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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.
Chronic idiopathic myopathy in Icelandic horses: A case series.
Equine veterinary journal    April 24, 2025   Volume 57, Issue 5 1341-1346 doi: 10.1111/evj.14519
Hansen S, Hopster-Iversen C, Berg L, Fjeldborg J, Massey C, Piercy RJ, Carstensen H.Exertional myopathies are recognised as a cause of poor performance in equines. In Icelandic horses presenting reduced performance and/or multi-limb lameness, no specific myopathy has been identified. Objective: To characterise the clinical presentation and histopathological findings in muscle biopsy samples from Icelandic horses demonstrating poor performance. Methods: Case series. Methods: Phenotypic characteristics, clinical examination and diagnoses of 17 Icelandic horses were studied. All horses had a resting serum creatine kinase (CK) and aspartate transaminase activities measured, and C...
Sorghum poisoning in ruminants and horses: a review.
Toxicon : official journal of the International Society on Toxinology    April 24, 2025   Volume 261 108375 doi: 10.1016/j.toxicon.2025.108375
Vasconcelos de Sousa AL, Riet-Correa F, Botelho de Castro M, Machado M.We reviewed the history, epidemiology, clinical signs, pathology, pathogenesis, treatment, control, and prophylaxis of Sorghum poisoning in livestock. Economic losses in the livestock industry associated with sorghum have been reported since the 19th century. Hyperacute/acute poisoning associated with cyanide (HCN) or nitrate/nitrite frequently occurs in ruminants that consume high quantities of growth and regrowth sorghum after drought, followed by rainfall, respectively. Chronic cystitis-ataxia syndrome primarily affects horses after weeks of grazing on sorghum pastures, while congenital art...
Population pharmacokinetics and clinical evaluation of intravenous acetaminophen and its metabolites in Andalusian horses.
Veterinary journal (London, England : 1997)    April 24, 2025   Volume 312 106357 doi: 10.1016/j.tvjl.2025.106357
Granados MM, Medina-Bautista F, Navarrete-Calvo R, Argüelles D, Domínguez-Pérez JM, Priego-Capote F, Muñoz-Rascón P, Serrano-Rodríguez JM.To date, no intravenous pharmacokinetics (PK) studies have assessed acetaminophen or its major metabolites (acetaminophen-glucuronide and acetaminophen-sulphate) in horses. The influence of sex on acetaminophen metabolism in horses is unclear, and Monte Carlo simulations have not been applied to explore potential clinical applications. This study aimed to determine the intravenous PK and safety of acetaminophen in Andalusian horses at 10 and 20 mg/kg, evaluate sex as a covariate, and simulate clinical regimens. Twenty mares and twenty stallions received intravenous acetaminophen, and plasma ...
Management of an Equine Herpesvirus-1 Outbreak During a Multi-Week Equestrian Event.
Viruses    April 24, 2025   Volume 17, Issue 5 doi: 10.3390/v17050608
Pusterla N, Lawton K, Barnum S, Flynn K, Hankin S, Runk D, Mendonsa E, Doherty T.The present study reports on the management of an EHV-1 outbreak at a large, multi-week equestrian event with ongoing showing. Within a 48 h period, 8 horses out of a cohort of 38 horses from the same trainer displayed elevated rectal temperatures ranging from 38.4 to 39.0 °C. Initial testing using a point-of-care PCR assay detected EHV-1 in 2/8 horses, with the results being confirmed at a later time by qPCR. As a precautionary measure and because of the inability to isolate the entire at-risk population, the 38 horses were relocated to an equine facility outside the equestrian event for dai...
Correction: Clinical features and treatment response to differentiate idiopathic peritonitis from non‑strangulating intestinal infarction of the pelvic flexure associated with Strongylus Vulgaris infection in the horse.
BMC veterinary research    April 14, 2025   Volume 21, Issue 1 265 doi: 10.1186/s12917-024-04388-y
Hedberg-Alm Y, Tydén E, Tamminen LM, Lindström L, Anlén K, Svensson M, Riihimäki M.No abstract available
Characteristics of the Mare-Uterine-Culture-Based Bacterial Composition Using Practical Clinical Evaluation Methods.
