Subjective and objective evaluations of horses for fit-to-compete or unfit-to-compete judgement.

At Fédération Equestre Internationale (FEI) competitions, horses undergo veterinary inspection for judgement of 'fit-to-compete'. However, FEI Veterinary Delegates (VDs) often differ in opinion. The aim of the present study was to evaluate intra- and inter-observer agreements of fit-to-compete judgement and compare these with objective gait analysis measurements. Twelve horses were evaluated by three experienced VDs and one veterinary specialist and video-recorded for re-evaluation later. Simultaneously, quantitative gait analysis measurements were acquired. Inter-observer agreement during live evaluations was fair (κ = 0.395, 58% agreement). Intra-observer agreement between live observations and videos at one and 12 months was 71% and 73% respectively. Sensitivity and specificity of motion symmetry measured with quantitative gait analysis system were 83.3% and 66.7% respectively, against the consensus of all observers as a reference. These findings might suggest that more VDs should be used to adequately judge fit-to-compete. Quantitative-gait-analysis may be useful to support decision making during fit-to-compete judgement.

Quantitative and qualitative aspects of standing-up behavior and the prevalence of osteochondrosis in Warmblood foals on different farms: could there be a link?

BACKGROUND: Osteochondrosis (OC) is a common, clinically important joint disorder in which endochondral ossification is focally disturbed. Reduced blood supply to growing cartilage is considered an important cause of the condition, which has both genetic and environmental origins. Housing conditions can influence cartilage injury through peak-pressure changes during limb sliding. Additionally, circulatory perturbation can cause the avascular necrosis of cartilage. In this study, we evaluated the type and frequency of limb sliding during standing up and the occurrence of OC in foals aged up to 12 months on different farms. METHODS: Standing-up behavior was observed in 50 weaned, group-housed, Dutch Warmblood foals aged 6-9 months at five farms using black-and-white surveillance cameras, and their standing-up behavior was scored using a predetermined ethogram. OC was scored using a categorical scale between 6 and 12 months of age in 50 foals in the weanling period, and in 48 from the weanling to yearling periods because two foals died in this time. RESULTS: At both 6 and 12 months of age, the total prevalence of OC differed between the farms: the lowest prevalence was observed on a farm with no sliding, and the highest prevalence was evident on a farm with a higher sliding frequency. The mean ratio of sliding versus normal standing-up behavior was 29% (range: 0-50%); i.e., foals experienced limb sliding during around 29% of standing-up maneuvres. The frequency of sliding instead of normal standing-up behavior differed significantly between the farms (range: 0-50%; P < 0.05), but significantly decreased when foals could better prepare themselves to stand, e.g., when there was an obvious provocation such as the announced approach of another foal (P < 0.05). CONCLUSIONS: Small but significant differences exist between farms in the sliding frequency and total OC incidence in Warmblood foals, but whether environmental factors are causally related to these differences requires further elucidation.

The propagation of induced tendon lesions in the equine superficial digital flexor tendon: an ex vivo study.

REASONS FOR PERFORMING STUDY: Clinical tendon lesions usually enlarge during the first days to weeks after sustaining the injury due to enzymatic and biomechanical influences. Limiting this enlargement would positively influence prognosis related to lesion size. OBJECTIVES: To investigate the effect of cyclic loading on the propagation of enzymatically and physically induced tendon lesions and to assess the effect of immobilisation thereon in an ex vivo model. METHODS: Equine cadaver limbs with either physically or collagenase-induced SDFT lesions were placed in a pneumatic loading device. Groups consisted of unloaded limbs, cyclically loaded limbs and cyclically loaded limbs with fibreglass cast immobilisation. Lesion size was evaluated ultrasonographically and macroscopically and load at failure was determined for groups where lesions enlarged. RESULTS: Physically induced lesions did not propagate after cyclical loading and were not further investigated. Collagenase-induced lesions propagated significantly more after cyclical loading compared to unloaded limbs. This propagation could effectively be reduced by immobilisation through a lower limb cast. Immobilisation did not influence load at failure. CONCLUSIONS: The combination of enzymatic and mechanical stimulation caused the lesions to propagate most. Casting appeared effectively to reduce the enlargement of the original tendon lesions in this ex vivo model, while it did not affect ultimate tendon strength. POTENTIAL RELEVANCE: As prognosis of tendon injuries is related to lesion size, the outcome of this study warrants further investigations in vivo.

