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Topic:Clinical Pathology

Clinical pathology in horses involves the study and analysis of biological samples to diagnose and monitor diseases and health conditions. This discipline encompasses various laboratory tests and procedures that assess the physiological and biochemical status of equines. Common analyses include hematology, biochemistry, urinalysis, and cytology, each providing insights into different aspects of equine health. Hematology evaluates blood components, such as red and white blood cells and platelets, to identify conditions like anemia or infection. Biochemistry tests measure enzymes, electrolytes, and metabolites to assess organ function and metabolic status. Urinalysis examines urine samples for indicators of renal function and systemic diseases. Cytology involves the microscopic examination of cells from tissues or fluids to detect abnormalities. This page aggregates peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and diagnostic value of clinical pathology in equine medicine.
Clinical effects of immunization, bleeding, and albumin-based fluid therapy in horses used as immunoglobulin source to produce a polyspecific antivenom (Echitab-plus-ICP) towards venoms of African snakes.
Toxicon: X    April 17, 2023   Volume 18 100158 doi: 10.1016/j.toxcx.2023.100158
Huertas RM, Arguedas M, Estrada JM, Moscoso E, Umaña D, Solano G, Vargas M, Segura Á, Sánchez A, Herrera M, Villalta M, Arroyo-Portilla C....During the production of snake antivenoms, the animals used as immunoglobulin source are subjected to processes that could deteriorate their physical condition. Therefore, these conditions must be carefully designed and validated. In this work, the immunization and bleeding protocols applied to horses used to produce the African polyspecific antivenom EchiTAb-plus-ICP were evaluated regarding their effects on the horses' health. The study focused on horses that had been previously immunized with venoms and then received periodic booster venom injections for antivenom production. It was found t...
Changes in Calprotectin (S100A8-A9) and Aldolase in the Saliva of Horses with Equine Gastric Ulcer Syndrome.
Animals : an open access journal from MDPI    April 16, 2023   Volume 13, Issue 8 doi: 10.3390/ani13081367
Muñoz-Prieto A, Contreras-Aguilar MD, Cerón JJ, Ayala de la Peña I, Martín-Cuervo M, Eckersall PD, Holm Henriksen IM, Tecles F, Hansen S.Equine gastric ulcer syndrome (EGUS) is a highly prevalent disease that affects horses worldwide. Within EGUS, two different forms have been described: equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD). The associated clinical signs cause detrimental activity performance, reducing the quality of life of animals. Saliva can contain biomarkers for EGUS that could be potentially used as a complementary tool for diagnosis. The objective of this work was to evaluate the measurements of calprotectin (CALP) and aldolase in the saliva of horses as potential biomarkers ...
Assessment of Magnetic Resonance Imaging Artefacts Caused by Equine Anaesthesia Equipment: A Cadaver Study.
Journal of equine veterinary science    April 16, 2023   Volume 126 104492 doi: 10.1016/j.jevs.2023.104492
Testa B, Biggi M, Byrne CA, Bell A.Acquisition of magnetic resonance images of the equine limb is still sometimes conducted under general anaesthesia. Despite low-field systems allow the use of standard anaesthetic equipment, possible interferences of the extensive electronic componentry of advanced anaesthetic machines on image quality is unknown. This prospective, blinded, cadaver study investigated the effects of seven standardised conditions (Tafonius positioned as in clinical cases, Tafonius on the boundaries of the controlled area, anaesthetic monitoring only, Mallard anaesthetic machine, Bird ventilator, complete electro...
Homocysteine-Potential Novel Diagnostic Indicator of Health and Disease in Horses.
Animals : an open access journal from MDPI    April 11, 2023   Volume 13, Issue 8 1311 doi: 10.3390/ani13081311
Gołyński M, Metyk M, Ciszewska J, Szczepanik MP, Fitch G, Bęczkowski PM.Homocysteine is an endogenous, non-protein sulfuric amino acid, an intermediate metabolite formed by the methionine transmethylation reaction. Its elevated serum concentration in humans, hyperhomocysteinemia, is a sensitive indicator and a risk factor for coagulation disorders, cardiovascular diseases and dementia. However, the role of homocysteine in veterinary species has not been unequivocally established. Although some research has been conducted in dogs, cats, cattle and pigs, relatively few studies on homocysteine have been conducted in horses. So far, it has been established in this spe...
A case of chronic schistosomiasis in a Dongola stallion (Equus ferus caballus Linnaeus, 1758) from Nigeria.