Pathogens (Basel, Switzerland)    April 7, 2025   Volume 14, Issue 4 doi: 10.3390/pathogens14040357
Carvalho IB, Branco S, Laranjo M, Queiroga MC, Bettencourt E.Uterine health is paramount to fertility in broodmares and for the success of a breeding project, and the Lusitano breed is no exception. This study aimed to characterize the mare uterine microbiota using practical clinical evaluation methods. Mares were examined by transrectal palpation and ultrasonography, followed by the collection of samples by one of three different techniques: uterine lavage, biopsy, or swab. The results of cytology, histology, microbiology, and antimicrobial susceptibility testing were recorded, and statistical analyses were performed. Inflammation was present in 42.2% ...
Enzyme-Linked Immunosorbent Assay (ELISA) Development for Equine Serum Amyloid A (SAA) Determination Using Recombinant Proteins.
Methods and protocols    April 7, 2025   Volume 8, Issue 2 37 doi: 10.3390/mps8020037
Souto PC, Santos MR, Orozco AMO, Bento LD, Ramirez-Lopez CJ, Girardi FM, Machado JCA, de Oliveira LL, da Fonseca LA.We aimed to develop a species-specific ELISA for qualitatively and quantitatively determining serum amyloid A (SAA) in horses. Current methods for measuring SAA in horses utilize ELISA or immunoturbidimetric tests designed for human SAA, which are not specific to horses. Mice and rabbits were used to generate polyclonal antibodies against equine SAA. The study examined serum samples from 32 horses with acute inflammatory disease (SG) and 25 clinically healthy horses. Furthermore, the SAAeq kinetics were observed in three horses from the SG group at three different timepoints. The SAA-ELISA est...
The Effect of Vaccination Status on Total Lymphocyte Count in Horses Affected by Equine Herpes Virus-1 Myeloencephalopathy.
Animals : an open access journal from MDPI    April 1, 2025   Volume 15, Issue 7 doi: 10.3390/ani15071019
de la Cuesta-Torrado M, Vitale V, Velloso Alvarez A, Neira-Egea P, Diss C, Cuervo-Arango J.Equine herpesvirus 1-induced myeloencephalopathy has a significant impact on the equine industry. Nevertheless, the clinical variables that may affect the severity of the disease are still under investigation. The objective of this research is studying the relationship between the level of lymphopenia and vaccination status with the severity of the disease in horses at an event, considering whether they had been correctly vaccinated or not prior to exposure to EHV-1. Ten horses were admitted to a veterinary teaching hospital following an equine herpesvirus myeloencephalopathy outbreak during a...
Renal Lipidosis in Horses and Donkeys: 25 Cases (2008-2022).
Journal of veterinary internal medicine    March 20, 2025   Volume 39, Issue 2 e70072 doi: 10.1111/jvim.70072
Slavik K, Bender S, Sharkey L, Nolen-Walston R.Renal lipidosis is a well-documented histologic finding in humans and small animals with renal and metabolic disorders, but it is not well described in equids. Objective: To describe the signalment, clinicopathologic indices, and postmortem findings of equids with a histologic diagnosis of both hepatic and renal lipidosis (HL + RL) and compare them to cases with hepatic lipidosis only (HL). Methods: Equids with necropsy findings of renal or hepatic lipidosis (state diagnostic lab) between 2008 and 2022. Methods: Retrospective case-control study. Signalment, history, necropsy diagnosis, and...
The diagnostic accuracy of the Brix refractometer in determining mare colostrum with high and low immunoglobulin G concentrations.
Journal of equine veterinary science    March 17, 2025   105417 doi: 10.1016/j.jevs.2025.105417
Akköse M.Foals, that receive poor-quality colostrum, are exposed to a risk of failure of transfer of passive immunity. The Brix refractometer can be used for the estimation of the immunoglobulin (IgG) concentration of mare colostrum, yet there is a scarce literature available on Brix refractometer thresholds for use in the detection of mare colostra with high and low IgG concentrations. Objective: This study aimed to assess the diagnostic accuracy of the Brix refractometer in determining mare colostra with IgG concentrations of <50g/L, <60g/L, >80g/L, >100g/L and >125g/L. Methods: Two hundred and seven...
