Long-term assessment of horses and ponies post exposure to monensin sodium in commercial feed.

REASONS FOR PERFORMING STUDY: Acute monensin intoxication in equids is well described; however, the long-term effects of sublethal intoxication and ability to return to previous use are less well understood. Long-term observations may allow improved estimation of prognosis in cases of sublethal intoxication. OBJECTIVES: To assess horses and ponies exposed to sublethal amounts of monensin for evidence of chronic sequelae and ability to return to prior/intended use. METHODS: Twenty-nine horses and 8 ponies were assessed utilising serum biochemistry, treadmill exercise stress testing, electrocardiography, and pre- and post exercise echocardiography > or = 6 weeks after ingestion of monensin-contaminated feed. Animals with evidence of monensin-induced cardiomyopathy were re-examined after a period of rest of > or = 11 months. Follow-up information was obtained by owner telephone interview > or = 52 months after exposure. RESULTS: During resting echocardiography, 11 animals had reduced/low-normal left ventricular fractional shortening (FS); an increase in FS in 8 of these animals was measured > or = 11 months later. Six animals had reduced or low-normal FS during post exercise echocardiography. Two horses had ventricular premature depolarisations during exercise. Follow-up information was available for 35 animals: 21 returned to athletic/reproductive use, 13 were retired immediately and one died. Mean FS increased significantly (P < 0.001) between initial and second examination in 15 animals that underwent resting echocardiography on 2 occasions. CONCLUSIONS: Some equids exposed to sublethal doses of monensin may not develop permanent myocardial disease and a return to athletic/reproductive use is possible. POTENTIAL RELEVANCE: Exercise stress testing, echocardiography and electrocardiography may be useful for detection and monitoring of cardiac dysfunction in equids exposed to monensin and determining whether a return to athletic/reproductive use is possible.

Long-term control of olfactory neuroblastoma in a dog treated with surgery and radiation therapy.

BACKGROUND: Olfactory neuroblastoma is a rare malignancy of the nasal cavity in dogs that is thought to arise from specialised sensory neuroendocrine olfactory cells derived from the neural crest. CASE REPORT: An 8-year-old dog was presented for reclusiveness and pacing. On CT and MRI, a contract-enhancing mass was disclosed within the rostral fossa, extending caudally from the cribriform plate into the left nasal sinus. Surgical excision was performed and the diagnosis was histological grade III (Hyams grading scheme) olfactory neuroblastoma. Based on human CT criteria this was high stage (modified Kadish stage C). Surgical excision was incomplete and was followed by curative-intent radiation therapy using a linear accelerator to a total dose of 48 Gy. CONCLUSION: The dog survived 20 months after diagnosis. Although olfactory neuroblastoma is a rare tumour in dogs, aggressive local therapy may allow for prolonged survival, even when the tumour is advanced.

Serum and plasma cardiac troponin I concentrations in clinically normal Thoroughbreds in training in Australia.

Cardiac troponin I is a potentially useful test to identify cardiac muscle damage in the horse. Measurements of cardiac troponin I from serum or heparinised plasma samples from 23 clinically normal Thoroughbred horses in race training were analysed through a standard Australian commercial laboratory using the ADVIA Centaur Assay. The cardiac troponin I concentrations were < 0.15 microg/L from all samples. The test was then validated using macerated equine myocardium. Cardiac troponin I concentration may be useful in determining whether poor performance in Thoroughbred horses is related to active myocardial disease.

Intracerebral hemorrhage outcome: apolipoprotein E genotype, hematoma, and edema volumes.

We investigated whether early hematoma or edema volumes could explain the adverse association between APOE epsilon4 and survival in intracerebral hemorrhage. Among 102 patients, epsilon4 carriers had a higher mortality rate than non-epsilon4 carriers (38 versus 24%, p = 0.05). Nonsurvivors had larger hematoma (75.5 cm3 versus 27.1 cm3, p<0.001) and edema volumes (37.5 cm3 versus 17.1 cm3, p<0.01), but these were not associated with epsilon4 after adjusting for race, age, and type of hemorrhage.

Anandamides inhibit binding to the muscarinic acetylcholine receptor.

