Ultrasonographic assessment of the atlanto-occipital space in healthy Thoroughbred foals and Thoroughbred foals with neonatal maladjustment syndrome.

Ultrasonography of the atlanto-occipital (AO) space may be useful as a non-invasive diagnostic tool in neonatal foals. The aims of the study were establish a range of values for ultrasonographic measurements of the AO space in healthy Thoroughbred foals and to compare these variables in healthy foals with foals diagnosed with neonatal maladjustment syndrome (NMS). Ultrasonography of the AO space was performed on 38 healthy Thoroughbred foals and 28 Thoroughbred foals with NMS≤4days of age. Transverse image spinal cord height (P=0.001), width (P<0.001) and spinal cord cross sectional area (P<0.001), and longitudinal image dorsoventral diameter of the ventral spinal artery, were significantly smaller in foals with NMS than in healthy foals. Ratios of spinal canal to cord width and cross sectional area were significantly smaller in healthy foals than in foals with NMS (P<0.001). Spinal canal variables were not significantly different between groups. Several ultrasonographic measurements of the AO space were significantly different between healthy foals and foals with NMS. Further investigation is warranted to investigate the clinical application of this technique.

The effect of mare obesity and endocrine function on foal birthweight in Thoroughbreds.

BACKGROUND: Birthweight of Thoroughbred foals has increased in recent years. It is unknown whether this is associated with increased broodmare obesity or endocrine dysfunction. OBJECTIVES: To determine insulin, leptin and triglyceride concentrations in Thoroughbred mares throughout gestation and investigate their association with obesity and foal birthweight. STUDY DESIGN: Cohort study. METHODS: A total of 66 mares were included from 40 days post-breeding. Body condition score (BCS), weight and blood samples were obtained every 60 days throughout gestation. Serum/plasma insulin, leptin and triglyceride concentrations and foal birthweight were recorded. Associations between hormone/triglyceride concentration with BCS, stage of gestation and birthweight were analysed using a linear mixed effects model. RESULTS: Serum insulin concentrations were greater at 1-60 days (4.31 µiu/mL) compared with 241-300 days (3.13 µiu/mL) and 61-120 days (5.33 µiu/mL) compared with 181-240, 241-300 and 301-360 days (3.78, 3.13, 3.37 µiu/mL) gestation (P<0.05). There was no significant hyperinsulinaemia and no association of insulin concentration with BCS. Leptin concentration was greater at 181-240 days (2.28 µg/L, P<0.0001) compared with all other time points and correlated with BCS (P<0.0003). Triglyceride concentration was greater at 241-300 days (0.245 mmol, P<0.02) compared with earlier time points, but was not associated with BCS. Foal birthweight was weakly positively correlated with BCS (r = 0.13, P<0.001) and inversely correlated with leptin concentrations at 61-120 and 241-300 days gestation (r = -0.64, P<0.05). MAIN LIMITATIONS: Reduction in sample size over the study and tight clustering of BCS. CONCLUSIONS: Mare BCS correlated with foal birthweight; obese mares had heavier foals. Significant hyperinsulinaemia was not identified in this population. Increased leptin concentration in early and late gestation was associated with decreased foal birthweight. Further work is required to establish whether leptin concentration in late gestation could predict foal birthweight.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

REASONS FOR PERFORMING STUDY: The birthweight of Thoroughbred foals has increased in recent years. It is unknown whether this is associated with increased broodmare obesity or endocrine dysfunction. OBJECTIVES: To determine insulin, leptin and triglyceride concentrations in obese and non-obese Thoroughbred mares throughout gestation and to investigate their association with foal birthweight. STUDY DESIGN: Prospective, cohort study. METHODS: Fifty-seven pregnant Thoroughbred mares were included in the study. From 40 days post-breeding, body condition score (BCS), weight and venous blood samples were obtained every 60 days throughout gestation. Feed was withheld for 6 h before blood sampling. Serum/plasma insulin, leptin and triglyceride concentrations were measured using validated/standard methods. Foal birthweight was recorded. Association of hormone or triglyceride concentration with time, BCS and birthweight were analysed using a linear mixed effects model. A Pearson correlation co-efficient was calculated between hormone or triglyceride concentration, BCS and birthweight. RESULTS: Serum insulin concentrations were significantly greater (P<0.05) at 0-59 days compared with 240-299 days and at 60-119 days compared with 180-359 days gestation. 55% of mares had BCS ≥ 7. There was 1.5% incidence of fasting hyperinsulinaemia throughout gestation and no association of fasting insulin concentration with BCS. Leptin concentration was significantly (P<0.0001) greater at 180-239 days compared with all other time points and was significantly (r = 0.29, P<0.0003) correlated with BCS. Triglyceride concentration was significantly (P<0.02) greater at 240-299 days compared with earlier time points but was not associated with BCS. Foal birthweight was significantly positively correlated with BCS (r = 0.13, P<0.001) and inversely correlated with leptin concentration at 60-119 days and 240-299 days gestation (r = -0.64, P<0.05). CONCLUSIONS: Mare BCS correlated with foal birthweight such that obese mares had heavier foals. Significant fasting hyperinsulinaemia was not identified in this population. Increased leptin concentration in early and late gestation was associated with decreased foal birthweight and may be useful to predict foal birthweight. Ethical animal research: Informed client consent was obtained for all animals used in the study. SOURCE OF FUNDING: Private donor. Competing interests: None declared.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