Association Between Adrenocorticotropic Hormone Concentration and Clinical Signs of Pituitary Pars Intermedia Dysfunction in Swiss and Austrian Equids.
Journal of veterinary internal medicine    March 17, 2025   Volume 39, Issue 2 e70008 doi: 10.1111/jvim.70008
Fouché N, Doras C, Schüpbach-Regula G, Scherer A, Freudenschuss B, Gerber V.There remains a scarcity of data concerning the relationship between the clinical signs associated with PPID and plasma ACTH concentrations. Objective: Report the frequency of clinical signs in the study cohort and identify individual clinical signs or combinations of clinical signs associated with high ACTH concentrations. Methods: Two hundred eighty equids were examined by private veterinarians. Methods: A cross-sectional study of animals with clinical suspicion of PPID was conducted between August and November. Private practitioners completed an online questionnaire reporting detailed infor...
ESTABLISHING REFERENCE INTERVALS FOR SERUM INFLAMMATORY MARKERS AND INVESTIGATING THEIR STORAGE STABILITY AND CLINICAL UTILITY IN ASIAN WILD HORSES (EQUUS FERUS PRZEWALSKII) UNDER MANAGED CARE.
Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians    March 12, 2025   Volume 56, Issue 1 54-61 doi: 10.1638/2024-0015
Toy S, Black SR, Pastor AR, Whiteside DP.Acute phase proteins (APPs) are commonly used in domestic equine practice, where they rise rapidly in response to inflammation and decrease soon after resolution. This response provides useful information to identify, monitor, and prognosticate a variety of inflammatory conditions. Asian wild horses (Equus ferus przewalskii) are an endangered relative of the domestic horse, and APP reference intervals (RI) and clinical utility in this species are not well documented. This study used serum samples from clinically healthy Asian wild horses under managed care to establish RI for serum amyloid A (...
Systemic, hemodynamic and neurological effects of caudal epidural administration of Neosaxitoxin in horses.
Toxicon : official journal of the International Society on Toxinology    March 5, 2025   Volume 257 108303 doi: 10.1016/j.toxicon.2025.108303
Oyaneder L, Lagos N, Dörner C.The present study was conducted to evaluate the safety and the long-lasting anesthetic properties of Neosaxitoxin (NeoSTX) when injected into the intercoccygeal space in standing horses. A group of eighteen (n = 18) healthy client-owned mature crossbreed horses were enrolled in this study. Caudal epidural injection was ascertained by two methods, the "hanging drop" technique and radiographs. Horses were allocated into three groups (n = 6) each group receiving different dosages of NeoSTX. To assess the onset of action and duration of anesthesia, six horses received 20 μg in 2 mL, six 20Â...
Diagnosis and treatment of a congenital cervical tracheal diverticulum in an Arabian foal.
Journal of equine veterinary science    March 1, 2025   Volume 147 105397 doi: 10.1016/j.jevs.2025.105397
Fernandes T, Robin MG, Oikawa MA, Alexander GR, Pompermayer E, Uberti B.Tracheal congenital defects are infrequent but serious findings in animals. Tracheal diverticula are congenital air-filled cystic lesions, a sub-type of paratracheal air cyst mainly found extra-thoracically in foals. We describe a case in a twelve-day old show Arabian colt with right sided unilateral cervical swelling since birth. Percutaneous ultrasound revealed a heterogeneously air- and fluid-filled spheroid mass, and upper airway endoscopy confirmed luminal communication to the trachea. Contrasted computed tomography showed a narrow isthmus originating between two proximal tracheal rings a...
Metabolomic and proteomic stratification of equine osteoarthritis.
Equine veterinary journal    February 19, 2025   doi: 10.1111/evj.14490
Anderson JR, Phelan MM, Caamaño-Gutiérrez E, Clegg PD, Rubio-Martinez LM, Peffers MJ.Equine osteoarthritis (OA) is predominantly diagnosed through clinical examination and radiography, leading to detection only after significant joint pathology. The pathogenesis of OA remains unclear and while many medications modify the disease's inflammatory components, no curative or reversal treatments exist. Identifying differentially abundant metabolites and proteins correlated with osteoarthritis severity could improve early diagnosis, track disease progression, and evaluate responses to interventions. Objective: To identify molecular markers of osteoarthritis severity based on histolog...
