Effect of video angle on detection of induced front limb lameness in horses.

BACKGROUND: Lameness examinations are commonly performed in equine medicine. Advancements in digital technology have increased the use of video recordings for lameness assessment, however, standardization of ideal video angle is not available yielding videos of poor diagnostic quality. The objective of this study was to evaluate the effect of video angle on the subjective assessment of front limb lameness. A randomized, blinded, crossover study was performed. Six horses with and without mechanically induced forelimb solar pain were recorded using 9 video angles including horses trotting directly away and towards the video camera, horses trotting away and towards a video camera placed to the left and right side of midline, and horses trotting in a circle with the video camera placed on the inside and outside of the circle. Videos were randomized and assessed by three expert equine veterinarians using a 0-5 point scoring system. Objective lameness parameters were collected using a body-mounted inertial sensor system (Lameness Locator®, Equinosis LLC). Interobserver agreement for subjective lameness scores and ease of grading scores were determined. RESULTS: Induction of lameness was successful in all horses. There was excellent agreement between objective lameness parameters and subjective lameness scores (AUC of the ROC = 0.87). For horses in the "lame" trials, interobserver agreement was moderate for video angle 2 when degree of lameness was considered and perfect for video angle 2 and 9 when lameness was considered as a binary outcome. All other angles had no to fair agreement. For horses in the "sound" trials, interobserver agreement was perfect for video angle 5. All other video angles had slight to moderate agreement. CONCLUSIONS: When video assessment of forelimb lameness is required, a video of the horse trotting directly towards the video camera at a minimum is recommended. Other video angles may provide supportive information regarding lameness characteristics.

Feasibility of bone marrow edema detection using dual-energy cone-beam computed tomography.

BACKGROUND: Dual-energy (DE) detection of bone marrow edema (BME) would be a valuable new diagnostic capability for the emerging orthopedic cone-beam computed tomography (CBCT) systems. However, this imaging task is inherently challenging because of the narrow energy separation between water (edematous fluid) and fat (health yellow marrow), requiring precise artifact correction and dedicated material decomposition approaches. PURPOSE: We investigate the feasibility of BME assessment using kV-switching DE CBCT with a comprehensive CBCT artifact correction framework and a two-stage projection- and image-domain three-material decomposition algorithm. METHODS: DE CBCT projections of quantitative BME phantoms (water containers 100-165 mm in size with inserts presenting various degrees of edema) and an animal cadaver model of BME were acquired on a CBCT test bench emulating the standard wrist imaging configuration of a Multitom Rax twin robotic x-ray system. The slow kV-switching scan protocol involved a 60 kV low energy (LE) beam and a 120 kV high energy (HE) beam switched every 0.5° over a 200° angular span. The DE CBCT data preprocessing and artifact correction framework consisted of (i) projection interpolation onto matched LE and HE projections views, (ii) lag and glare deconvolutions, and (iii) efficient Monte Carlo (MC)-based scatter correction. Virtual non-calcium (VNCa) images for BME detection were then generated by projection-domain decomposition into an Aluminium (Al) and polyethylene basis set (to remove beam hardening) followed by three-material image-domain decomposition into water, Ca, and fat. Feasibility of BME detection was quantified in terms of VNCa image contrast and receiver operating characteristic (ROC) curves. Robustness to object size, position in the field of view (FOV) and beam collimation (varied 20-160 mm) was investigated. RESULTS: The MC-based scatter correction delivered > 69% reduction of cupping artifacts for moderate to wide collimations (> 80 mm beam width), which was essential to achieve accurate DE material decomposition. In a forearm-sized object, a 20% increase in water concentration (edema) of a trabecular bone-mimicking mixture presented as ∼15 HU VNCa contrast using 80-160 mm beam collimations. The variability with respect to object position in the FOV was modest (< 15% coefficient of variation). The areas under the ROC curve were > 0.9. A femur-sized object presented a somewhat more challenging task, resulting in increased sensitivity to object positioning at 160 mm collimation. In animal cadaver specimens, areas of VNCa enhancement consistent with BME were observed in DE CBCT images in regions of MRI-confirmed edema. CONCLUSION: Our results indicate that the proposed artifact correction and material decomposition pipeline can overcome the challenges of scatter and limited spectral separation to achieve relatively accurate and sensitive BME detection in DE CBCT. This study provides an important baseline for clinical translation of musculoskeletal DE CBCT to quantitative, point-of-care bone health assessment.