REASONS FOR PERFORMING STUDY: Atrial fibrillation is a common equine arrhythmia. Quinidine alone, or with digoxin are common treatments. Studies on outcome in Warmblood populations in which duration of the AF is often unknown are limited. OBJECTIVES: To identify the factors that are associated with the success of full treatment cardioversion with oral medication, and establish whether there are differences in these factors between institutions. STUDY DESIGN: Retrospective case series using patient records of Equine University Clinic of Utrecht University and Rossdales Equine Hospital, Newmarket. METHODS: Forty-nine horses treated with quinidine were identified (29 Warmbloods, 20 Thorougbreds, 1 Anglo-Arabian). Details of signalment, history, duration physical examination and echocardiography including left atrial size and presence of mitral regurgitation were retrieved. Clinical details including mean weight, age and left atrial size were compared between clinics using independent samples t test. Association between variables and cardioconversion were evaluated in a backwards logistic regression using Akaike's information criterium (AIC) and odds ratios were calculated. Factors were sex, clinic, breed, mitral regurgitation, duration and poor performance. Covariates were age, weight and the size of the left atrium. Significance was set at 0.05. RESULTS: Fifty-one horses (mean age 8.8 s.d. 4.5 years) were treated with quinidine sulfate, 18 also received digoxin. Eighty per cent converted to sinus rhythm. In 8 horses the known duration was less than 3 months. The only factor associated with successful treatment was the use of digoxin in combination with quinidine sulfate (odds ratio 12.4; 95% CI 2.61 and 91.85 according to AIC analysis). CONCLUSIONS: In this retrospective case series, there is much potential for bias in the data; however, the use of digoxin in addition to quinidine was associated with improved conversion rates regardless of breed even though AF duration was unknown in most horses. Ethical animal research: Research ethics committee oversight not currently required by this conference: retrospective study of clinical records. Explicit owner informed consent for inclusion of animals in this study was not stated. SOURCE OF FUNDING: None. Competing interests: None declared.

Pneumocephalus in five horses.

Pneumocephalus is occasionally encountered in horses but poorly described in the literature. The study aimed to describe historical, clinical and diagnostic imaging findings and outcome in horses to increase the awareness and recognition of the condition amongst equine practitioners, allowing appropriate management of these cases. Cases of pneumocephalus from 4 participating institutions were identified and case details extracted from the medical records. Five cases of pneumocephalus were identified. Head trauma with suspected or confirmed fractures of the sinuses was the underlying cause in 4 cases, while the remaining horse was thought to have developed pneumocephalus secondary to sinusitis or trauma. Diagnosis was established radiographically in 4 cases and by computed tomography in a fifth. Gas was noted between the cranial vault and the brain, in the lateral ventricles, in the brain parenchyma and within the cranial cervical canal. The gas accumulation resolved gradually in all horses and did not appear independently to result in neurological compromise. Long-term outcome was available for 3 cases, 2 of which were ultimately subjected to euthanasia due to neurological deficits. Pneumocephalus is a possible consequence of head trauma or sinusitis in horses; although the finding is frequently incidental, it has the potential to develop into a life-threatening complication. Imaging the complete skull and cranial cervical spine is important to allow identification and appropriate management of these cases. The use of computed tomography enables easier identification and localisation of the gas accumulation within the central nervous system.

The impact of birthweight on mare health and reproductive efficiency, and foal health and subsequent racing performance.

