An inertial sensor-based system can objectively assess diagnostic anaesthesia of the equine foot.

REASONS FOR PERFORMING STUDY: In order for changes in lameness to be accurately and repeatably detected and recorded during diagnostic investigations, an objective measure of lameness is required. OBJECTIVES: To ascertain whether an inertial sensor-based system can distinguish between a positive and negative response to diagnostic anaesthesia of the foot and objectively assess the effect of a positive response on the trot. STUDY DESIGN: Restrospective clinical study. METHODS: Data obtained during lameness investigations undertaken between August 2011 and December 2012 in which either a palmar digital or abaxial sesamoid nerve block was performed were retrospectively reviewed. Response to diagnostic anaesthesia was categorised as positive (n = 14) or negative (n = 9) by one of 2 evaluators before analysis of kinematic data (i.e. blinded). Changes in maximum and minimum head difference (ΔHDMax and ΔHDMin) and change in head movement asymmetry/change in pelvic movement asymmetry (ΔHMA/PMA, measure of asymmetry) allocated to each limb were calculated. A Kruskal-Wallis one way analysis of variance on ranks was performed. Receiver operating characteristic (ROC) curves were generated for ΔHDMax, ΔHDMin and ΔHMA for the blocked limb to identify cut-off values to distinguish positive and negative responses to the block. RESULTS: Median ΔHDMax and ΔHDMin were significantly greater after a positive response to diagnostic anaesthesia (P<0.01). Change in head movement asymmetry allocated to the blocked limb and contralateral forelimb and ΔPMA allocated to the contralateral hindlimb were significantly greater in the positive response group (P<0.05). Change in head movement asymmetry allocated to the blocked limb and ΔHDMax and ΔHDMin are useful diagnostic tests for identifying positive response to anaesthesia (area under the curve = 0.98, 0.83 and 0.96 respectively). CONCLUSIONS: An inertial sensor-based system can identify a positive response to diagnostic anaesthesia of the foot. Symmetry of movement allocated to the blocked limb, contralateral forelimb and contralateral hindlimb significantly improve, and head movement significantly decreases in horses with a positive response to the block. Cut-off values for a positive response have been identified with good sensitivity and specificity. Forelimb lameness significantly affects contralateral hindlimb movement, which has implications for the investigation of multi-limb lameness.

Use of a wireless, inertial sensor-based system to objectively evaluate flexion tests in the horse.

OBJECTIVES: A wireless, inertial sensor-based system has previously been validated for evaluation of equine lameness. However, threshold values have not been determined for the assessment of responses to flexion tests. The aim of this investigation was to evaluate a sensor-based system for objective assessment of the response to flexion. METHODS: Healthy adult horses (n = 17) in work were recruited prospectively. Horses were instrumented with sensors on the head (accelerometer), pelvis (accelerometer) and right forelimb (gyroscope), before trotting in a straight line (minimum 25 strides) for 2 consecutive trials. Sensors measured 1) vertical pelvic movement asymmetry (PMA) for both right and left hindlimb strides and 2) average difference in maximum and minimum pelvic height (PDMax and PDMin) between right and left hindlimb strides in millimetres. A hindlimb was randomly selected for proximal flexion (60 s), after which the horse trotted a minimum of 10 strides. Response to flexion was blindly assessed as negative or positive by an experienced observer. Changes in PMA, PDMax and PDMin between baseline and flexion examinations were calculated for each test. Statistical analysis consisted of a Pearson's product moment test and linear regression on baseline trials, Mann-Whitney rank sum test for effect of flexion and receiver operator curve (ROC) analysis of test parameters. RESULTS: There was a strong correlation between trials for PMA, PDMin and PDMax measurements (P < 0.001). A positive flexion test resulted in a significant increase in PMA (P = 0.021) and PDMax (P = 0.05) only. Receiver-operator curve analysis established cut-off values for change in PMA and PDMax of 0.068 and 4.47 mm, respectively (sensitivity = 0.71, specificity = 0.65) to indicate a positive response to flexion. CONCLUSIONS: A positive response to flexion resulted in significant changes to objective measurements of pelvic symmetry. POTENTIAL RELEVANCE: Findings support the use of inertial sensor systems to objectively assess response to flexion tests. Further investigation is warranted to establish cut-off values for objective assessment of other diagnostic procedures.