Prevalence of various radiographic manifestations of osteochondrosis and their correlations between and within joints in Dutch warmblood horses.

REASONS FOR PERFORMING STUDY: Osteochondrosis (OC) is the most important orthopaedic developmental disorder in horses and may manifest in several different forms. No detailed study on the prevalence and/or interrelation of these forms is available, even though these data are a prerequisite for conclusive genetic studies. OBJECTIVES: To assess the prevalence of the various manifestations of OC as detected radiographically and to evaluate possible relationships between their occurrence within the same joint and between different joints. METHODS: The FP (femoropatellar), TC (tarsocrural) and MCP/MTP (metacarpophalangeal/metatarsophalangeal) joints of 811 yearlings selected randomly, descending from 32 representative stallions, were radiographed and scored for the presence and grade of osteochondrotic lesions. Results were compared at the sire, animal, joint and predilection site levels. RESULTS: In the FP joint, the percentage of animals showing normal joint contours in all sites was 60.7%. For the TC joint and the combined MCP/MTP joints, these figures were 68.6 and 64.6%, respectively. For all joints combined, the percentage dropped to 30.5%. Sedation improved detection of OC lesions in the FP joint. There was a high correlation between the right and left joints. The correlation between flattened bone contours and fragments was considerably less. CONCLUSIONS: Scoring on a detailed scale is necessary to achieve good insight into the prevalence of OC. Observations on the right and left joints can be combined in further analyses, whereas flattened bone contours and fragments should be evaluated as statistically different disorders. POTENTIAL RELEVANCE: This study provides insight into the prevalences of various manifestations of OC and their relationships, within and between joints. These results form the basis for detailed quantitative and/or molecular genetic studies that should lead to the establishment of breeding indices and/or genetic marker sets for OC.

Subclinical hypocalcaemia in captive Asian elephants (Elephas maximus).

The hypothesis that hypocalcaemia may play a role in dystocia in captive Asian elephants (Elephas maximus) was investigated. The objectives of the study were to measure the total calcium concentration in elephant plasma; assess the changes in parameters of calcium metabolism during a feeding trial; investigate a possible relationship between calcium metabolism and dystocia; and assess bone mineralisation in captive Asian elephants in vivo. The following parameters were measured: total and ionised calcium, inorganic phosphorous and magnesium, the fractional excretions of these minerals, intact parathyroid hormone, 25-OH-D(3) and 1,25-OH-D(3). Radiographs were taken from tail vertebrae for assessment of bone mineralisation. The mean (sd) heparinised plasma total calcium concentration was 2.7 (0.33) mmol/l (n=43) ranging from 0.84 to 3.08 mmol/l in 11 Asian elephants. There was no significant correlation between plasma total calcium concentration and age. Following feeding of a calcium rich ration to four captive Asian elephant cows, plasma total and ionised calcium peaked at 3.6 (0.24) mmol/l (range 3.4 to 3.9 mmol/l) and 1.25 (0.07) mmol/l (range 1.17 to 1.32 mmol/l), respectively. Plasma ionised calcium concentrations around parturition in four Asian elephant cows ranged from 0.37 to 1.1 mmol/l only. The present study indicates that captive Asian elephants might be hypocalcaemic, and that, in captive Asian elephants, the normal plasma concentration of total calcium should actually be around 3.6 mmol/l and normal plasma concentration of ionised calcium around 1.25 mmol/l. Given the fact that elephants absorb dietary calcium mainly from the intestine, it could be concluded that elephants should be fed calcium-rich diets at all times, and particularly around parturition. In addition, normal values for ionised calcium in captive Asian elephants should be reassessed.