Campylobacter jejuni hepatitis in a horse: case report and literature review. Macías-Rioseco M, Ochoa J, Choi EA, Blanchard P, Moeller RB, Uzal FA. spp. can cause gastroenteritis, hepatitis, bacteremia, and abortions in domestic animals and humans. Some spp. are zoonotic. To our knowledge, hepatitis caused by has not been reported in horses. Here we present a case of acute necrosuppurative hepatitis caused by infection in a 3-y-old gelding, and we review the literature on infections in various animal species. The horse had a one-week history of weight loss and weakness before becoming recumbent and dying. Grossly, the liver had rounded edges and was mottled. There were ecchymoses on the gastric serosa, and a large amount of mucoid, p...
Cerebellar abiotrophy in a quarter horse foal.
Journal of equine veterinary science    February 16, 2025   Volume 147 105386 doi: 10.1016/j.jevs.2025.105386
Primo ALM, Assis DM, Santos VGS, de Melo LRB, da Nóbrega LD, Medeiros Dantas AF, Maciel TA.Cerebellar abiotrophy is a neurodegenerative disease that affects the Purkinje cells of the cerebellum, resulting in premature neuronal death. In horses, its occurrence has been reported mainly in the Arabian breed as a congenital mutation inherited in an autosomal recessive manner. The objective of this study was to describe the case of cerebellar abiotrophy in a Quarter Horse foal. An 8-day-old foal was treated after presenting signs of ataxia, hypermetria, difficulty maintaining a standing position, and decreased menace response. The foal was hospitalized for 26 days, received treatment wit...
Suspected chlorfenapyr poisoning in a horse.
Journal of equine veterinary science    February 7, 2025   Volume 146 105380 doi: 10.1016/j.jevs.2025.105380
Simões BP, Cerri FM, Takahira RK, Borges AS, Oliveira-Filho JP, Amorim RM.Chlorfenapyr is a pesticide that interferes with mitochondrial function, leading to cell death and mortality. Although poisoning is primarily documented in humans and dogs, it can result in severe clinical signs, including sweating, respiratory distress, and neurological dysfunction. This report describes the clinical and laboratory findings of a horse with suspected accidental intoxication with chlorfenapyr. A 4-year-old Quarter Horse mare was referred to the veterinary hospital with signs of excessive sweating, hyperthermia, tachypnea, muscle fasciculation, and fearful facial expression. The...
Can Arterial Blood Gas, Electrolyte and Acid-Base Analysis at Admission be Used to Predict Survival to Hospital Discharge for Different Causes of Colic?
Veterinary medicine and science    February 6, 2025   Volume 11, Issue 2 e70210 doi: 10.1002/vms3.70210
Milner PI, Bardell D.Predicting outcome in horses presenting with colic remains challenging. Objective: To test whether arterial blood samples in horses admitted for colic predict outcome to hospital discharge for different colic types. Methods: Arterial blood samples collected on admission from 358 horses undergoing medical or surgical management of colic were evaluated for pH, PaO, PaCO, Na, K, iCa, Cl, HCO (P), HCO (P, set), Base (B), Base (ecf) and anion gap. Categories were small intestinal non-strangulating (SINS) or strangulating (SIS) lesions, large colon non-volvulus (LCNV) or volvulus (LCV), small colo...
Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) in Icelandic Horses in Germany: A Correlation Between Clinical and Radiographic Findings.
Journal of veterinary dentistry    February 4, 2025   Volume 42, Issue 3 202-211 doi: 10.1177/08987564241308731
Tretow M, Hain AM, Bienert-Zeit A.Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a widespread dental disease with an unknown aetiology, mainly affecting the incisors and canine teeth of senior horses. Being clinically asymptomatic in early stages but progressively destructive and painful in many cases highlights the need for improvements in early diagnosis of EOTRH. This study describes how clinical and radiological findings correlate with distinguishing EOTRH-specific symptoms from non-specific findings. Clinical and radiographic examinations of the rostral oral cavity were performed in 154 Icelandic hor...
