimbs, a flat landing (39.6% and 70.8% at walk and trot, respectively) predominated over all hoof conformations. No significant association between hoof conformation and landing pattern was observed (P > 0.05). Toed-out horses had significantly higher loading of the medial zone at the end of the stance phase at walk than normal horses (P = 0.002). No other statistically significant differences in load distribution were observed (P > 0.05). In conclusion, flat landing was more common in Standardbred horses than previously described in Warmbloods, emphasising the need for breed-specific clinical reference data and biomechanical studies. Moreover, mild deviations in hoof conformation did not necessarily affect load distribution.

The use of equine chondrogenic-induced mesenchymal stem cells as a treatment for osteoarthritis: A randomised, double-blinded, placebo-controlled proof-of-concept study.

BACKGROUND: There is a need to improve therapies for osteoarthritis in horses. OBJECTIVES: To assess the efficacy of equine allogeneic chondrogenic-induced mesenchymal stem cells combined with equine allogeneic plasma as a novel therapy for osteoarthritis in horses. STUDY DESIGN: Randomised, double-blinded, placebo-controlled experiment. METHODS: In 12 healthy horses, osteoarthritis was induced in the metacarpophalangeal joint using an osteochondral fragment-groove model. Five weeks after surgery, horses were randomly assigned to either an intra-articular injection with chondrogenic-induced mesenchymal stem cells + equine allogeneic plasma (= intervention) or with 0.9% saline solution (= control). From surgery until the study end, horses underwent a weekly joint and lameness assessment. Synovial fluid was collected for cytology and biomarker analysis before surgery and at Weeks 5, 5 + 1d, 7, 9 and 11. At Week 11, horses were subjected to euthanasia, and the metacarpophalangeal joints were evaluated macroscopically and histologically. RESULTS: No serious adverse events or suspected adverse drug reactions occurred during the study. A significant improvement in visual and objective lameness was seen with the intervention compared with the control. Synovial fluid displayed a significantly higher viscosity and a significantly lower glycosaminoglycan concentration in the intervention group. Other biomarkers or cytology parameters were not significantly different between the treatment groups. Significantly less wear lines and synovial hyperaemia were present in the intervention group. The amount of cartilage oligomeric matrix protein, collagen type II and glycosaminoglycans were significantly higher in the articular cartilage of the intervention group. MAIN LIMITATIONS: This study assessed the short-term effect of the intervention on a limited number of horses, using an osteoarthritis model. This study also included multiple statistical tests, increasing the risk of type 1 error. CONCLUSIONS: Equine allogeneic chondrogenic-induced mesenchymal stem cells combined with equine allogeneic plasma may be a promising treatment for osteoarthritis in horses. The Summary is available in Spanish - see Supporting Information.

Can the hoof be shod without limiting the heel movement? A comparative study between barefoot, shoeing with conventional shoes and a split-toe shoe.

Conventional shoeing restricts heel movement, which may have a negative effect on the orthopaedic health of the horse. A randomised crossover experimental study using noninvasive techniques was performed to compare the mediolateral heel movement in barefoot horses, horses shod with a conventional toe clipped shoe and with a new type of shoe with a split toe. In eight horses, 16 forelimbs were tested barefoot, shod with a conventional shoe and with the split-toe (ST) shoe, in random order. A displacement sensor was secured on the heels and measurements were collected continuously at a frequency of 679Hz while horses were exercised on a treadmill at the walk (1.8m/s), trot (3.5m/s) and canter (8m/s). Differences in heel movement between the conditions were analysed using a generalised estimating equations approach. The conventional shoe was associated with significantly less heel expansion compared with the ST shoe and barefoot situation in all gaits (P≤0.001). Heel expansion with the ST shoe was not significantly different from the barefoot condition. For all gaits, shoeing was associated with a significant reduction in heel contraction compared with the barefoot situation (P≤0.038), except for the heel contraction at the canter using a conventional shoe. In conclusion, the heel expansion with the ST shoe did not differ significantly from when the horse was barefoot, in contrast with the significant restriction of the heel movement when a conventional shoe was used.

Equine allogeneic chondrogenic induced mesenchymal stem cells: A GCP target animal safety and biodistribution study.