Journal of parasitic diseases : official organ of the Indian Society for Parasitology    April 8, 2023   Volume 47, Issue 2 442-450 doi: 10.1007/s12639-023-01581-y
Abalaka SE, Audu Z, Kolawole VO, Adeyemo BT, Idoko IS, Okafor ROS, Oyelowo-Abdulraheem FO, Tags SZ, Ogbe AO, Sanni S, Jegede OC, Sani NA, Tenuche OZ....Schistosomiasis is a worldwide snail-borne parasitic infestation of man and animals with acute or chronic phases having devastating sequelae. The present case report focused on post-mortem examination of a cachexic Dongola stallion ( Linnaeus, 1758) in Abuja, Nigeria, that failed to respond to treatment. Typical dense collagenous granulomatous lesions with marked inflammatory responses and fibrosis occurred in the liver and several visceral organs of the horse along with other lesions indicative of systemic collapse. Special Ziehl-Neelsen and Periodic Acid-Schiff staining as well as microbial ...
Plasma UCHL-1 as a Biomarker of Brain Injury in Hospitalized Foals With Neonatal Encephalopathy.
Journal of equine veterinary science    April 7, 2023   Volume 126 104490 doi: 10.1016/j.jevs.2023.104490
Ryan CA, Giguère S, Morresey PR.A plasma biomarker such as ubiquitin carboxyl-terminal hydrolase L1 (UCHL-1) to distinguish neonatal encephalopathy (NE) from other disorders and provide prognostic information would be useful for equine practitioners. In this prospective study, plasma UCHL-1 was measured in 331 hospitalized foals ≤4 days of age. Clinical diagnoses of neonatal encephalopathy only (NE group, n = 77), sepsis only (Sepsis group, n = 34), concurrent sepsis and NE (NE+Sepsis group, n = 85), or neither sepsis nor NE (Other group, n = 101) were made by the attending veterinarian. Plasma UCHL-1 concentration...
Comparison of Hemodynamic Effects of Dobutamine and Ephedrine Infusions in Isoflurane-Anesthetized Horses.
Veterinary sciences    April 6, 2023   Volume 10, Issue 4 doi: 10.3390/vetsci10040278
Garcia Filho SG, de Andrade FSRM, Dos Santos RST, Gonçalves LA, Pereira MAA, de Souza AF, Ambrósio AM, Fantoni DT.The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension ( 0.05); however, the heart rate was higher in the ephedrine group (p = 0.0098), and sinus bradyarrhythmia occurred in the dobutamine group. Furthermore, bo...
Equine Gastric Ulcer Syndrome: An Update on Current Knowledge.
Animals : an open access journal from MDPI    April 5, 2023   Volume 13, Issue 7 doi: 10.3390/ani13071261
Vokes J, Lovett A, Sykes B.Equine Gastric Ulcer Syndrome (EGUS) is a term that has been used since 1999, initially being used to describe all gastric mucosal disease in horses. Since this time, the identification of two distinct main disease entities of the equine gastric mucosa have been described under the umbrella of EGUS; these are Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD). In 2015 the European College of Equine Internal Medicine (ECEIM) released a consensus statement defining these disease entities. This document highlighted the lack of evidence surrounding EGGD compared to ...
Rapport de cas Mononuclear pleocytosis and meningoencephalitis caused by Listeria monocytogenes in an adult horse.
The Canadian veterinary journal = La revue veterinaire canadienne    April 4, 2023   Volume 64, Issue 4 363-366 
Phelps S, Chong D, McKenzie E, Kiupel M, Gorman E.Clinical disease caused by infection with Listeria monocytogenes is rare in adult horses, and there is a paucity of ante-mortem clinicopathologic changes for this species reported in the literature. Confirmatory diagnosis is difficult and often requires post-mortem sampling of the brainstem. This report details a case of meningoencephalitis caused by Listeria monocytogenes in an adult American quarter horse gelding presenting with central neurologic signs. Pre-mortem analysis of the cerebrospinal fluid revealed a mononuclear, primarily lymphocytic, pleocytosis, which is a reported finding in o...
Evaluation of Three Methods of Sensory Function Testing for the Assessment of Successful Maxillary Nerve Blockade in Horses.
Journal of veterinary dentistry    April 3, 2023   Volume 42, Issue 1 48-54 doi: 10.1177/08987564231164769
McAndrews A, Zarucco L, Hopster K, Stefanovski D, Foster D, Driessen B.Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were s...
Proliferative tenosynovitis in Brazilian Mangalarga Marchador horses.