Osteochondrosis lesions of the lateral trochlear ridge of the distal femur in four ponies.

Lesions of the lateral trochlear ridge (LTR) of the distal femur were investigated in four pony or pony cross horses. The animals were all geldings and were six to 15 months of age. Lesions were bilateral in three ponies and unilateral in one. Femoropatellar joint effusion and lameness were present in two ponies; clinical signs were absent in the others. The proximal LTR was affected in all four animals. The radiographic appearance of the lesions was a subchondral defect containing mineralised bodies. Arthroscopic and postmortem examination findings included an osteochondral flap, a fissured or irregular articular surface and a smooth surface overlying focally thickened cartilage that extended into subchondral bone. Thickened articular cartilage was a histological feature of all the lesions. Among the other histological features, the most common were chondronecrosis, chondrocyte clusters, phenotypically abnormal chondrocytes, horizontal fissures at the osteochondral junction and retained blood vessels. The signalment of the four ponies, their clinical signs and the pathological features of their lesions were consistent with osteochondrosis of the LTR in horses. The use of multiple criteria was considered to be important in making a specific diagnosis.

Radiographic anatomy of the articular process joints of the caudal cervical vertebrae in the horse on lateral and oblique projections.

REASONS FOR PERFORMING STUDY: Plain radiography is the standard imaging technique for investigation of diseases associated with the articular process joints (APJ) of the caudal neck; however, the radiographic anatomy of these structures on both lateral and oblique radiographic projections has not previously been described in detail. OBJECTIVES: To determine the optimal technique for obtaining oblique radiographs of the APJ of the caudal cervical vertebrae (C4-5, C5-6 and C6-7) and to provide a detailed description of their normal radiographic appearance, on both lateral and oblique radiographic projections. METHODS: Radiopaque markers were used to highlight the contours of the APJ on both lateral and oblique radiographs. A novel cineradiographic technique was employed to determine the optimal oblique projection to permit both left and right APJ to be assessed on the same radiograph. Lateral and oblique radiographs of the caudal neck were obtained in 6 live horses under standing sedation to assess the feasibility of the technique. RESULTS: The radiopaque markers facilitated identification of the APJ by clearly outlining the margins of the cranial and caudal articular processes on lateral and oblique radiographs. The optimal range of angles for obtaining oblique radiographs was 50-55 degrees for C4-5, 45-55 degrees for C5-6 and 45-5 degrees for C6-7. Obtaining oblique radiographs within the specified range of angles resulted in a consistent radiographic image of the APJ in the caudal cervical region in the live individual. CONCLUSIONS AND POTENTIAL RELEVANCE: The description of the normal radiographic anatomy of the cervical APJ of the caudal neck region in horses provides a valuable reference for the interpretation of cervical radiographs. Using the standardised technique to obtain oblique radiographs of the equine cervical vertebrae may provide additional diagnostic information about the APJ.

Diagnostic accuracy of digital photography and image analysis for the measurement of foot conformation in the horse.

REASONS FOR PERFORMING STUDY: Rigorous evaluation of practicable methods for the objective assessment of foot conformation has not been performed. OBJECTIVES: To assess the practicability, precision and accuracy of the process of obtaining measurements of horses' feet using photography and image processing software. METHODS: Precision study: Lateral photographs of horses' feet were obtained twice by 2 veterinary surgeons (image acquisition - IAc). Photographs were analysed by 2 masked veterinary surgeons on 2 occasions (image analysis - IAn). Measurements were compared within and between operators for self and non-self acquired photographs. Agreement indices (AIs) and 95% limits of agreement (LOA) were calculated for the IAn process alone and for the combined IAc + IAn processes. Accuracy study: Measurements obtained from lateral photographs were compared with those obtained from lateromedial radiographs. AIs and 95% LOA were calculated for each measurement. RESULTS: Precision study: Mean intra- and interoperator AIs for the IAn process alone were > or = 0.90 while those for the combined IAc + IAn processes were > or = 0.89 for all measurements. Similar mean AIs and 95% LOA were calculated regardless of image origin. The 95% LOA for hoof angle, heel height/toe height% and coronary band angle for all comparisons were within target values. Accuracy study: Mean AIs were > or = 0.89 for all measurements. The 95% LOA for heel height/toe height% and coronary band angle were within target values. CONCLUSIONS: Excellent precision was identified within and between operators regardless of image origin. High levels of accuracy were also identified, especially for heel height/toe height% and coronary band angle, indicating that photography and radiography may be used interchangeably. POTENTIAL RELEVANCE: Acquisition and analysis of photographic images is an appropriate method for the objective measurement of foot conformation, both in clinical and, research settings.

Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses.

Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or without ha, improved after a median of 56 days (P<0.0001), and there was no significant difference between mpa and tr. There was no significant further improvement in the horses treated twice. In the horses in which there was a diffuse increase in the uptake of a radiopharmaceutical by the distal tarsal joints, identified by scintigraphy, the lameness tended to improve (P=0.032), whereas in the horses in which the uptake was focal, it did not. At telephone follow-up 13 of 34 horses were reported to have had a positive outcome, but the outcome in the other 21 was reported to have been negative.

Exposure of veterinary personnel to ionising radiation during bone scanning of horses by nuclear scintigraphy with 99mtechnetium methylene diphosphonate.

The aim of this study was to compare the radiation doses received by the personnel drawing up and injecting the radiopharmaceutical and operating the nuclear scintigraphy equipment, and those restraining nine horses while they were being scanned during scintigraphic investigations of lameness. Sensitive electronic dosimeters were worn by the personnel and the doses they received during the administration of the radiopharmaceutical and during the period of image acquisition were recorded at intervals. On average, 90 per cent of the total doses were received during the period of image acquisition. There was no significant difference between the total dose received by the person who drew up and injected the radiopharmaceutical, and the person restraining the horse during its administration. However, the person holding the horse received approximately twice the dose received by the person operating the equipment during the period of image acquisition.

Skeletal scintigraphy in the horse: current indications and validity as a diagnostic test.

Gamma scintigraphy is a well established imaging modality, which in equine practice is predominantly used in the investigation of lameness and suspected musculoskeletal problems. Whilst there is a growing literature on the indications for scintigraphy in the horse, there has been little emphasis so far on identifying the validity of scintigraphy as a diagnostic test. In particular, to what extent can the results of a scintigraphic examination be trusted? In this opinionated review the current indications for skeletal scintigraphy in the horse are considered and its validity as a diagnostic test reviewed. It is concluded that in the majority of published studies, inherent biases in study design make it difficult to assess accurately the validity of skeletal scintigraphy in the horse. Further well designed, prospective studies are required to assess the validity of skeletal scintigraphy as a diagnostic tool, particularly in horses with subtle alterations in radiopharmaceutical uptake.

Investigations of the reliability of observational gait analysis for the assessment of lameness in horses.

The objectives of this study were to assess the reliability of a numerical rating scale (NRS) and a verbal rating scale (VRS) for the assessment of lameness in horses and to determine whether they can be used interchangeably. Sixteen independent observers graded the severity of lameness in 20 videotaped horses, and the agreement between and within observers, correlation and bias were determined for each scale. The observers agreed with each other in 56 per cent of the observations with the NRS and in 60 per cent of the observations with the VRS, and the associated Kendall coefficient of concordance was high. Similar trends were evident in the agreement between two observations by each observer. The correlation between and within observers was high for both scales. There were no significant differences (bias) among the observers' mean scores when using either scale. There was a significant correlation between the lameness scores attributed when using the two scales, but the differences between the scores when plotted against their overall mean were unacceptable for clinical purposes. The results indicate that the NRS and VRS are only moderately reliable when used to assess lameness severity in the horse, and that they should not be used interchangeably.

Application of the 51Cr-EDTA urinary recovery test for assessment of intestinal permeability in the horse.