Loss of memory and cholinergic transmission are associated with both Alzheimer's disease (AD) and marijuana use. The human brain muscarinic acetylcholine receptor (mAChR), which is involved in memory function and is inhibited by arachidonic acid, is also inhibited by anandamides. Two agonists of the cannabinoid receptor derived from arachidonic acid, anandamide (AEA) and R-methanandamide, inhibit ligand binding to the mAChR. Binding of the mAChR antagonist [3H]quinuclidinyl benzilate ([3H]QNB) is inhibited up to 89% by AEA (half-maximal inhibition at 50 microM). Binding of the more polar antagonist [N-methyl-3H]scopolamine ([3H]NMS) is inhibited by AEA up to 76% (half-maximal inhibition at 44 microM). R-methanandamide inhibits more than 90% of both [3H]QNB binding (I50 = 34 microM) and [3H]NMS binding (I50 = 15 microM) to the mAChR. Both AEA and R-methanandamide stimulate mAChR binding of the agonist [3H]oxotremorine-M at low concentrations (25-75 microM), but significantly inhibit agonist binding at higher concentrations (I50 = 150 microM). The cannabinoid antagonist SR141716A did not alter AEA or R-methanandamide inhibition of [3H]NMS binding to the mAChR, even at concentrations as high as 1 microM. Further, the cannabinoid agonist WIN 55212-2 does not alter antagonist binding to the mAChR. This demonstrates that mAChR inhibition by the anandamides is not mediated by the cannabinoid receptor. Since AEA and R-methanandamide are structurally similar to arachidonic acid, they may interact with the mAChR in a similar manner to inhibit receptor function.

Doppler sonographic measurements of arterial blood flow and their repeatability in the equine foot during weight bearing and non-weight bearing.

In six normal adult horses, pulsed-wave Doppler sonographic inspections were made of the left and right lateral palmar proper digital artery (LPPDA) of each thoracic limb. Using a two-period, crossover design with repeated measures, each LPPDA was inspected on four occasions throughout the day over a 7 hour period and, on each occasion, with the limb weight bearing and non-weight bearing. In comparison with the observations made during weight bearing, there were significant increases (P<0.001) in blood-flow velocities when the limb was non-weight bearing. There was no relationship between blood velocities and the time of day, the order in which the inspections were made, resting heart rate, age of the horse, or hoof angle. In both weight bearing and nonweight bearing, the Doppler waveform demonstrated a systolic peak followed by at least two diastolic peaks and an end diastolic plateau. Horses that moved least during sonographic inspections had the lowest co-efficients variation.

Ultrasonography of the equine neonatal kidney.

Ultrasonography is important in the clinical examination of the foal. The ultrasonographic appearance and size of the neonatal kidneys were defined and an imaging protocol established in 6 normal Thoroughbred foals (mean age +/- s.d. 5.0 +/- 3.2 days). Characteristically, in both the heart-shaped right kidney and bean-shaped left kidney, the renal cortex was more echogenic than the medulla. The terminal recesses, renal crest and pelvis were identified, as was the ureter, which contained anechoic urine in its lumen. The renal, interlobar and arcuate vessels were seen. For the right kidney, the ultrasonographic probe was placed at the 14-17th intercostal spaces and paralumbar fossa. For the left kidney, the probe was at the 16th or 17th intercostal spaces and paralumbar fossa. Perirenal structures, including the caudate lobe of the liver, the dorsal extremity of the spleen, the adrenals, the aorta and caudal vena cava were also identified. An understanding of the ultrasonographic appearance of the normal neonatal kidney, accompanied by a routine imaging protocol to ensure that all regions of each kidney are examined, permit a more informed interpretation of renal images in the first few days postpartum.

Postprandial arterial vasodilation in the equine distal thoracic limb.

The effects of feeding on blood flow to the equine foot are poorly understood. In a temperature-controlled room, duplex Doppler ultrasonographic observations were made pre- and postprandially of the lateral proper palmar digital artery of 5 horses, randomly assigned to twice and 4 times daily feeding in an unbalanced 2 period crossover design. Arterial diameter and blood velocity were measured over 4 h and additional observations made of heart rate, blood pressure, total plasma protein, packed cell volume, plasma glucose and insulin. There was no effect of the feeding regimen on any variable. Postprandially, there were significant increases in arterial diameter, blood velocity, total plasma protein, plasma glucose and insulin; the other variables were unchanged. It appeared that the normal postprandial response was an increase in blood flow to the foot. The value of ultrasonography for noninvasive investigation of the peripheral vasculature of the conscious horse was established; and in the future it may have a role in the diagnosis of vascular diseases of the foot.

Sonographic-anatomic correlation and imaging protocol for the kidneys of horses.