The safety of the intra-articular use of mesenchymal stem cells (MSCs) is scarcely reported. Therefore, the goal of this study was to investigate the safety of a single intra-articular injection with allogeneic chondrogenic induced MSCs combined with equine plasma (=the investigational product: IVP) compared to a saline (0.9% NaCl) placebo control (=control product: CP). Sixteen healthy experimental horses were randomly assigned to receive a single intra-articular injection with either the IVP (n=8) or the CP (n=8) in the left metacarpophalangeal joint. All horses underwent a daily clinical assessment throughout the entire study period of 42days to assess adverse events. Additionally, a local joint assessment and a lameness examination were performed daily during the first two weeks, and weekly the following 4weeks. Blood samples were taken weekly for hematological and biochemical analysis. At the end of the study period, horses of the IVP group were euthanized for a thorough necropsy and to check for biodistribution. Tissue samples of the injected joint were collected for histological examination. In both CP and IVP treated horses a mild transient subjective increase in periarticular temperature and lameness was noted after the intra-articular injection with no significant differences between the treatment groups. No distribution of the cells was found using immunohistochemistry and no ectopic tissue formation or signs of inflammation were found on histology. A single intra-articular injection of allogeneic chondrogenic induced MSCs combined with allogeneic plasma in horses had the same clinical side effects as an intra-articular injection with saline solution.

Evaluation of direct Etest for antimicrobial susceptibility testing of bacteria isolated from synovial fluid of horses using enrichment bottles.

This study evaluated the Etest for direct antimicrobial susceptibility testing (AST) of bacteria from equine synovial specimens, incubated in BACTEC enrichment bottles. Ninety-four culture-positive broths were inoculated onto agar to directly determine the minimum inhibitory concentrations (MICs) of 13 antimicrobials, using the Etest (direct Etest). Results were compared with those obtained with the agar dilution reference method, the standard Etest, and the disc diffusion method, after subculture and standardisation of the inoculum. For categorical comparison of AST results, MICs were translated into susceptibility categories, using clinical breakpoints. The direct Etest predicted categorical susceptibility/resistance of bacteria from equine synovial fluid with acceptable accuracy (overall categorical agreement, 91%) and was more reliable than the disc diffusion test. The direct Etest was less accurate than the standard Etest for generating MICs ± 1 log dilution relative to the reference method (overall essential agreement, 69% vs. 89%). As the Etest generated a high percentage of inaccuracies with trimethoprim and sulfadiazine, these were less suitable antimicrobial agents for inclusion. In conclusion, the direct Etest reliably predicted the susceptibility of isolates from equine synovial fluid for the tested antimicrobials, except for trimethoprim and sulfadiazine. Since it did not require subculture and preparation of a standardised inoculum, direct Etest results were available at least 24 h earlier than with other methods, which could facilitate the diagnosis of synovial infections. However, when accuracy is prioritised over speed for MIC determination, the standard Etest is preferred over the direct Etest.

The preventive effects of two nutraceuticals on experimentally induced acute synovitis.

BACKGROUND: Nutraceuticals are often used in the management of equine osteoarthritis, but scientific evidence of their efficacy is lacking. OBJECTIVES: To study the preventive effects of two new nutraceuticals after the experimental induction of synovitis in comparison with positive and negative control treatments. STUDY DESIGN: Blinded, controlled, randomised experiment. METHODS: Twenty-four healthy Standardbred horses were randomly allocated to supplement AT (multi-ingredient, 28 days), supplement HP (collagen hydrolysate, 60 days), meloxicam (4 days) or placebo (60 days). Synovitis was induced in the right intercarpal joint by intra-articular injection of 0.5 ng lipopolysaccharide (LPS) of Escherichia coli while treatments were continued. Blood and synovial fluid were sampled before treatment, immediately prior to LPS injection, and at 8, 24 and 48 h post-injection. Synovial fluid samples were analysed for total nucleated cell count (TNCC), total protein (TP) and selected biomarkers (prostaglandin E2 [PGE2 ], interleukin-6 [IL-6], glycosaminoglycans [GAGs], type II collagen synthesis [CPII], matrix metalloproteinase [MMP]). Lameness was scored by visual examination and pressure plate analysis immediately prior to LPS injection, and at 8, 24 and 48 h post-injection. Clinical examinations were performed before treatment, immediately prior to LPS injection, at 2, 4 and 6 h post-injection, and then twice per day during the test period. RESULTS: Before treatment and intra-articular challenge, there were no statistically significant differences among the treatment groups for any of the parameters. After intra-articular challenge, the placebo group showed significantly higher synovial fluid TP, TNCC and PGE2 compared with the meloxicam group, although the model did not induce a relevant amount of lameness. Both nutraceuticals resulted in significantly lower synovial fluid TP, TNCC and PGE2 compared with placebo. No statistical differences in IL-6, GAGs, CPII or MMPs were observed among treatment groups. No adverse effects were observed. MAIN LIMITATIONS: Despite evidence of synovitis, lameness was too mild to detect. CONCLUSIONS: The preventive administration of these nutraceuticals showed anti-inflammatory effects in this validated synovitis model. Therefore, further studies of their clinical applicability are warranted.