A missed opportunity: A scoping review of the effect of sex and age on osteoarthritis using large animal models.

OBJECTIVE: The objective was to critically analyze the published literature accounting for sex differences and skeletal age (open vs. closed physis) in preclinical animal models of OA, including the disaggregation of data by sex and skeletal maturity when data is generated from combined sex and/or multi-aged cohorts without proper confounding. METHOD: A scoping literature review of PubMed, Web of Science, EMBASE, and SCOPUS was performed for studies evaluating the effect of sex and age in experimental studies and clinical trials utilizing preclinical large animal models of OA. RESULTS: A total of 9727 papers were identified in large animal (dog, pig, sheep, goat, horse) models for preclinical OA research, of which 238 ex vivo and/or in vivo studies disclosed model type, animal species, sex, and skeletal age sufficient to analyze their effect on outcomes. Dogs, followed by pigs, sheep, and horses, were the most commonly used models. A paucity of preclinical studies evaluated the effect of sex and age in large animal models of naturally occurring or experimentally induced OA: 26 total studies reported some kind of analysis of the effects of sex or age, with 4 studies discussing the effects of sex only, 11 studies discussing the effects of age only, and 11 studies analyzing both the effects of age and sex. CONCLUSION: Fundamental to translational research, OARSI is uniquely positioned to develop recommendations for conducting preclinical studies using large animal models of OA that consider biological mechanisms linked to sex chromosomes, skeletal age, castration, and gonadal hormones affecting OA pathophysiology and treatment response.

Computed tomography and fluoroscopy versus radiographic guidance for internal fixation of simulated dorsomedial-plantarolateral central tarsal bone fractures in nonracehorses.

OBJECTIVE: The aim of this study was to assess screw placement in simulated dorsomedial-plantarolateral central tarsal bone (CTB) fractures using two imaging guidance techniques - computed tomography (CT) with fluoroscopy compared to digital radiography alone (DR). STUDY DESIGN: Experimental study. SAMPLE POPULATION: Equine cadaver hindlimbs (n = 10 pairs). METHODS: One tarsus per pair was randomly assigned to have a 4.5 mm cortical screw placed across the CTB using CT and fluoroscopy (CT/F group) or digital radiography alone (DR group). Postoperative CT was performed on all limbs. Variables related to marker placement, procedure time, and screw positioning were recorded and compared using a paired t-test for dependent means (p < .05). RESULTS: Time for marker placement was longer for the CT/F group (p = .001), with no difference in total procedure time (p = .12). CT/F was not superior to radiography alone (p > .05) for parameters related to screw positioning. Based on the 95% CI, there was greater range in relative screw length using radiography (76.5%-91.2%) versus CT/F (78.4%-84.0%). CONCLUSION: Internal fixation of CTB fractures can be successfully performed using either technique for imaging guidance. CT and fluoroscopy did not result in faster or more accurate screw placement compared to radiographs alone, except in determining screw length. CLINICAL SIGNIFICANCE: Mild adjustments in fluoroscopic or radiographic angle appeared to be a point of variability in the perception of screw placement. While CT is recommended for improved understanding of fracture configuration and surgical planning, radiographic guidance may be a suitable alternative for internal fixation of dorsomedial-plantarolateral fractures.

Cone-beam computed tomography produces images of numerically comparable diagnostic quality for bone and inferior quality for soft tissues compared with fan-beam computed tomography in cadaveric equine metacarpophalangeal joints.

Cone-beam computed tomography (CBCT) is an emerging modality for imaging of the equine patient. The objective of this prospective, descriptive, exploratory study was to assess visualization tasks using CBCT compared with conventional fan-beam CT (FBCT) for imaging of the metacarpophalangeal joint in equine cadavers. Satisfaction scores were numerically excellent with both CBCT and FBCT for bone evaluation, and FBCT was numerically superior for soft tissue evaluation. Preference tests indicated FBCT was numerically superior for soft tissue evaluation, while preference test scoring for bone was observer-dependent. Findings from this study can be used as background for future studies evaluating CBCT image quality in live horses.