REASONS FOR PERFORMING STUDY: Although low birthweight is a risk factor for neonatal illness, the impact of high birthweight on the health of foals and mares, and on the foals' long-term athletic capability, is unknown. OBJECTIVES: To investigate whether: 1) foals that are excessively heavy are associated with an increased prevalence of maternal illness in the first month post partum and reproductive dysfunction in the following season; 2) excessively light or heavy foals are at an increased risk of illness in the first month of life; and 3) birthweight is associated with racing success. METHODS: Veterinary records from 230 Thoroughbred mares and 409 foalings were reviewed. Data relating to foaling, foal and mare health during the first month postpartum and subsequent breeding efficiency were extracted. Foals' racing records were obtained and the association between birthweight and these outcomes examined. RESULTS: Mares with heavy foals had a higher prevalence of minor nonreproductive problems than those with light and average foals. Compared to average foals, placental weight was lower in the light group and higher in the heavy group. Light foals took longer to stand, nurse and pass meconium, whereas gestation period and duration of Stage 2 parturition were longer in heavy foals. Heavy foals were at increased risk of nonseptic musculoskeletal conditions and conformational defects. Birthweight was not associated with racing outcomes. CONCLUSIONS: High birthweight was associated with increased prevalence of neonatal musculoskeletal conditions but birthweight did not have a major impact on mares' health and reproductive efficiency, orfoals' racing success. POTENTIAL RELEVANCE: These data add to the understanding of the impact of birthweight on short- and long-term health outcomes in mares and foals.

Intraoperator, intraobserver and interoperator variability of echocardiographic measurements in healthy foals.

REASON FOR PERFORMING STUDY: The repeatability of various echocardiographic measurements is unknown. OBJECTIVES: To determine the intraoperator, intraobserver and interoperator variability of echocardiographic measures in healthy foals. METHODS: Echocardiographic examinations were carried out on 6 healthy foals by 3 experienced echocardiographers. Intraoperator variability was determined by having a single echocardiographer obtain and measure images from 6 foals scanned on 3 consecutive days. Interoperator and intraobserver variability were determined by having 3 echocardiographers each obtain images from an additional 6 sedated foals. Within-day interoperator variability was determined by having each echocardiographer measure their own images. Intraobserver variability was determined by having a single echocardiographer measure images obtained by all 3 echocardiographers. The coefficient of variation (CV) and standard error were calculated for each measure. RESULTS: The variability for most measurements was either very low (CV < 5%) or low (CV = 5-15%). Measurements of right ventricular internal diameter (RVID) in systole and E-point to septal separation (EPSS) showed moderate (CV 15-25%) to high variability (CV > 25%) in all 3 categories. Measurements of the left ventricular ejection time (LVET) and velocity time integral from the right parasternal long axis view of right outflow tract in the fourth intercostal space showed moderate intraoperator variability. Measurements of the LVET, RVID in diastole and left atrial appendage (LAA) showed moderate interoperator variability and measurements of the RVID in diastole and acceleration time from the short axis view of the right outflow tract in the right third intercostal space showed moderate interobserver variability. CONCLUSION: The intraoperator, intraobserver and interoperatorvariabilities for most echocardiographic measurements in foals are low. POTENTIAL RELEVANCE: Most standard transthoracic echocardiographic measurements in foals have a low enough variability to warrant their use in serial clinical evaluations or experimental studies. Repeated measurements of RVID, EPSS, LVET and LAA should be interpreted with caution.

Two-dimensional and M-mode echocardiographic findings in healthy Thoroughbred foals.

OBJECTIVE: The aim of this study was to establish reference values for a series of conventional two-dimensional (2-D) and M-mode echocardiographic variables in Thoroughbred foals at increasing age intervals. DESIGN: Nineteen healthy Thoroughbred foals (11 males, 8 females) were examined at 1, 2, 4, 8, 12 and 16 weeks of life. Auscultatory findings were recorded and echocardiographic examinations (2-D and M-mode) were performed. Descriptive statistical analyses, including mean, standard deviation and 95% confidence interval for the means, were used to summarise the data. The relationships between selected echocardiographic variables and age, body weight and heart rate were analysed. RESULTS: Reference values were determined for 12 routinely used 2-D and M-mode echocardiographic variables in healthy Thoroughbred foals at increasing age intervals. Linear relationships between echocardiographic variables and age (P < 0.001) and body weight (P < 0.001) were found, with the linear relationships between echocardiographic variables and body weight being stronger than those with age. Weak (R(2) ≤ 0.37) but significant (P < 0.001) correlations between the echocardiographic variables and heart rate were identified. CONCLUSIONS: Reference values for 2-D and M-mode echocardiographic variables in clinically normal Thoroughbred foals up to 4 months of age and approximately 190 kg body weight may assist in the interpretation of echocardiograms of Thoroughbred foals of similar age and body weight with suspected congenital or acquired cardiac disease.