Nonexertional Rhabdomyolysis.
The Veterinary clinics of North America. Equine practice    January 31, 2025   Volume 41, Issue 1 95-110 doi: 10.1016/j.cveq.2024.11.002
Valberg SJ.Although horses most commonly develop exertional rhabdomyolysis, there are numerous causes for nonexertional rhabdomyolysis (nonER) that pose a serious health threat to horses. Their etiologies can be broadly categorized as toxic, genetic, inflammatory/infectious, nutritional, and traumatic and a variety of diagnostic tests are available to discern among them. This study discusses causes of nonER as well as diagnostics and treatments that are specific to each etiology. General treatment of acute rhabdomyolysis is covered in detail in the study in this issue on sporadic and recurrent exertional...
Polysaccharide Storage Myopathy.
The Veterinary clinics of North America. Equine practice    January 31, 2025   Volume 41, Issue 1 125-137 doi: 10.1016/j.cveq.2024.11.004
Firshman AM, Valberg SJ.Type 1 Polysaccharide Storage Myopathy (PSSM1) is an autosomal dominant glycogen storage disorder affecting more than 20 breeds of horses that can present with a variety of signs, including exertional rhabdomyolysis (ER). It is diagnosed by genetic testing or muscle biopsies containing muscle fibers with abnormal amylase-resistant polysaccharide. Type 2 PSSM has recently been subdivided. PSSM2-ER is a glycogen storage disorder identified in Quarter Horses that causes ER and is diagnosed by muscle biopsy as its genetic basis is unknown. Both PSSM1 and PSSM2-ER respond well to a low nonstructura...
Clinical Examination of the Muscle System.
The Veterinary clinics of North America. Equine practice    January 29, 2025   S0749-0739(24)00087-7 doi: 10.1016/j.cveq.2024.10.001
McKenzie E.The equine muscle system is complex and prone to a large range of hereditary and acquired diseases that often have overlapping clinical signs with orthopedic, neurologic, and other disorders. Obtaining a clinical history that fully outlines the client concerns and any known information about the disorder and following with a comprehensive physical examination and screening clinical pathology tests are fundamental to achieve definitive diagnosis. A methodical and comprehensive approach aids accurate diagnosis and development of an optimal treatment and management plan. This article describes th...
Sporadic and Recurrent Exertional Rhabdomyolysis.
The Veterinary clinics of North America. Equine practice    January 28, 2025   Volume 41, Issue 1 111-124 doi: 10.1016/j.cveq.2024.11.003
Valberg SJ.Horses are particularly susceptible to developing exertional rhabdomyolysis (ER) characterized by muscle stiffness, pain, and reluctance to move. Diagnosis requires establishing abnormal increases in serum creatine kinase activity when horses exhibit clinical signs. The 2 main categories of ER include sporadic ER arising from extrinsic causes and chronic ER that arises from intrinsic continuous or episodic abnormalities in muscle function. This article focuses on treatment of acute ER and causes and management of sporadic ER. Differential diagnoses for chronic ER as well as the pathophysiology...
Myofibrillar Myopathy.
The Veterinary clinics of North America. Equine practice    January 28, 2025   Volume 41, Issue 1 139-150 doi: 10.1016/j.cveq.2024.11.005
Valberg SJ, Williams ZJ.Myofibrillar myopathy (MFM) is characterized by segmental disarray of myofibrils and ectopic accumulation of a protein called desmin. Previously thought to be a glycogen storage disease, MFM is now recognized as a stand-alone myopathy. Endurance Arabians with MFM usually present with exertional rhabdomyolysis (MFM-ER) at the end of races, elevated serum muscle enzymes, and myoglobinuria. Warmblood horses with MFM (MFM-WB) usually present with pain-associated behaviors such as exercise intolerance, reluctance to engage hind quarter muscles, shifting lameness and normal serum muscle enzymes. Bot...
Unravelling Faecal Microbiota Variations in Equine Atypical Myopathy: Correlation with Blood Markers and Contribution of Microbiome.