Employing direct electromagnetic coupling to assess acute fracture healing: An ovine model assessment.

OBJECTIVES: This study explored the efficacy of collecting temporal fracture site compliance data via an advanced direct electromagnetic coupling (DEC) system equipped with a Vivaldi-type antenna, novel calibration technique, and multi-antenna setup (termed maDEC) as an approach to monitor acute fracture healing progress in a translational large animal model. The overarching goal of this approach was to provide insights into the acute healing dynamics, offering a promising avenue for optimizing fracture management strategies. METHODS: A sample of twelve sheep, subjected to ostectomies and intramedullary nail fixations, was divided into two groups, simulating normal and impaired healing scenarios. Sequential maDEC compliance or stiffness measurements and radiographs were taken from the surgery until euthanasia at four or eight weeks and were subsequently compared with post-sacrifice biomechanical, micro-CT, and histological findings. RESULTS: The results showed that the maDEC system offered straightforward quantification of fracture site compliance via a multiantenna array. Notably, the rate of change in the maDEC-measured bending stiffness significantly varied between normal and impaired healing groups during both the 4-week (p = 0.04) and 8-week (p = 0.02) periods. In contrast, radiographically derived mRUST healing measurements displayed no significant differences between the groups (p = 0.46). Moreover, the cumulative normalized stiffness maDEC data significantly correlated with post-sacrifice mechanical strength (r2 = 0.80, p < 0.001), micro-CT measurements of bone volume fraction (r2 = 0.60, p = 0.003), and density (r2 = 0.60, p = 0.003), and histomorphometric measurements of new bone area fraction (r2 = 0.61, p = 0.003) and new bone area (r2 = 0.60, p < 0.001). CONCLUSIONS: These data indicate that the enhanced maDEC system provides a non-invasive, accurate method to monitor fracture healing during the acute healing phase, showing distinct stiffness profiles between normal and impaired healing groups and offering critical insights into the healing process's progress and efficiency.

Comparison of a Thiolated Demineralized Bone Matrix Hydrogel to a Clinical Product Control for Regeneration of Large Sheep Cranial Defects.

Regeneration of calvarial bone remains a major challenge in the clinic as available options do not sufficiently regenerate bone in larger defect sizes. Calvarial bone regeneration cases involving secondary medical conditions, such as brain herniation during traumatic brain injury (TBI) treatment, further exacerbate treatment options. Hydrogels are well-positioned for severe TBI treatment, given their innate flexibility and potential for bone regeneration to treat TBI in a single-stage surgery. The current study evaluated a photocrosslinking pentenoate-modified hyaluronic acid polymer with thiolated demineralized bone matrix (i.e., TDBM hydrogel) capable of forming a completely interconnected hydrogel matrix for calvarial bone regeneration. The TDBM hydrogel demonstrated a setting time of 120 s, working time of 3 to 7 days, negligible change in setting temperature, physiological setting pH, and negligible cytotoxicity, illustrating suitable performance for in vivo application. Side-by-side ovine calvarial bone defects (19 mm diameter) were employed to compare the TDBM hydrogel to the standard-of-care control material DBX®. After 16 weeks, the TDBM hydrogel had comparable healing to DBX® as demonstrated by mechanical push-out testing (~800 N) and histology. Although DBX® had 59% greater new bone volume compared to the TDBM hydrogel via micro-computed tomography, both demonstrated minimal bone regeneration overall (15 to 25% of defect volume). The current work presents a method for comparing the regenerative potential of new materials to clinical products using a side-by-side cranial bone defect model. Comparison of novel biomaterials to a clinical product control (i.e., standard-of-care) provides an important baseline for successful regeneration and potential for clinical translation.

Evaluation of a modified subchondroplasty technique in an equine full-thickness cartilage defect model: a pilot study.