Anatomical Description of the Presence and Variability of the Digital Manica Flexoria in the Equine Digital Flexor Tendon Sheath.

During endoscopy (tenoscopy) of the distal aspect of the equine digital flexor tendon sheath (DFTS), the digital manica flexoria can be visualized connecting the distal branches of the superficial digital flexor tendon. However, this structure has been inconsistently described and variably named in the veterinary literature. The objectives of this study were to describe the presence, configuration and variability of the digital manica flexoria in the equine distal limb. Dissection of 144 equine cadaveric limbs revealed the presence of this structure in all the feet, although different types and conformations were identified. In the forelimbs, a membranous digital manica flexoria predominated (94%; P < 0.001), in particular a synovial bridge type (83%; P < 0.001). In the hindlimbs, a tendinous digital manica flexoria predominated (93%; P < 0.001), in particular the oblique-crossing of tendinous bundles (61%; P < 0.001). Passage dorsal to the digital manica flexoria towards the distal DFTS was only possible in 22 of the 144 limbs, all forelimbs. Clinicians should be aware of the intra- and inter-individual anatomical variations of the digital manica flexoria to avoid misinterpretation during ultrasonographic and tenoscopic examinations of the DFTS.

Diffusion of mepivacaine to adjacent synovial structures after intrasynovial analgesia of the digital flexor tendon sheath.

REASONS FOR PERFORMING STUDY: Controversy exists about the specificity of diagnostic analgesia of the digital flexor tendon sheath (DFTS) in horses. OBJECTIVES: To evaluate the degree of diffusion of mepivacaine from the equine DFTS to adjacent synovial structures. STUDY DESIGN: Crossover experiment. METHODS: Under general anaesthesia, the DFTS of one front and one hindlimb of 8 horses were injected simultaneously with mepivacaine. Synovial fluid samples of the injected DFTS, the adjacent metacarpo-/metatarsophalangeal (MCP/MTP) joint, proximal interphalangeal joint, distal interphalangeal joint, navicular bursa and contralateral MCP/MTP joint were collected 15 min post injection (T15) from one of the injected limbs and 60 min post injection (T60) from the other limb. Venous blood samples were obtained at T0, T15 and T60 to evaluate systemic distribution of mepivacaine. After a 2-week washout period, the procedure was repeated using the same limbs but reversing the time of sampling (front vs. hindlimbs). The concentration of mepivacaine in samples was measured with a commercial ELISA kit. RESULTS: Mepivacaine concentrations in the DFTS samples, at both T15 (5077 mg/l) and T60 (3503 mg/l), exceeded those estimated sufficient to produce synovial analgesia (100 mg/l or 300 mg/l). Mepivacaine was found in all synovial structures adjacent to the injected DFTS and in the contralateral MCP/MTP joints, but concentrations were low, with a maximum value of only 3.2 mg/l. With the exception of the navicular bursa samples, the mepivacaine concentrations in the adjacent synovial structures were significantly higher at T60 than at T15 (P<0.03). Significantly higher mepivacaine concentrations were found in the ipsilateral than the contralateral MCP/MTP joints at T60 (P<0.001). Blood samples had significantly higher mepivacaine concentrations at T15 and T60 than at T0 (P<0.001). CONCLUSIONS: Mepivacaine injected into the DFTS of horses diffuses towards adjacent synovial structures without achieving clinically relevant concentrations.