Phenotypic diagnosis of dwarfism in six Friesian horses.

An extreme form of abnormal development, dwarfism, is common in man and some animals, but has not been officially reported in horses. Within the Friesian horse breed, congenital dwarfism has been recognised for many years, but no detailed report exists on its phenotype. The most salient feature of the dwarf syndrome is the physeal growth retardation in both limbs and ribs. Affected animals have approximately 25% shorter fore- and hindlimbs and approximately 50% reduced bodyweight. Postnatal growth is still possible in these animals, albeit at a slower rate: the head and back grow faster than the limbs and ribs leading to the characteristic disproportional growth disturbance. Thus, adult dwarfs exhibit a normal, but a relatively larger head conformation, a broader chest with narrowing at the costochondral junction, a disproportionally long back, abnormally short limbs, hyperextension of the fetlocks and narrow long-toed hooves. Furthermore, a dysplastic metaphysis of the distal metacarpus and metatarsus is radiographically evident. Microscopic analysis of the growth plates at the costochondral junction shows an irregular transition from cartilage to bone, and thickening and disturbed formation of chondrocyte columns, which is similar to findings in osteochondrodysplasia.

Identification and phenotyping of leukocytes in bovine bronchoalveolar lavage fluid.

A method is proposed to identify leukocyte subpopulations in bovine bronchoalveolar lavage fluid by dual-laser flow cytometry. The technique uses several parameters, i.e., exclusion of highly autofluorescent alveolar macrophages and inclusion of leukocytes on the basis of labeling by specific antibodies and light scatter characteristics.

The role of electromyography in clinical diagnosis of neuromuscular locomotor problems in the horse.

REASONS FOR PERFORMING STUDY: Systematically performed EMG needle examination of muscles provides essential information about the functional aspects of the motor unit. However, clinical studies in which information is given on the diagnostic and discriminative values of electromyography (EMG) in the horse are scarce. OBJECTIVES: To determine to what extent inclusion of EMG analysis in clinical examination contributes to determination of type and localisation of abnormality. METHODS: EMG analysis, complete clinical examination and diagnosis of 108 horses (mean +/- s.d. age 75 +/- 3.8 years; bodyweight 548 +/- 86 kg; height 1.67 +/- 0.07 m) were performed, and results without and with EMG analysis compared. RESULTS: Without EMG, myopathy and neuropathy were diagnosed in 20 and 58 horses, respectively, and with EMG in 17 and 82 horses. EMG changed localisation in myopathy and neuropathy in 12 and 37% of cases, respectively. Lesions in the C1-T2, T2-L3 and L3-S3 segments were, respectively, diagnosed without EMG in 7, 11 and 30%, and with EMG in 27, 7 and 17% of cases. Where no clinical diagnosis could be made prior to EMG, many patients appeared to be suffering from localised cervical lesions (29%) or generalised neuropathy (54%). CONCLUSIONS AND POTENTIAL RELEVANCE: The assistance of EMG in discriminating between normal, neuropathy and myopathy, and in locating pathology, contributes to diagnosis of neuromuscular problems.

Brain abscesses as a metastatic manifestation of strangles: symptomatology and the use of magnetic resonance imaging as a diagnostic aid.