Sonographic and anatomic observations were made of the kidneys of 23 Thoroughbreds or Standardbreds. In an in vitro study of 16 horses, precise correlations were established between the gross anatomic features of the kidneys and their sonographic appearance in images obtained in dorsal, sagittal, transverse, and transverse oblique anatomic planes. The renal cortex had a uniformly mottled echogenicity, and the renal medulla was relatively hypoechogenic, compared with the cortex. Acoustic anisotropy was observed in the cortex and medulla of the cranial and caudal extremities of each kidney. The distinctive renal pelvis was seen in the transverse plane as an echogenic pair of diverging lines that lead to the crescent shaped renal crest in the lateral half of the kidney. In images made in the sagittal plane, the renal pelvis was seen as a pair of parallel echogenic lines separated by the moderately echogenic line of the renal crest. The terminal recesses were best seen in the transverse oblique views of each extremity, where they appeared as moderately echogenic lines in the medulla of the cranial and caudal extremities. The interlobar vessels were represented as irregular echogenic lines in the medulla, and the arcuate vessels were seen as echogenic points at the corticomedullary junction. At the hilus, the renal artery or its branches was located cranial to the renal vein, which in turn was cranial to the position of the proximal portion of the ureter. In an in vivo study of 7 horses, sonographic images of the right kidney were obtained in the sagittal, transverse, and transverse oblique anatomic planes in all horses, with the transducer positioned at the 15th, 16th, or 17th intercostal space; images in the dorsal plane were obtained, however, in only 3 of the horses. For the left kidney, sonographic images were obtained in each of the anatomic planes when the transducer was positioned at the 16th or 17th intercostal space or the paralumbar fossa; rectal location of the transducer gave images in the dorsal and sagittal planes. In this study, a routine sonographic imaging protocol, using standard anatomic planes, enabled each kidney to be examined in its entirety. The protocol provided definition of normal renal sonographic anatomic features and may permit a more informed and accurate recognition of renal pathologic change.

Use of Doppler ultrasonography to evaluate renal arterial blood flow in horses.

OBJECTIVE: To obtain Doppler ultrasonographic images of renal arteries in horses and to establish reference range values for systolic and diastolic renal arterial blood flow and resistive indices. Also to determine whether Doppler ultrasonography could be used in horses to detect changes in renal blood flow after IV administration of furosemide. ANIMALS: 11 clinically normal adult horses. PROCEDURES: Pulsed-wave Doppler examinations were performed on arcuate arteries of 5 sedated horses. Continuous-wave Doppler examinations were performed on pyelorenal arteries in 7 nonsedated horses and were repeated in 6 horses after furosemide administration. Peak-systolic velocity (SV) and end-diastolic velocity (EDV) were measured and the resistive indices (RI) were calculated. RESULTS: Using pulse-wave Doppler ultrasonography in sedated horses, arcuate arteries were determined to have a SV of 0.406 +/- 0.116 m/s (mean +/- SD), EDV of 0.184 +/- 0.057 m/s, and RI of 0.549 +/- 0.044. Using continuous-wave Doppler ultrasonography in nonsedated horses, pyelorenal arteries were determined to have SV of 1.047 +/- 0.009 m/s, EDV of 0.510 +/- 0.006 m/s, and RI of 0.512 +/- 0.004. Doppler waveforms from the arcuate and pyelorenal arteries had a low resistance flow pattern, characterized by a systolic peak followed by a continuous antegrade diastolic flow. After furosemide administration, the pyelorenal arterial velocities increased, but the RI remained unchanged. CONCLUSIONS: Doppler ultrasonography may be used to record renal blood flow in horses and to detect changes following furosemide administration. CLINICAL RELEVANCE: Doppler ultrasonographic images may assist in the diagnosis of renal diseases that affect either blood flow or Doppler waveform.

Multiple congenital cardiac anomalies and idiopathic thoracic aortitis in a horse.

An echocardiographical and clinical pathological investigation of the rapid loss of weight by a yearling thoroughbred filly revealed an atrial septal defect, a ventricular septal defect and hyperfibrinogenaemia. A post mortem examination confirmed the cardiac abnormalities and revealed a severe thoracic aortitis. It is proposed that the idiopathic thoracic aortitis contributed to the horse's compromised cardiovascular homoeostasis.

Acute lameness associated with osseous metastasis of a peri-renal carcinoma in a horse.

We present a case of aggressive metastatic carcinoma in a horse that was initially presented for shoulder lameness. Although radiography and scintigraphy were useful for localising a lesion in the proximal humerus, subsequent development of non-specific signs of systemic disease prompted further evaluation. Haematology and blood biochemistry, urinalysis and ultrasonography were all instrumental in identifying renal involvement. A diagnosis of a peri-renal mass causing secondary renal failure prompted euthanasia of the horse because of the poor prognosis. Antemortem findings were supported by necropsy, with secondary lesions also identified in the spleen, liver, 8th left rib and proximal humerus. Histological examination yielded a diagnosis of undifferentiated metastatic carcinoma.

Intestinal strangulation after elective ovariohysterectomy.

A 6-month-old female spayed domestic shorthair cat was presented with an acute onset of vomiting and marked lethargy. The cat had undergone elective ovariohysterectomy via a small midline incision 2 weeks prior to presentation. Intestinal strangulation through a mesenteric rent was diagnosed via abdominal ultrasound and exploratory laparotomy. Intestinal resection and anastamosis resulted in a good clinical outcome despite excision of 60% of the small intestine.

Crossed renal ectopia with fusion in a cat.