Journal of comparative pathology    April 3, 2023   Volume 202 8-15 doi: 10.1016/j.jcpa.2023.03.002
Daoualibi Y, Pereira AHB, Lima LR, Pool RR, Ubiali DG.Proliferative tenosynovitis (PT) is an inflammatory and proliferative disorder of the synovial membrane of the tendon sheath that is rare in animals. The histological alterations are characterized by multinodular neovascularization, with infiltration of histiocytic and multinucleated giant cells and haemosiderin deposition. We reviewed necropsy and biopsy records of horses submitted to the Setor de Anatomia Patológica of the Universidade Federal Rural do Rio de Janeiro from January 2017 to December 2020 to select cases of PT. We identified PT in three adult Brazilian Mangalarga Marchador hors...
A Comparison of the Efficacy of Two Omeprazole Formulations in the Treatment of Equine Gastric Ulcer Syndrome in Racehorses: A Blinded, Randomized Clinical Trial.
Journal of equine veterinary science    March 31, 2023   Volume 126 104296 doi: 10.1016/j.jevs.2023.104296
Busechian S, Conti MB, Sgorbini M, Conte G, Marchesi MC, Pieramati C, Zappulla F, Vitale V, Rueca F.Equine gastric ulcer syndrome (EGUS) is the most common disease of the stomach in horses and treatment is based on the oral administration of omeprazole for at least 28 days. Aim of this study was to compare the efficacy of two formulations of oral omeprazole-powder paste and gastro-enteric resistant granules-in the treatment of naturally occurring gastric ulcers in racehorses. Thirty-two adult racehorses, aged between 2 and 10 years old, with clinical signs of EGUS were included in this blinded, randomized clinical trial. Two gastroscopies were performed to evaluate gastric lesions in the squ...
Pathological features of African horse sickness virus infection in IFNAR-/- mice.
Frontiers in veterinary science    March 30, 2023   Volume 10 1114240 doi: 10.3389/fvets.2023.1114240
Jones LM, Hawes PC, Salguero FJ, Castillo-Olivares J.African Horse Sickness (AHS) is a vector-borne viral disease of equids. The disease can be highly lethal with mortality rates of up to 90% in non-immune equine populations. The clinical presentation in the equine host varies, but the pathogenesis underlying this variation remains incompletely understood. Various small animal models of AHS have been developed over the years to overcome the financial, bio-safety and logistical constraints of studying the pathology of this disease in the target species. One of the most successful small animal models is based on the use of interferon-alpha gene kn...
Limitations of transthoracic echocardiography in equine patients.
Veterinary medicine and science    March 30, 2023   Volume 9, Issue 4 1618-1620 doi: 10.1002/vms3.906
Vitale V, Laurberg M, van Galen G, van Loon G.No abstract available
Relationship between Clinical Uterine Findings, Therapy, and Fertility in the Mare.
Veterinary sciences    March 29, 2023   Volume 10, Issue 4 doi: 10.3390/vetsci10040259
Scarlet D, Malama E, Fischer S, Knutti B, Bollwein H.Persistent breeding-induced endometritis (PBIE) is a major cause of subfertility in horses and the susceptibility is increased by several factors. The aim of this study was to determine the effects of clinical uterine findings and PBIE therapies, respectively, on pregnancy rate in mares. The analysis included records from 220 mares (390 cycles) inseminated at an artificial insemination (AI) center in Switzerland. Gynecological examinations were performed repeatedly before and after AI to determine cervical tone, uterine edema, and intrauterine fluid accumulation. Pregnancy rate was lower (p 0...
Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings.
Journal of veterinary internal medicine    March 28, 2023   Volume 37, Issue 3 1223-1232 doi: 10.1111/jvim.16674
Bevevino KE, Cohen ND, Gordon SG, Navas de Solis C.A point-of-care ultrasound (POCUS) protocol for evaluation of the cardiac and respiratory systems in horses does not exist. Objective: (a) Describe the windows of a POCUS protocol for cardiorespiratory assessment of horses (CRASH); (b) Estimate the number of acoustic windows that can be acquired by a sonographer-in-training; (c) Estimate the time required to complete the protocol for specific groups of horses; (d) Describe the sonographic abnormalities detected in horses presented with cardiovascular, respiratory, or systemic disease. Methods: Twenty-seven healthy horses, 14 horses competing i...
Straight Egyptian Arabian skull morphology presents unique surgical challenges compared to the Thoroughbred: a computed tomography morphometric anatomical study.