The effect of perineural anaesthesia and handler position on limb loading and hoof balance of the vertical ground reaction force in sound horses.

REASONS FOR PERFORMING STUDY: The effects of handler position and perineural anaesthesia in sound horses need investigation to facilitate interpretation of pressure plate analysis in lame horses. OBJECTIVES: To evaluate the effect of handler position and perineural anaesthesia on limb loading and particularly hoof balance in sound horses. STUDY DESIGN: Nonrandomised crossover study. METHODS: Six sound horses were walked and trotted over a pressure plate, with the handler on the left and subsequently on the right side, and finally after a bilateral low palmar digital nerve block. One week later this procedure was repeated before and after a bilateral abaxial sesamoidean nerve block. Peak vertical force, vertical impulse and stance time of 5 hoof prints of both forelimbs were obtained (126 Hz), and toe-heel and mediolateral hoof balance curves of the vertical force were plotted throughout stance. Limb-loading and timing data and hoof balance data (beginning, middle and end of the stance phase) were statistically compared (handler left compared with right; before compared with after low palmar digital nerve block and abaxial sesamoidean nerve block; baseline at first measurement session compared with second). RESULTS: There were no significant effects of handler position and perineural anaesthesia on peak vertical force, vertical impulse and stance time. Hoof balance curves were not affected by handler position or perineural anaesthesia. The limb loading data and hoof balance curves were comparable for each horse over the one-week interval. CONCLUSIONS: Handler position and perineural anaesthesia do not have an effect on limb loading and toe-heel and mediolateral hoof balance in sound horses, which is of fundamental importance before embarking on pressure plate analysis for lameness diagnosis.

Recording of cord dorsum potentials in calves.

Cord dorsum potentials are sensory evoked potentials being used to assess proximal sensory nerve, dorsal nerve root and spinal cord dorsal horn function. The purpose of the present study was to establish normal values for onset latency, peak latency and peak-to-peak amplitude of cord dorsum potentials after saphenous nerve stimulation in 15 healthy calves. Under general anesthesia, the saphenous nerve was stimulated in the periphery and cord dorsum potentials were recorded from the interarcuate space L3-L4, L4-L5, L5-L6 and L6-S1. Cord dorsum potentials were easily recorded at the different recording sites and consisted of a large negative peak followed by a long latency positive phase. The largest responses were recorded at the L5-L6 interarcuate space. Body temperature significantly influenced peak-to-peak amplitude. Onset latency prolonged with increasing limb length.

A preliminary study on pressure-plate evaluation of forelimb toe-heel and mediolateral hoof balance on a hard vs. a soft surface in sound ponies at the walk and trot.

REASONS FOR PERFORMING STUDY: Thus far, pressure-plate analysis has been limited to measurements on a hard surface, whereas equine athletes routinely perform on a deformable substrate. OBJECTIVES: To explore pressure-plate analysis on arena footing. STUDY DESIGN: Nonrandomised crossover study using noninvasive techniques. METHODS: Five sound, unshod ponies were walked and trotted over a pressure plate in 2 different conditions. In the first session, the plate was covered with only a 5 mm rubber mat, and in the second session, with an additional 50 mm layer of sand and synthetic fibres. Limb loading and timing variables (peak vertical force, vertical impulse, peak vertical pressure, hoof contact area and stance phase duration) were obtained. Toe-heel and mediolateral hoof balance of the vertical force were calculated throughout stance (126 Hz). RESULTS: Peak vertical force, vertical impulse, peak vertical pressure and stance phase duration were decreased on the soft substrate, while hoof contact area increased. At impact, there was more even load distribution between the toe and heel region on the soft vs. hard surface. At mid-stance, there was more loading of the toe region on the soft compared with the hard surface. At impact, there was more even load distribution between lateral and medial on the soft vs. hard surface at walk, but not at trot. CONCLUSIONS: Comparison of observed vs. expected impulse indicated that the main factor involved in the lower loading on the soft surface is the dampening effect of the soft substrate, although definitive conclusions require concurrent force-plate analysis. The pressure plate permitted quantitative evaluation of hoof balance of the vertical force on a deformable surface at the walk and trot and proved that there is more even load distribution on arena footing.