In humans, crossed renal ectopia is a rare, usually asymptomatic, congenital malpositioning of the kidneys, involving wandering of one or both embryonic kidneys across the midline and usually fusion with its contralateral partner. This is the first report of crossed renal ectopia in the cat. A 7-year-old, neutered male cat was presented with polyuria, polydipsia, and a palpable abdominal mass. Diagnostic investigations, including clinical pathology, survey and contrast radiography, and ultrasonography, confirmed the presence of an ectopic left kidney fused with an orthotopic right kidney, with concurrent renal failure and hypertension. Many features of crossed renal ectopia in this cat are similar to those described in humans, however the vascular supply, the presence of renal failure, and the axial rotation of the fused kidney are atypical.

Shoulder-out immersion in pregnant women.

In the laboratory, water immersion or lower body positive pressure produces significant diuresis and natriuresis. Shoulder-out immersion appeared to induce significant diuresis and natriuresis in 42 pregnant women who were exercising in swimming pools. Lower body positive pressure (pressure calf sleeves) or Hubbard tanks (bathtubs) was not associated with increased renal function. In selected pregnant women with abnormal water distribution, shoulder-out immersion may prove to be effective therapy.

Alternatives for improving veterinary medical students' learning of clinical sonography.

With the widespread clinical use of sonography there is a need to introduce the topic into the curriculum. A new problem-based course in clinical sonography without lectures was developed to emphasise experiential learning, and engage students actively in individual and collective acts of discovery. Four different approaches were used to deliver the new course to 141 veterinary medical students over four semesters. The physical principles of sonography were taught by computer-assisted instruction and a practical class, clinical examinations were introduced during a session with a tutor, and finally each student wrote an essay on a sonographic topic of their choice. To evaluate the new course, students' responses to a questionnaire were analyzed. Students gained reasonable understanding of the physical principles of sonography and had some confidence in conducting a sonographic examination of an animal. Of most use to student learning was discussion with the teachers. Surprisingly, half the students thought the topic should also be taught by lectures. The students learned the material and acquired the sonographic skills through processes which required more independence and self-responsibility than traditional teaching methods. The teachers' interaction with students on an individual basis, as they encountered individual problems, was the most important resource in learning about sonography. The continued request for lectures suggests an insecurity in some students caught between two different paradigms of teaching and learning (experiential, problem-based learning versus lectures).

Familial clustering of intracerebral hemorrhage: a prospective study in North Carolina.

Few studies have assessed the frequency of familial clustering in intracerebral hemorrhage (ICH). Of 144 patients with ICH prospectively assessed, 14 (9.8%) had a positive family history of ICH (FH+). Four pedigrees had more than two affected family members. Comparisons between FH+ and FH- probands demonstrated no significant differences in race, age, sex, ICH type or location. An underlying genetic etiology may account for familial clustering in some ICH patients.

Sonographic observations of the peripheral vasculature of the equine thoracic limb.

Investigations of the equine peripheral vascular system have been constrained by the lack of a non-invasive method of examining the arteries and veins of the limbs of the conscious horse. Precise correlations were established between the gross anatomical features of the peripheral vessels and their B-mode sonographic appearance in each thoracic limb of 35 horses. A sonographic imaging protocol was established. Additional Doppler sonographic recordings defined the arterial waveforms and demonstrated that blood flow to the foot could be evaluated in the lateral proper digital artery, distal to the level of the coronary band. Valves (with 2-4 cusps) were identified in the lumina of the medial and lateral palmar common digital veins and those of the medial and lateral palmar proper digital veins. Spontaneous echo contrast, a smoke-like haze of echoic blood, was seen in the lateral and medial palmar common digital veins, the distal deep palmar venous arch and communicating branches, and the palmar proper digital veins, and occasionally seen in the distal deep palmar arterial arch and distal proper palmar digital arteries. The value of duplex sonography (B-mode and Doppler) for anatomical and physiological studies of the peripheral vasculature of the horse was clearly established. Such data could be applied to the investigation of diseases affecting the peripheral circulation.

Effect of apolipoprotein E genotype on in-hospital mortality following intracerebral haemorrhage.

OBJECTIVE: To determine the relationship between the apolipoprotein E (APOE) epsilon4 allele and in-hospital mortality from intracerebral haemorrhage (ICH). MATERIAL AND METHODS: Patients admitted to two acute stroke units with ICH were prospectively evaluated and APOE genotyped. In-hospital survival was recorded in 176 patients. RESULTS: There were 85 men and 91 women, mean age 68 years. Fifty-two (30%) of the 176 patients died in hospital. After adjusting for sex, age, hospital, and race, increased age (P = 0.009) and the presence of the APOEepsilon4 allele (P = 0.026) significantly reduced in-hospital survival. CONCLUSION: The APOEepsilon4 allele in this population may be associated with poor survival following ICH.