American journal of veterinary research    March 28, 2023   Volume 84, Issue 5 ajvr.22.11.0191 doi: 10.2460/ajvr.22.11.0191
Pompermayer E, Hoey S, Ryan J, David F, Johnson JP.The objective of this study was to compare the skull morphology of the Straight Egyptian Arabian (SEAR) to the Thoroughbred (TB), using computed tomography (CT) in the context of surgical procedures commonly performed on the equine head. Methods: Measurements relating to surgical considerations of the equine head were taken from 29 clinically normal adult horses (15 SEAR, 14 TB). Methods: A clinical prospective study. Standing skull CTs were performed. Fourteen gross and 10 CT measurements were taken. Results: Several variables showed a significant difference between groups, in all cases great...
Neutrophil gelatinase-associated lipocalin as a potential biomarker for equine asthma.
Equine veterinary journal    March 28, 2023   doi: 10.1111/evj.13939
Hansen S, Otten ND, Spang-Hanssen L, Bendorff C, Jacobsen S.Studies in people have found neutrophil gelatinase-associated lipocalin (NGAL) concentrations are increased in asthma and can be used to distinguish between asthma subtypes. NGAL has not yet been investigated in equine asthma (EA). Objective: To investigate the ability of NGAL concentrations in bronchoalveolar lavage (BAL) fluid and serum to distinguish between control horses, horses with mild-moderate EA (MEA) and horses with severe EA (SEA). Methods: Retrospective cross-sectional study. Methods: Details of endoscopic examination including tracheal mucus score (TMS, scale 0-5) and BAL cytolog...
Bronchoalveolar lavage hemosiderosis in lightly active or sedentary horses.
Journal of veterinary internal medicine    March 28, 2023   Volume 37, Issue 3 1243-1249 doi: 10.1111/jvim.16692
Mahalingam-Dhingra A, Bedenice D, Mazan MR.Hemosiderophages in bronchoalveolar lavage fluid (BALF) are commonly ascribed to exercise-induced pulmonary hemorrhage (EIPH). Little information exists regarding the presence of these cells in horses that perform light or no work and that are referred for respiratory problems. Objective: Evaluate the presence of hemosiderophages in BALF of horses suspected of respiratory disease without history of or risk factors for EIPH and determine predictors of hemosiderophages in BALF in this population. Methods: Observational retrospective cross-sectional study using STROBE (Strengthening the Reporting...
Clinical evaluation of the Immulite® 1000 chemiluminescent immunoassay for measurement of equine serum insulin.
Frontiers in veterinary science    March 27, 2023   Volume 10 1018230 doi: 10.3389/fvets.2023.1018230
Go YY, Hazard NW, Balasuriya UBR, Chapman AM, Fitton NS, Kenéz Á, Andrews FM.Accurate quantitative analysis of equine insulin in blood samples is critical for assessing hyperinsulinemia in horses. Although there are various laboratory methods for evaluating equine serum insulin, different immunoassays show significant discrepancies between the determined insulin concentrations and are often not comparable. The aim of this study was to evaluate the Immulite® 1000 chemiluminescent immunoassay (CLIA) to establish independent laboratory and assay-specific cut values to provide an accurate diagnosis of hyperinsulinemia in horses. Thus, the analytical and clinical performan...
Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses.
Veterinary anaesthesia and analgesia    March 22, 2023   Volume 50, Issue 4 363-371 doi: 10.1016/j.vaa.2023.03.002
Portela DA, Di Franco C, Chiavaccini L, Araos J, Romano M, Otero PE, Biedrzycki AH, Schramel JP.To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (V), airway (V) and physiological (V) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO) elimination per breath (Vcobr), PaCO and the ratio of PaO-to-fractional inspired oxygen (PaO:FiO). Methods: Prospective research study. Methods: A group of eight healthy research horses undergoing laparotomy. Methods: Anesthetized horses were mechanically ventilated as follows: 6 breaths minute, tidal volume (V) 13 mL kg, inspiratory-to-expir...
Biochemical and Hematological Indexes of Liver Dysfunction in Horses.
Journal of equine veterinary science    March 22, 2023   Volume 126 104294 doi: 10.1016/j.jevs.2023.104294
Satué K, Fazio E, Medica P, Miguel L, Gardón JC.In the present review, the authors, based on the multiple functions performed by the liver, analyze the multiple biochemical and hematological changes as an expression of altered liver function in the horse. The liver performs important metabolic functions related to the synthesis, degradation, and excretion of various substances. Modification of these functions can be evaluated and diagnosed by determining serum concentrations of several serum analytes, including enzymes and other endogenous substances. Hepatocellular enzymes, such as sorbitol dehydrogenase-SDH and glutamate dehydrogenase-GLD...
Contribution of Hemogram Plan in the Horse’s Clinical Evaluation.