OBJECTIVE: To perform a pilot study with the intent of assessing the feasibility of a modified subchondroplasty (mSCP) technique in a validated preclinical equine model of full-thickness articular cartilage loss and evaluate the short-term patient response to the injected materials. ANIMALS: 3 adult horses. PROCEDURES: Two 15-mm-diameter full-thickness cartilage defects were created on the medial trochlear ridge of each femur. Defects were treated with microfracture and then filled by 1 of 4 techniques: (1) autologous fibrin graft (FG) via subchondral injection of fibrin glue (FG), (2) autologous fibrin graft via direct injection of FG, (3) subchondral injection of a calcium phosphate bone substitute material (BSM) with direct injection of FG, and (4) untreated control. Horses were euthanized after 2 weeks. Patient response was evaluated via serial lameness examination, radiography, magnetic resonance imaging, computed tomography, gross evaluation, microcomputed tomography, and histopathology. RESULTS: All treatments were successfully administered. The injected material perfused through the underlying bone into the respective defects without adversely affecting the surrounding bone and articular cartilage. Increased new bone formation was seen at the margins of the trabecular spaces containing BSM. There was no treatment effect on the amount or composition of tissue within defects. CLINICAL RELEVANCE: The mSCP technique was a simple, well-tolerated technique in this equine articular cartilage defect model without significant adverse effects to host tissues after 2 weeks. Larger studies with long-term follow-ups are warranted.

Experimental models of bone marrow lesions in ovine femoral condyles.

OBJECTIVE: To develop an in vivo experimental model for bone marrow lesions (BMLs) in ovine femorotibial joints. STUDY DESIGN: Randomized, prospective experimental study. ANIMALS: Eighteen healthy, skeletally-mature Dorper cross ewes. METHODS: One medial femoral condyle was penetrated with a 1.1 mm pin, and the contralateral medial femoral condyle was treated with transcutaneous extracorporeal shockwave (ESW) at 0.39 ± 0.04 mJ/mm2 . Clinical examination, magnetic resonance imaging (MRI), computed tomography (CT), and histopathological analyses were used to detect and characterize the development and progression of BMLs in the medial femoral condyle at 4, 8, and 12 weeks post-surgery. RESULTS: Pin penetration induced a BML detected on MRI within 2 weeks and lasted at least 12 weeks. BMLs were not observed in ESW-treated condyles. Histologically, BMLs were characterized by hemorrhage and inflammatory cellular infiltrate, and progressed to more dense fibrous tissue over time. Pathological changes were not observed in the articular cartilage overlying the region of BMLs. CONCLUSIONS: Direct, focal trauma to all layers of the osteochondral unit was sufficient to create an experimentally-induced BML which persisted for at least 90 days. The protocol used for ESW in this study did not induce BMLs. CLINICAL SIGNIFICANCE: Experimental induction of BMLs is possible and mimicked naturally occurring disease states. Volumetric imaging is a sensitive method for characterization of the dynamic nature of these lesions.

A Large Animal Model for Orthopedic Foot and Ankle Research.

Trauma to the soft tissues of the ankle joint distal syndesmosis often leads to syndesmotic instability, resulting in undesired movement of the talus, abnormal pressure distributions, and ultimately arthritis if deterioration progresses without treatment. Historically, syndesmotic injuries have been repaired by placing a screw across the distal syndesmosis to provide rigid fixation to facilitate ligament repair. While rigid syndesmotic screw fixation immobilizes the ligamentous injury between the tibia and fibula to promote healing, the same screws inhibit normal physiologic movement and dorsiflexion. It has been shown that intact screw removal can be beneficial for long-term patient success; however, the exact timing remains an unanswered question that necessitates further investigation, perhaps using animal models. Because of the sparsity of relevant preclinical models, the purpose of this study was to develop a new, more translatable, large animal model that can be used for the investigation of clinical foot and ankle implants. Eight (8) skeletally mature sheep underwent stabilization of the left and right distal carpal bones following transection of the dorsal and interosseous ligaments while the remaining two animals served as un-instrumented controls. Four of the surgically stabilized animals were sacrificed 6 weeks after surgery while the remaining four animals were sacrificed 10 weeks after surgery. Ligamentous healing was evaluated using radiography, histology, histomorphometry, and histopathology. Overall, animals demonstrated a high tolerance to the surgical procedure with minimal complications. Animals sacrificed at 10 weeks post-surgery had a slight trend toward mildly decreased inflammation, decreased necrotic debris, and a slight increase in the healing of the transected ligaments. The overall degree of soft tissue fibrosis/fibrous expansion, including along the dorsal periosteal surfaces/joint capsule of the carpal bones was very similar between both timepoints and often exhibited signs of healing. The findings of this study indicate that the carpometacarpal joint may serve as a viable location for the investigation of human foot and ankle orthopedic devices. Future work may include the investigation of orthopedic foot and ankle medical devices, biologic treatments, and repair techniques in a large animal model capable of providing translational results for human treatment.