REASONS FOR PERFORMING STUDY: The occurrence of unexpectedly high numbers of horses with neurological signs during two outbreaks of strangles required prompt in-depth researching of these cases, including the exploration of magnetic resonance imaging (MRI) as a possible diagnostic technique. OBJECTIVES: To describe the case series and assess the usefulness of MRI as an imaging modality for cases suspected of space-occupying lesions in the cerebral cavity. METHODS: Four cases suspected of suffering from cerebral damage due to Streptococcus equi subsp. equi infection were examined clinically, pathologically, bacteriologically, by clinical chemistry (3 cases) and MRI (2 cases). In one case, MRI findings were compared to images acquired using computer tomography (CT). RESULTS: In all cases, cerebral abscesses positive for Streptococcus equi subsp. equi were found, which explained the clinical signs. Although the lesions could be visualised with CT, MRI images were superior in representing the exact anatomic reality of the soft tissue lesions. CONCLUSIONS: The diagnosis of bastard strangles characterised by metastatic brain abscesses was confirmed. MRI appeared to be an excellent tool for the imaging of cerebral lesions in the horse. POTENTIAL CLINICAL RELEVANCE: The high incidence of neurological complications could not be explained but possibly indicated a change in virulence of certain strains of Streptococcus equi subsp. equi. MRI images were very detailed, permitting visualisation of much smaller lesions than demonstrated in this study and this could allow prompt clinical intervention in less advanced cases with a better prognosis. Further, MRI could assist in the surgical treatment of brain abscesses, as has been described earlier for CT.

Relationships of age and shape of the navicular bone to the development of navicular disease: a radiological study.

Estimating the shape of the proximal articular border of the navicular bone and grading the radiological navicular bone condition (grades 3 and 4 representing the most severe changes), the aim of this study was to assess potential age-related implications of the previously reported shape predisposition to navicular disease in 746 normal and 174 clinically affected Dutch Warmbloods age 3-19 years. A significant, age-independent, shape-grade association found in normal and affected horses emphasises the fundamental character of the shape predisposition to navicular disease. A significant age-related increase of the least susceptible shape prevalence was found in elderly normal horses. A shape-independent low grades 3 and 4 prevalence (mean 15%) was found in normal horses, vs. a high grades 3 and 4 prevalence (mean 85%) in the affected horses. Therefore, the clinical manifestation of the disease is grade-rather than shape-dependent. A significant age-related appearance of inverted flask-shaped channels and enthesophytes was found in the clinically affected horses. However, considering the significant shape-radiological features association previously reported in 3-year-old normal horses, this association may be shape- rather than age-dependent.

The radiographic development of the distal and proximal double contours of the equine navicular bone on dorsoproximal-palmarodistal oblique (upright pedal) radiographs, from age 1 to 11 months.

The aim of this study was to monitor the postnatal radiographic development of the proximal and distal double contours and the modelling of the shape of the proximal articular border. In mature horses, the proximal and distal contours of the navicular bone on dorsopalmar dorsoproximal-palmarodistal oblique (upright pedal) radiographs are commonly visualised as 2 lines, one being the articular border and the second representing the border of the cortex facing the deep digital flexor tendon (flexor border). The shape of the proximal articular border may be concave, undulating, straight or convex in the mature animal. These shapes have been found to be hereditary and to constitute a predisposing factor in the pathogenesis of navicular disease. This predisposing role may result from a shape dependent distribution of the biomechanical forces exerted on this region. There is no agreement in the literature with respect to the moment when the navicular bone takes its mature radiographic appearance. Upright pedal radiographs of the left front foot of 19 Dutch Warmblood foals were made at age 1 month and subsequently at intervals of 4 weeks, until the age of 11 months. The distal double contour developed soon after birth and the radiographic visibility of the articular border improved from ill-defined at 1 or 2 months to clear manifestation at 3 or 4 months. The proximal double contour developed later. The articular border became usually visible at age 3 or 4 months and was clearly visible from age 9 months. The mature shape of the proximal articular border usually became recognisable from age 7 months and was always obvious between 9 and 11 months. This development was associated with a gradual modelling of the lateral and medial extremities of the navicular bone. It was concluded that the navicular bone adopts its mature radiological appearance during the first year postpartum. Considering this early manifestation of the mature shape of the proximal articular border and its previously demonstrated inheritance, a force-dependent development of this shape, as predicted by the trajectional theory/Wolffs law, is improbable. The predisposing role of this shape in the pathogenesis of navicular disease may therefore be explained by a shape-dependent distribution of the biomechanical forces exerted on the navicular bone. Considering the potential application of these findings, from age 1 year shape determination enables identification of the individual and breed susceptibility for the development of navicular disease.