Distal limb desensitisation following analgesia of the digital flexor tendon sheath in horses using four different techniques.

REASONS FOR PERFORMING STUDY: Controversy exists about the desensitisation obtained after diagnostic analgesia of the digital flexor tendon sheath (DFTS) during lameness examinations. OBJECTIVES: To determine whether DFTS analgesia results in inadvertent desensitisation of the palmar/plantar digital nerves and whether this depends on the injection technique used. STUDY DESIGN: Crossover experimental study. METHODS: The DFTS of 9 horses were injected with local anaesthetic solution and radiodense contrast medium using one of the following techniques: Proximal (at lateral proximal recess of the DFTS), Axial (axial to the lateral proximal sesamoid bone), Base (at base of the lateral proximal sesamoid bone), and Distal (at palmar/plantar mid-pastern). In total, 72 injections were performed. Skin desensitisation at the heel bulbs was tested with a dynamometer before and at 15, 30, 90 and 120 min after injection. RESULTS: Overall, complete desensitisation of a heel bulb at one or more time points after injection occurred in 22 limbs (30.6%). An additional 7 limbs were partially desensitised. Complete skin desensitisation occurred in 10, 3, 4 and 5 limbs using the Proximal, Axial, Base and Distal techniques respectively. Significant differences between techniques were only found at T30. The probability of skin desensitisation at the heel bulbs was 4 times higher when using the Proximal compared with the Axial and Base techniques in the forelimbs, and 3 times higher compared with the Axial and Distal techniques in the hindlimbs. Skin desensitisation nearly always occurred exclusively on the lateral heel bulb. Bilateral desensitisation only occurred in 5 limbs. CONCLUSIONS: Anaesthesia of the palmar/plantar digital nerves with distal limb desensitisation often occurs after DFTS analgesia. A higher chance of desensitisation exists when injecting the proximal DFTS recess. It is advisable to verify skin sensitivity at the heel bulbs after DFTS analgesia to avoid false interpretations about the origin of pain causing lameness.

Clinical, radiographic, ultrasonographic and computed tomographic features of nonseptic osteitis of the axial border of the proximal sesamoid bones.

REASONS FOR PERFORMING STUDY: Lysis of the axial aspect of equine proximal sesamoid bones (PSBs) is a rare condition reported to have septic or traumatic origins. Limited information exists regarding imaging of nonseptic axial osteitis of a PSB. OBJECTIVES: To report the clinical, radiographic, ultrasonographic, computed tomographic and intra-arterial contrast-enhanced computed tomographic abnormalities in horses with axial nonseptic osteitis of a PSB. STUDY DESIGN: Retrospective clinical study. METHODS: Eighteen horses diagnosed with nonseptic osteitis of the axial border of a PSB between 2007 and 2012 were reviewed retrospectively. Case details, clinical examination, radiographic, ultrasonographic, computed tomographic and intra-arterial/intra-articular contrast-enhanced computed tomographic features were recorded, when available. Radiographic, ultrasonographic and computed tomographic evaluations of the fetlock region had been performed on 18, 15 and 9 horses, respectively. The effect of the degree of lysis on the grade and duration of lameness was determined. RESULTS: All horses had chronic unilateral lameness, 4 with forelimb and 14 with hindlimb signs. On radiographs, lysis was identified in both PSBs in 14 horses, one PSB in 3 horses and in one horse no lysis was identified. The degree of osteolysis was variable. Ultrasonography identified variably sized irregularities of the bone surface and alteration in echogenicity of the palmar/plantar ligament (PL). All horses undergoing computed tomographic examination (n = 9) had biaxial lysis. The lesions were significantly longer and deeper on computed tomographic images compared with radiographic images. Intra-arterial contrast-enhanced computed tomography may reveal moderate to marked contrast enhancement of the PL. There was no significant effect of the degree of lysis on the grade and duration of lameness. CONCLUSIONS: Lesions of nonseptic axial osteitis of a PSB can be identified using a combination of radiography and ultrasonography. Computed tomography provides additional information regarding the extent of the pathology.

Pressure plate analysis of toe-heel and medio-lateral hoof balance at the walk and trot in sound sport horses.