Comparative evaluation of tomosynthesis, computed tomography, and magnetic resonance imaging findings for metacarpophalangeal joints from equine cadavers.

OBJECTIVE: To describe the technique and assess the diagnostic potential and limitations of tomosynthesis for imaging of the metacarpophalangeal joint (MCPJ) of equine cadavers; compare the tomosynthesis appearance of pathological lesions with their conventional radiographic, CT, and MRI appearances; and evaluate all imaging findings with gross lesions of a given MCPJ. SAMPLE: Distal portions of 4 forelimbs from 4 equine cadavers. PROCEDURES: The MCPJs underwent radiography, tomosynthesis (with a purpose-built benchtop unit), CT, and MRI; thereafter, MCPJs were disarticulated and evaluated for the presence of gross lesions. The ability to identify pathological lesions on all images was assessed, followed by semiobjective scoring for quality of the overall image and appearance of the subchondral bone, articular cartilage, periarticular margins, and adjacent trabecular bone of the third metacarpal bone, proximal phalanx, and proximal sesamoid bones of each MCPJ. RESULTS: Some pathological lesions in the subchondral bone of the third metacarpal bone were detectable with tomosynthesis but not with radiography. Overall, tomosynthesis was comparable to radiography, but volumetric imaging modalities were superior to tomosynthesis and radiography for imaging of subchondral bone, articular cartilage, periarticular margins, and adjacent bone. CONCLUSIONS AND CLINICAL RELEVANCE: With regard to the diagnostic characterization of equine MCPJs, tomosynthesis may be more accurate than radiography for identification of lesions within subchondral bone because, in part, of its ability to reduce superimposition of regional anatomic features. Tomosynthesis may be useful as an adjunctive imaging technique, highlighting subtle lesions within bone, compared with standard radiographic findings.

Use of cone-beam computed tomography for advanced imaging of the equine patient.

Access to volumetric imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT), has increased over the past decade and has revolutionised the way clinicians evaluate equine anatomy. More recent advancements have resulted in the development of multiple commercially available cone-beam CT (CBCT) scanners for equine use. CBCT scanners modify the traditional fan-shaped beam of ionising radiation into a three-dimensional pyramidal- or cone-shaped beam of radiation. This modification enables the scanner to acquire sufficient data to create diagnostic images of a region of interest after a single rotation of the gantry. The rapid acquisition of data and divergent X-ray beam causes some artifacts to be more prominent on CBCT images-as well as the unique cone-beam artifact-resulting in decreased contrast resolution. While the use of CT for evaluation of the equine musculoskeletal anatomy is not new, there is a paucity of literature and scientific studies on the capabilities of CBCT for equine imaging. CBCT units do not require a specialised table for imaging and in some cases are portable for imaging in the standing or anaesthetised patient. This review article summarises the basic physics of CT technology, including how CBCT imaging differs, and provides objective information about the strengths and limitations of this modality. Finally, potential future applications and techniques for imaging with CT which will need to be explored in order to fully consider the capabilities of CT imaging in the horse are discussed.

The clinical and histopathologic effects of potentiated chlorhexidine in the upper respiratory tract of horses.