Clinical and force plate evaluation of the effect of a high plantar nerve block in lameness caused by induced mid-metatarsal tendinitis.

To answer the question whether it is possible to differentiate, by means of a high plantar nerve block in the hind limb, flexor tendon lameness from a suspensory ligament lameness, mid-plantar tendinitis or desmitis was induced with collagenase in five Standardbred horses in two trials. Before the induction of lameness, and on the fourth (D4) and fourteenth day (D14) after the induction of lameness the horses were evaluated subjectively (clinical lameness score), objectively (ground reaction force (GRF) measurements), and ultrasonographically. Clinical evaluation and GRF measurements were also done on D4 and D14 after a high plantar nerve block. From the GRF measurements variables were selected and analysed and related to the clinical lameness score. The horses were significantly lame on D4; this lameness had decreased on D14. The clinical findings were supported by the GRF data. In the flexor tendon group, a high plantar nerve block resulted in soundness or lameness in the other hind limb, whereas in the suspensory ligament group the effect was less conclusive. The correlation between the subjective clinical lameness score and several objectively measured GRF variables proved to be moderate to high. The collagenase model proved to be useful to study the effect of a high plantar nerve block on lameness resulting from induced tendon/ligament lesion. However, a high plantar nerve block cannot be used to differentiate between flexor tendon and suspensory ligament lesions.

Ultrasonographic evaluation and long-term follow-up of flexor tendonitis/desmitis in the metacarpal/metatarsal region in Dutch warmblood horses and standardbred racehorses.

Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb (SLf, SDFf, and CL, respectively) and the suspensory ligament (11%) of the hind limb (SLh) occurred the most often. In the ST-group, tendonitis of the SDFf (34%) and desmitis of the SLh (34%) and SLf (18%) were the most common injuries. Of the 60 Dutch Warmblood horses available for follow-up, 25% showed full-functional recovery. Of the 61 Standardbreds available for follow-up, 18% showed full-functional recovery. Overall, local axial lesions seemed to have a worse prognosis than local abaxial or diffusive lesions.

The correlation between the dose and distribution of intratendinous fluid injections in the flexor tendons/ligaments of the horse.

An in vitro study was carried out to define the correlation between the dose and distribution of intratendinous fluid injections in the different flexor tendons/ligaments of the palmar/plantar, metacarpal/metatarsal region of the horse. Injection of 0.1-0.2 ml resulted in a local intratendinous fluid depot showing minimal abaxial spreading and more extensive proximodistal expansion. If 0.3-0.5 ml was injected the abaxial spreading remained minimal but the proximodistal expansion increased significantly, the depots in the axial proximal, mid and distal region flowing together. Also minimal peritendinous fluid accumulation was visible. Increasing the dose from 0.5 to 2 ml resulted in extensive abaxial spreading and peritendinous accumulation. These findings indicate that the 2 ml injection recommended in the veterinary literature probably represents an oversized dose. If a small lesion is present a 0.1-0.2 ml intratendinous injection should be adequate. The injection should preferably be guided by ultrasonography to allow precise deposition of the drug into the lesion. In larger local defects a depot of 0.3-0.5 ml apparently is sufficient. If a very large portion of the tendon is injured, several depots of 0.3-0.5 ml approximately 5 cm apart is preferred to cover the full proximodistal extension of the lesion.

Desmitis of the accessory ligament of the deep digital flexor tendon in the horse: clinical and ultrasonographic features. A report of 24 cases.

The clinical and ultrasonographic features of desmitis of the accessory ligament of the deep digital flexor tendon (carpal check ligament) are reported in a series of 24 horses. Lameness associated with the carpal check ligament especially was found in Warmblood riding horses ranging in age from 6 to 18 years with a mean age of 11.3 years. The most striking clinical feature was a firm, painful swelling medially and laterally in the proximal and/or mid metacarpal region, corresponding with the dorsoproximal-palmarodistal oblique direction of the carpal check ligament. Sonographically swelling of the carpal check ligament was common, the enlarged ligament mostly showing a type 1-2 texture. Occasionally a more localized lesion with a type 3-4 texture was present. About 40% of the horses also showed additional lesions in (one of three other flexor tendons or ligaments in the metacarpal region. Most horses were treated conservatively, i.e. boxstallrest and/or a controlled exercise regime were applied. From the 19 horses available for follow up (1-36 months), only 3 horses resumed full work. Obviously the prognosis of this injury is guarded.