Empirically, equine distal limb lameness is often linked to hoof imbalance. To objectively quantify dynamic toe-heel and medio-lateral hoof balance of the vertical ground reaction force in sound sport horses, seven Royal Dutch Sport Horses were led at the walk and trot over a dynamically calibrated pressure plate. Forelimb hoof prints were divided into a toe and heel region and a medial and lateral zone. Toe-heel and medio-lateral hoof balance of the vertical ground reaction force were calculated throughout the stance. Toe-heel balance was highly symmetrical between contralateral limbs at both gaits. At the walk, medio-lateral balance of both forelimbs presented higher loading in the lateral part of the hoof throughout the stance. However, at the trot, left medio-lateral balance presented higher loading of the medial part of the hoof at impact, whereas the right limb showed higher loading of the lateral part of the hoof in all horses, and both limbs presented increased lateral loading at the end of the stance. This study provides objective data for toe-heel and medio-lateral hoof balance in sound sport horses.

Do developmental orthopaedic disorders influence future jumping performances in Warmblood stallions?

REASONS FOR PERFORMING THE STUDY: Few reports are available on the relationship between developmental orthopaedic diseases (DOD) and future performances in Warmblood horses. OBJECTIVES: To investigate the relationship between performance and the presence of DOD lesions. METHODS: Records of Warmblood stallions for which radiographic and performance data were available were collected. Showjumping performances were expressed as scores derived from the final ranking of horses in each competition. These scores are available in an established performance database. The relationship between radiographic findings and both performance scores and number of performances was analysed using a linear regression model. RESULTS: Two hundred and fifteen horses met the inclusion criteria. There was no difference in either the number of performances or performance score between horses categorised as affected with DOD lesions (independent of joint location) compared with controls. Significantly lower numbers of performances were recorded for horses with osteochondral fragments (OCD) located at the dorsal aspect of the sagittal ridge of the metacarpo/metatarsophalangeal bone. No significant difference was found between horses affected with DOD lesions of the tarsocrural joint and controls. Horses with osteochondrosis of the lateral trochlear ridge of the femur had both significantly lower performance scores and numbers of performances compared with controls. CONCLUSION: This study demonstrated that specific DOD location and site within the joint have an influence on performance. Osteochondral fragments in the femoropatellar and at the dorsal aspect of the sagittal ridge of the metacarpo/metatarsophalangeal joint resulted in lowered performance. Fragmentation in the tarsocrural joint had no influence on performance. POTENTIAL RELEVANCE: The future athletic performance of Warmblood jumping horses may be limited as a result of OCD in the femoropatellar joint and to a certain extent the metacarpo/metatarsophalangeal joint.

Equine myeloperoxidase: a novel biomarker in synovial fluid for the diagnosis of infection.

REASONS FOR PERFORMING STUDY: Equine joint infection is a life-threatening disorder, and confirmation of the diagnosis can be difficult. Synovial fluid biomarkers may assist the discrimination between infectious and noninfectious joint disease. OBJECTIVES: This study investigates whether the immunological detection of total and enzymatically active myeloperoxidase (MPO) assists the diagnosis of joint infection in horses. METHODS: The following 4 sample groups were included: healthy; osteochondritis dissecans (OCD); traumatic synovitis; and culture-confirmed infected joints. Synovial fluid was analysed for total MPO by a horse-specific sandwich enzyme-linked immunosorbent assay (ELISA) and for active MPO using the specific immunological extraction followed by enzymatic detection (SIEFED) technique. Western blot analysis was performed to confirm the antibody specificity. RESULTS: Synovial fluid from infected joints contained significantly more total and active MPO than samples from healthy joints, joints affected by OCD and joints with traumatic synovitis. Cut-off values were set at 5000 and 350 ng/ml for total and active MPO, respectively, with fair sensitivity, specificity, positive and negative predictive values and likelihood ratios for infection. Correlation coefficients were reported between the total as well as the active MPO levels and the routine synovial fluid parameters, i.e. the white blood cell count, the neutrophil count and the total protein level. No correlation was observed between MPO and either the age of the horse or the joint affected. Western blotting confirmed the antibody specificity for equine MPO. CONCLUSIONS AND POTENTIAL RELEVANCE: Synovial fluid MPO was identified as a very promising biomarker to augment the discrimination of infectious vs. noninfectious joint disease in horses. Both ELISA and SIEFED techniques can be used for its specific and rapid detection. The analysis of synovial fluid MPO can be used as a complementary test to aid in the discrimination between infectious and noninfectious joint disease, especially when the white blood cell counts and the total protein level are inconclusive.