Journal of equine veterinary science    March 22, 2023   Volume 126 104292 doi: 10.1016/j.jevs.2023.104292
Satué K, Fazio E, Gardón JC, Medica P.The interpretation of the blood count is essential to help the equine clinician in the diagnosis, prognosis, patient management, and control of equine diseases. Hematologic alterations often reflect the condition of the individual or an overall response to a pathological situation. A thorough clinical examination of the patient is essential to correctly interpret the hematological results. The most common abnormalities in the erythrogram are mainly anemia and polycythemia. The frequent causes of anemia in horses are acute and chronic blood loss, hemolytic anemia, and anemia caused by chronic d...
Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study.
Animals : an open access journal from MDPI    March 20, 2023   Volume 13, Issue 6 1107 doi: 10.3390/ani13061107
Spadari A, Gialletti R, Gandini M, Valle E, Cerullo A, Cavallini D, Bertoletti A, Rinnovati R, Forni G, Scilimati N, Giusto G.The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colic surgery in three referral centres (2018-2021) were analysed. Comparisons of the outcomes were performed using a Mann-Whitney or a Chi square test. Areas under the receiver operating characteristic (ROC) c...
Strangles in equines: An overview.
Microbial pathogenesis    March 15, 2023   Volume 178 106070 doi: 10.1016/j.micpath.2023.106070
Chhabra D, Bhatia T, Goutam U, Manuja A, Kumar B.Strangles, caused by Streptococcus equi subspecies equi, is a highly infectious respiratory disease affecting horses and other equines. The disease is economically important and compromises the productivity of equine farm significantly. The disease is characterized by pyrexia, mucopurulent nasal discharge, and abscess formation in the lymph nodes of the head and neck of horses. The disease transmission occurs either directly by coming in contact with infectious exudates or indirectly via fomite transmission. Besides this, carrier animals are the primary and most problematic source of disease i...
Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew.
Veterinary surgery : VS    March 15, 2023   Volume 52, Issue 4 545-553 doi: 10.1111/vsu.13946
Gandini M, Cerullo A, Gallo L, Iussich S, Minoli L, Giusto G.To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. Methods: Ex vivo study. Methods: Intestinal tracts from 24 slaughtered horses. Methods: A radiofrequency device was used to perform a jejunocecal anastomosis (Group RFA). The construction time and bursting pressure of this construct were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line....
A Randomized, Self-Controlled Case Series Evaluating Core Osteostixis of Osseous Cyst-Like Lesions of the Navicular Bone to Improve Lameness in Horses with Podotrochlear Syndrome.
Veterinary medicine (Auckland, N.Z.)    March 15, 2023   Volume 14 35-46 doi: 10.2147/VMRR.S399835
Brock BA, Greer HR, Honnas CM, Gilleland BE, Barrett MF, Moore JN, Cohen ND.Podotrochlear syndrome is a common cause of lameness in Quarter Horses involving both soft tissue and bony structures within the heel region. Current surgical treatment of podotrochlear syndrome addresses pathological changes affecting the soft tissue structures of the navicular region but does not address either edema or cyst-like lesions of the navicular bone. Unassigned: The objective of this randomized, self-controlled case series was to determine whether core osteostixis improved lameness in Quarter Horses with podotrochlear syndrome characterized by bilateral magnetic resonance imaging (...
Tulathromycin and Diclazuril Lack Efficacy against Theileria haneyi, but Tulathromycin Is Not Associated with Adverse Clinical Effects in Six Treated Adult Horses.
Pathogens (Basel, Switzerland)    March 14, 2023   Volume 12, Issue 3 453 doi: 10.3390/pathogens12030453
Onzere CK, Hulbert M, Sears KP, Williams LBA, Fry LM.Equine theileriosis, caused by and , leads to anemia, exercise intolerance, and occasionally, death. Theileriosis-free countries prohibit the importation of infected horses, resulting in significant costs for the equine industry. Imidocarb dipropionate is the only treatment for in the United States, but lacks efficacy against . The goal of this study was to assess the in vivo efficacy of tulathromycin and diclazuril against . Fourteen -infected horses were utilized. Six were treated with eight weekly 2.5 mg/kg doses of tulathromycin. Three were treated daily for eight weeks with 2.5 mg/kg di...
Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy.
The Veterinary record    March 12, 2023   Volume 192, Issue 11 e2782 doi: 10.1002/vetr.2782
Gandini M, Giusto G.Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. Methods: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from an...
The immune response to equine ascending placentitis: A narrative review.
Theriogenology    March 11, 2023   Volume 203 11-20 doi: 10.1016/j.theriogenology.2023.03.002
Fedorka CE, Troedsson MHT.No abstract available
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