OBJECTIVE: To describe the bactericidal and fungicidal properties of a 0.0005% chlorhexidine (CHD) solution potentiated with EDTA-Tris buffers (CHD-EDTA-Tris) and evaluate the safety of 0.0005% CHD-EDTA-Tris in the upper respiratory tract (URT) of normal horses. STUDY DESIGN: Clinical, prospective study. ANIMALS: Eight healthy, skeletally mature horses. METHODS: In vitro-serial dilutions of CHD-EDTA-Tris and EDTA-Tris alone were evaluated for bactericidal and fungicidal activity against Aspergillus fumigatus, Escherichia coli, Staphylococcus aureus, Streptococcus equi subspecies ssp. equi, Streptococcus equi ssp. zooepidemicus, and Pseudomonas aeruginosa. In vivo-eight healthy horses were topically treated twice with 30 ml of 0.0005% CHD-EDTA-Tris. Mucosal samples from each location were evaluated for the presence of inflammation or pathologic lesions. RESULTS: Solutions containing CHD were superior in fungal and bacterial killing to those without. In vitro-a 0.005% CHD-EDTA-Tris was 100% effective against all bacterial and fungal species evaluated, while a 0.0005% CHD-EDTA-Tris was less efficacious against A. fumigatus and S. equi ssp. equi. In vivo-a 0.0005% CHD-EDTA-Tris did not cause any clinical, gross, or histologic abnormalities when topically applied to the equine URT. CONCLUSIONS: A 0.0005% CHD-EDTA-Tris was highly effective for killing of common bacterial and fungal isolates in the equine upper respiratory tract. Short-term topical treatment of the equine URT with dilute CHD did not cause gross or histological inflammation in the tissue. CLINICAL SIGNIFICANCE: A 0.0005% CHD solution with EDTA-Tris should be considered for treatment of clinically relevant inflammatory or infectious conditions or in the URT of the horse.

Changes in the faecal bacterial microbiota during hospitalisation of horses with colic and the effect of different causes of colic.

BACKGROUND: Previous studies have identified alterations in the faecal microbiota of horses with colic; however, further work is needed to interpret these findings. OBJECTIVES: To compare the faecal microbiota of horses presenting for colic at hospital admission, day 1 and day 3/discharge and with different colic duration and lesion locations. STUDY DESIGN: Prospective observational clinical study. METHODS: Faecal samples were collected from 17 colic cases at hospital admission, on day 1 and on day 3 post-admission or at the time of hospital discharge if prior to 72 hours. Faecal samples were extracted for genomic DNA, PCR-amplified, sequenced and analysed using QIIME. Species richness and Shannon diversity (alpha diversity) were estimated. The extent of the relationship between bacterial communities (beta diversity) was quantified using pairwise UniFrac distances, visualised using principal coordinate analysis (PCoA) and statistically analysed using permutational multivariate analysis of variance (PERMANOVA). The relative abundance of bacterial populations at the different time points and in different types of colic was compared using ANCOM. RESULTS: There was a decrease in species richness from admission to day 3/hospital discharge (P < .05), and a lower species richness (P = .005) and Shannon diversity (P = .02) in horses with colic ≥60 h compared to <60 h. Based on PCoA and PERMANOVA, there was a significant difference in bacterial community composition for horses with different colic duration (P = .001) and lesion location (P = .006). Several differences in bacterial phyla and genera were observed at different time points and with different types of colic. MAIN LIMITATIONS: Relatively low numbers and a diverse population of horses. CONCLUSIONS: The microbiota change from hospital admission to day 3/discharge in horses with colic and horses with colic ≥60 h and large colon lesions have a distinct bacterial population compared to horses with colic <60 h and small intestinal lesions.

Physiologic effects of long-term immobilization of the equine distal limb.

OBJECTIVE: To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. STUDY DESIGN: Randomized, prospective experimental study. ANIMALS: Eight healthy, skeletally mature horses. METHODS: One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamoid bones, and associated soft tissues in each horse. Serum and synovial fluid were collected for biomarker analyses. RESULTS: Distal limb immobilization resulted in persistent lameness (P < .001), effusion (P = .002), and a decreased range of motion (P = .012) as well as radiographically visible fragments (P = .036) in the cast forelimb. Bone density was decreased (P < .001) in MC3 according to CT, and trabecular bone fluid was increased (P < .001) according to MRI in the cast forelimb. The cast forelimbs had a change (P = .009) in the appearance of the deep digital flexor tendon according to MRI immediately after removal of the cast. Numerous clinical, radiographic, CT, and MR abnormalities were visible at the end of the study period. CONCLUSION: Eights weeks of cast immobilization induced changes in bone, cartilage, and periarticular soft tissues that were not reversed after 12 weeks of remobilization. CLINICAL SIGNIFICANCE: Cast application should be used judiciously in horses with musculoskeletal injuries, balancing appropriate stabilization with potential morbidity secondary to cast placement.