[Anorexia in a pony with Cushing's disease]. / Anorexie bij een pony met de ziekte van Cushing.

An eighteen-year-old pony gelding was referred to the Faculty of Veterinary Medicine because of colic, due to cecal tympany. His haircoat was dull with long wavy hair. After medical treatment of the colic it was sent home three days later. Just before it had been dismissed the morning plasma glucose concentration measured 10.2 mmol.l-1. The basal plasma cortisol concentration was high (180 nmol.l1) and basal plasma ACTH concentration was highly elevated (> 960 pg.ml1). An ACTH-stimulation test was performed by intravenous administering of 0.25 mg synthetic ACTH 1 24 at 9.00 hours showing adrenocortical hyperfunction by an increase of plasma cortisol to 771 nmol.l-1. After 365 days the gelding was readmitted because of anorexia since two days, due to a mandibula fracture without obvious signs of osteoporosis. This time the morning plasma glucose concentration measured 11.9 mmol.l-1. Euthanasia was carried out and at necropsy both a mandibula fracture and a pituitary pars intermedia adenoma were found.

The effect of regional nerve blocks on the lameness caused by collagenase induced tendonitis in the midmetacarpal region of the horse: a study using gait analysis, and ultrasonography to determine tendon healing.

The influence of regional nerve blocks on lameness resulting from tendon injury was studied in six horses. Tendonitis was induced in the midmetacarpal region of the Superficial Digital Flexor Tendon (SDF), Deep Digital Flexor Tendon (DDF) and the Suspensory Ligament (SL) through collagenase injections. The results were evaluated through sequential clinical examinations, ultrasonographic imaging and kinetic gait analysis (force plate) during a period of 144 days post injury and subsequently compared with gross and microscopic findings. The lameness corresponding to the SDF and DDF tendon lesions was completely abolished by a high palmar nerve block. The SL desmitis was partly abolished by high palmar nerve block and completely blocked with an additional ulnar nerve block. The ultrasonic evaluations showed the lesions, expanding until approximately 30 days post injection (p.i.) and subsequently decreasing. The texture of the lesion also improved markedly after 30 days p.i. The post-mortem macro- and microscopic evaluation revealed still considerable abnormalities at 145 days p.i. At that time the tendon lesions were no longer detectable ultrasonographically.

Ultrasonographic evaluation of fetlock annular ligament constriction in the horse.

The diagnosis of restriction of free movement of the flexor tendons through the fetlock canal usually rests on the characteristic clinical appearance of this condition, or airtendography. In a series of seven normal Warmblood horses and 16 diseased horses of various breeds, the efficacy of ultrasonography in the diagnosis of this condition was determined. In normal limbs, the annular ligament is a very thin structure usually not visible on sonograms. In diseased limbs, ultrasonography outlined flexor tendon injury, distension and thickening of the digital sheath, peritendovaginal tissue proliferation and thickening of the annular ligament. Four different types of constriction syndrome were noticed. The first type (nine cases), was characterised by thickening of the annular ligament and distension of the digital sheath; the second type (three cases) was dominated by distension of the digital sheath; the third type (three cases) was characterised by superficial digital flexor tendon injury and thickening of the annular ligament and in the fourth type (one case), the constriction resulted from distension of the digital sheath and extensive peritendovaginal tissue proliferation.

Surgical repair of a cranial meningocele in a calf.

A meningocele at the anterior fontanelle was diagnosed in a two-and-a-half month old Meuse-Rhine-Yssel calf. After radiographic and ultrasonographic evaluation, the meningocele was successfully repaired surgically.