Comparison of four techniques for synoviocentesis of the equine digital flexor tendon sheath: a cadaveric study.

OBJECTIVE: To compare four different techniques for synoviocentesis of the equine digital flexor tendon sheath (DFTS). METHODS: Fifteen inexperienced operators performed each of the following injection techniques on two cadaveric limbs: Proximal (at the proximal recess of the DFTS), Axial (axial to the proximal sesamoid bone), Base (at the base of the proximal sesamoid bone), and Distal (at the pastern). The number of attempts needed before the needle was assumed to be correctly positioned into the DFTS was recorded and 10 ml of methylene blue was injected. The limbs were dissected to determine the presence of methylene blue in the DFTS, the distance between the needle entrance point and the lateral palmar or plantar (digital) nerve, the degree of subcutaneous leakage and the distance between the border of the leakage zone and the lateral digital nerve. RESULTS: The Axial (29/30) and Distal (25/30) approaches had the highest numbers of successful injections. The median number of attempts was highest for the Axial approach. The distances from the injection point and from the border of the leakage zone to the lateral digital nerve were longer for Distal and Axial approaches. CLINICAL RELEVANCE: In the hands of inexperienced operators, the Axial approach was the most successful technique for injection of the equine DFTS. Sparse subcutaneous leakage and larger distance to the nerve when using this technique might decrease the risk of in-advertent palmar or plantar digital nerve desensitisation when performing DFTS analgesia.

Use of a pressure plate to analyse the toe-heel load redistribution underneath a normal shoe and a shoe with a wide toe in sound warmblood horses at the walk and trot.

The objective of this study was to use a pressure plate to quantify the toe-heel load redistribution in the forelimbs of sound warmblood horses with normal shoes and shoes with a wide toe and narrow branches, used empirically in the treatment of superficial digital flexor tendon or suspensory ligament injuries. In a crossover-design study, six horses, randomly shod with normal shoes and shoes with a wide toe, were led over a dynamically calibrated pressure plate to record data from both forelimbs. There were no significant differences between both shoes in the toe-heel index of stance time, peak vertical force and vertical impulse. For the adapted shoe, the peak vertical pressure was slightly lower and was exerted slightly earlier in the stance phase, albeit not significantly. However, the significantly larger toe contact area of the adapted shoe resulted in a significantly lower total vertical pressure in the toe region. Hence, the pressure plate adequately visualised the individual loading of the toe and heel region, and clearly demonstrated the altered pressure distribution underneath the shoe with a wide toe. Although further research on a deformable surface is needed to confirm this hypothesis, the pressure redistribution from the toe to the heels could promote sinking of the heels in arena footing, thereby mimicking the biomechanical effects of a toe wedge and providing a rationale for its application in the treatment of SDFT or SL injuries. The pressure measuring equipment used in this study can offer to the clinician a diagnostic tool for the evaluation of the load distribution underneath the equine hoof and for the fine-tuning of corrective shoeing.

Association between navicular bone fragmentation and shape in Belgian Warmblood horses.

OBJECTIVES: To investigate whether in navicular bones (NB) from warmbloods, distal border fragmentation is associated with the shape of the proximal articular border or other radiological findings. METHODS: Radiographs of the front feet of 325 normal, subadult horses presented for admission as breeding stallions were reviewed. RESULTS: The proximal articular border of the total of 650 NB was classified as straight (n = 278), convex (n = 184), undulating (n = 147) or concave (n = 41). Distal border fragments were present in 57 NB (8.8%). They were significantly more prevalent in NB with a concave (9/41; 22%) or undulating (19/147; 13%) proximal articular border compared to NB with a straight (17/278; 6%) or convex shape (12/184; 7%). No other significant associations were found. CLINICAL SIGNIFICANCE: Hypothetically, since a shape-fragment association was found and the distribution of biomechanical forces exerted on the navicular bone are assumed to be shape dependent, distal border fragments may be a result of unfavourable loading of the navicular region.