The Importance of Subchondral Bone in the Pathophysiology of Osteoarthritis.

Subchondral bone plays a critical role in the pathogenesis of osteochondral disease across veterinary species. The subchondral bone is highly adaptable, with the ability to model and remodel in response to loading stresses experienced by the joint. Repetitive stress injuries within the joint can result in primary or secondary pathologic lesions within the subchondral bone, which have been recognized to contribute to the development and progression of osteoarthritis. Recent advances in diagnostic imaging, particularly volumetric imaging modalities have facilitated earlier identification of subchondral bone disease. Despite these advancements, limitations in our knowledge about subchondral bone makes treatment and prevention of these conditions challenging. The purpose of this report is to review our current understanding of subchondral bone and its relationship to osteoarthritis across veterinary species, with a specific focus in the research that has been performed in horses. It can be concluded that our current understanding of subchondral bone is advancing, and future experimental, clinical and pathologic studies will provide additional insight about subchondral bone and its relationship to joint disease.

Characterization of the fecal microbiota of healthy horses.

OBJECTIVE To characterize the fecal microbiota of horses and to investigate alterations in that microbiota on the basis of sample collection site (rectum vs stall floor), sample location within the fecal ball (center vs surface), and duration of environmental exposure (collection time). ANIMALS 6 healthy adult mixed-breed mares. PROCEDURES From each horse, feces were collected from the rectum and placed on a straw-bedded stall floor. A fecal ball was selected for analysis immediately after removal from the rectum and at 0 (immediately), 2, 6, 12, and 24 hours after placement on the stall floor. Approximately 250 mg of feces was extracted from the surface and center of each fecal ball, and genomic DNA was extracted, purified, amplified for the V1-V2 hypervariable region of the 16S rDNA gene, and analyzed with a bioinformatics pipeline. RESULTS The fecal microbiota was unique for each horse. Bacterial community composition varied significantly between center and surface fecal samples but was not affected by collection time. Bacterial community composition varied rapidly for surface fecal samples. Individual bacterial taxa were significantly associated with both sample location and collection time but remained fairly stable for up to 6 hours for center fecal samples. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, for horses, fecal samples for microbiota analysis should be extracted from the center of fecal balls collected within 6 hours after defecation. Samples obtained up to 24 hours after defecation can be analyzed with the realization that some bacterial populations may deviate from those immediately after defecation.

Clinical and intestinal histologic features of horses treated for recurrent colic: 66 cases (2006-2015).

OBJECTIVE To describe gastrointestinal histologic findings for horses with recurrent colic and evaluate possible associations between initial clinical signs, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge. DESIGN Retrospective case series. ANIMALS 66 horses with a history of recurrent colic for which gastrointestinal specimens had been submitted for histologic examination. PROCEDURES Histologic diagnosis was categorized as inflammatory, neoplastic, ischemic, other, and undiagnosed. Relationships among initial clinical features, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge (ie, alive vs dead and persistent recurrent colic [yes vs no]) and between corticosteroid treatment and outcome were investigated. Odds ratios and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. RESULTS Inflammatory disease (36/66 [55%]) was the most common histologic diagnosis. Horses undergoing rectal biopsy alone were significantly (OR, 14.4; 95% Cl, 2.7 to 76.1) more likely to not have a histologic diagnosis than were horses in which other biopsy methods were used. In multivariable modelling, persistence of recurrent colic (HR, 15.2; 95% Cl, 1.9 to 121.2) and a history of weight loss (HR, 4.9; 95% Cl, 1.4 to 16.5) were significantly associated with outcome (alive vs dead) 1 year after surgery. Corticosteroid treatment was not significantly associated with either outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a high proportion (36/66 [55%]) of horses with recurrent colic had inflammatory gastrointestinal disease. Use of rectal biopsy alone to obtain biopsy specimens was more likely to result in no histologic diagnosis. Use of corticosteroids in horses with inflammatory gastrointestinal disease was not associated with outcome but warrants further investigation.