Animals : an open access journal from MDPI    January 26, 2025   Volume 15, Issue 3 doi: 10.3390/ani15030354
François AC, Cesarini C, Taminiau B, Renaud B, Kruse CJ, Boemer F, van Loon G, Palmers K, Daube G, Wouters CP, Lecoq L, Gustin P, Votion DM.Hypoglycin A and methylenecyclopropylglycine are protoxins responsible for atypical myopathy in equids. These protoxins are converted into toxins that inhibit fatty acid β-oxidation, leading to blood accumulation of acylcarnitines and toxin conjugates, such as methylenecyclopropylacetyl-carnitine. The enzymes involved in this activation are also present in some prokaryotic cells, raising questions about the potential role of intestinal microbiota in the development of intoxication. Differences have been noted between the faecal microbiota of cograzers and atypical myopathy-affected horses. Ho...
Bladder rupture in late-pregnancy mares: Four cases.
Journal of equine veterinary science    January 23, 2025   Volume 146 105365 doi: 10.1016/j.jevs.2025.105365
Salcedo-Jiménez R, Kenney DG, Dubois MS.This case series reports four late pregnancy broodmares that were diagnosed with bladder rupture. The initial presentations were abdominal discomfort (n = 3) and dystocia (n = 1). All mares (n = 4) were overdue or at their expected time of delivery. Three mares showed clinical signs related to bladder rupture: pollakiuria (n = 2) and hematuria (n = 1). At the time of diagnosis, three mares had increased peritoneal fluid creatinine, the mean peritoneal: serum creatinine ratio was 4.1, and the bladder tear was observed via cystoscopy in 3 cases. Two mares were discharged from the hospital. Compl...
Effect of equine transvaginal follicle aspiration on serum concentrations of acute phase proteins and their utility in diagnosis of ovarian abscess.
Journal of equine veterinary science    January 22, 2025   Volume 146 105360 doi: 10.1016/j.jevs.2025.105360
Hinrichs K, Gleason K, Dobbie T, Felix MR.Transvaginal ultrasound-guided follicle aspiration (TVA) is being performed frequently in equine practice, to recover oocytes for in vitro embryo production via intracytoplasmic sperm injection. While complications from TVA are rare, one of the most prevalent major complications is formation of an ovarian abscess, which can result in the necessity for euthanasia. The acute-phase serum proteins, fibrinogen and serum amyloid A (SAA), are markers of inflammation that might be of use in diagnosis of ovarian abscess. However, no information is available on the effect of standard TVA on these acute ...
Chronic oral dosing of cannabidiol and cannabidiolic acid full-spectrum hemp oil extracts has no adverse effects in horses: a pharmacokinetic and safety study.
American journal of veterinary research    January 9, 2025   1-10 doi: 10.2460/ajvr.24.08.0235
Wang TC, Wakshlag JJ, Jager MC, Schwark WS, Trottier NL, Chevalier JM, Pearson G, Cercone M.To compare the pharmacokinetics of cannabidiol (CBD) and cannabidiolic acid (CBDA) in horses and to evaluate the safety of their chronic administration. Methods: CBD- and CBDA-rich oil (1 mg/kg) were administered orally twice daily to 7 adult horses over 6 weeks in a randomized, crossover design with a 2-week washout period. A 12-hour pharmacokinetic analysis was conducted on day 1 of each 6-week trial, followed by the measurement of peak and trough concentrations at weeks 1, 2, 4, and 6. The cannabinoids safety was assessed via daily physical examination, periodic bloodwork, and liver biopsy ...
From Prediction to Precision: Explainable AI-Driven Insights for Targeted Treatment in Equine Colic.
Animals : an open access journal from MDPI    January 8, 2025   Volume 15, Issue 2 doi: 10.3390/ani15020126
Cetintav B, Yalcin A.Colic is a leading cause of mortality in horses, demanding precise and timely interventions. This study integrates machine learning and explainable artificial intelligence (XAI) to predict survival outcomes in horses with colic, using clinical, procedural, and diagnostic data. Random forest and XGBoost emerged as top-performing models, achieving F1 scores of 85.9% and 86.1%, respectively. SHAP (Shapley additive explanations) was employed to provide interpretable insights, offering both global and local explanations for model predictions. The analysis revealed that key features, such as pulse r...