Altered intestinal permeability is implicated in the pathogenesis of diverse equine medical conditions including alimentary laminitis and protein-losing enteropathies associated with parasitic infection. The aims of this study were to assess the feasibility of applying the 51Cr-EDTA absorption test for the assessment of intestinal permeability in the horse, and to apply this test in horses with experimentally induced alterations in gastrointestinal function. Four healthy ponies were administered 36 MBq of 51Cr-EDTA via naso-gastric tube, and urine samples were collected into polythene bags strapped to the pony's abdomen. Total urine voided every 6 h was collected during each test, and 1 ml samples were taken for measurement of gamma-radiation. Urinary recovery of 51Cr-EDTA was measured following intravenous atropine sulphate or bethanecol, and following 22 and 46 days of administration of 250,000 third-stage cyathostome larvae. There was no significant difference in urinary 51Cr-EDTA recovery following the control treatment, and following atropine or bethanecol administration, but significant increases were detected in the animals with experimental cyathostome infection consistent with increased permeability of the intestinal membrane. Motility modifying agents (bethanecol and atropine) did not affect absorption of 51Cr-EDTA, suggesting that subtle changes in motility might not affect the ability of this test to detect altered intestinal permeability. The finding of increased urinary recovery of 51Cr-EDTA in ponies with cyathostome infection suggests that 51Cr-EDTA may be a useful marker for assessment of intestinal permeability in the horse.

Prevalence, heritability and significance of musculoskeletal conformational traits in Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: The assessment of belief that equine conformation is associated with performance and durability is a fundamental concept of horsemanship. Surprisingly, there is almost no quantitative evidence to support these beliefs. OBJECTIVES: To assess the prevalence and heritability of conformational traits in Thoroughbred yearlings, and investigate their significance for subsequent turf flat-racing performance and durability. METHODS: Nine selected conformational traits were assessed in a consistent, qualitative manner by a single veterinary observer and entered into a database together with details of pedigree and racing records. RESULTS: Conformational data were collected from 3916 Thoroughbred yearlings sold at public auction during the 7 year period 1993-1999. Most of the horses (72%) raced in the UK in turf flat races; just 7% of the yearlings failed to race. Prevalence of conformational defects for the UK horses was reported, with turned out feet the most commonly recorded defect (30% of all horses). There was a tendency towards a greater proportion of horses with defects in the group of unraced horses compared with horses that raced, but this was not statistically significant. There were some significant associations between racing performance and conformational defects but these were found to be almost completely explained by an effect of sire. All of the conformational traits showed considerable evidence of genetic influence, with heritability indices ranging 0.16-1.00. CONCLUSIONS AND POTENTIAL RELEVANCE: Overall, there were only weak associations between performance and conformation that could not be accounted for by the very strong relationship between pedigree and conformation. Further study of potential association between highly heritable conformation traits and racing durability and racing performance should be undertaken utilising validated, quantitative methods and technology.

Rupture of the flexor tendons of a horse secondary to a non-responsive digital sheath sepsis.

A 12-year-old hunter gelding became severely lame as a result of a laceration to the sheath of the digital flexor tendons of its left hindlimb, but there was no apparent damage to the tendons. The injury became chronically infected with Pseudomonas and Streptococcus species and Escherichia coli which did not respond to antibiotic treatment, and the horse remained lame. A postmortem examination revealed that the tendons had ruptured.

Bone scintigraphy in the investigation of occult lameness in the dog.

99mTechnetium methylene diphosphonate (99mTc-MDP) scintigraphy was performed in 14 dogs of different breeds after clinical lameness examination, radiography and synovial fluid analysis failed to localise lameness to a specific area of pain. The scintigraphic protocol included an intravenous injection of 17 MBq 99mTc-MDP/kg bodyweight and vascular, soft tissue and bone phase scans in standardised positions with a low-energy all-purpose collimator. Confirmation of diagnosis was achieved in nine dogs by arthroscopy, repeated lesion-orientated radiography, computed tomography and response to treatment. In seven cases, bone phase scans showed single elbow uptakes, in two cases unilateral limb uptake, and in one case each a single shoulder and tibia uptake; in three cases there was no increased uptake. Vascular and soft tissue phase images did not reveal additional information. Diagnosis of humeral condyle fissures, a fragmented medial coronoid process, panosteitis and arthropathy was possible in nine cases. Skeletal pathology was ruled out in three normal scintigrams. In two dogs with unilateral uptake of multiple joints, no diagnostic benefit was gained from scintigraphy. The highly sensitive and relatively specific uptake allowed localisation and characterisation or exclusion of skeletal lesions in most dogs.