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Topic:Clinical Signs
Clinical signs in horses refer to observable physical or behavioral manifestations that may indicate the presence of disease or injury. These signs can include a range of symptoms such as changes in appetite, alterations in gait, abnormal respiratory patterns, or variations in body temperature. Recognizing clinical signs is an integral part of equine veterinary practice, as they provide initial insights into the health status of the animal. Veterinarians rely on these signs to formulate differential diagnoses and guide further diagnostic testing. This page gathers peer-reviewed research studies and scholarly articles that explore the identification, interpretation, and diagnostic value of clinical signs in equine health management.
Inhaled ciclesonide is efficacious and well tolerated in the treatment of severe equine asthma in a large prospective European clinical trial. Ciclesonide is a glucocorticoid prodrug, already registered for human use. Due to its mode of action and inhaled route of administration, it was considered an appropriate treatment option for horses with severe equine asthma. Although the efficacy of inhaled ciclesonide has been demonstrated in horses with asthma exacerbations under controlled mouldy hay challenge conditions, it has not yet been reported under field conditions. Objective: To assess the effectiveness and safety of inhaled ciclesonide for the treatment of severe equine asthma. Methods: Prospective, multicentre, placebo-controlle...
Hepatogenous photosensitization in ruminants and horses caused by the ingestion of Chamaecrista serpens in Brazil. This study aimed to describe the first reports of outbreaks of hepatogenous photosensitization in cattle, sheep, and horses caused by spontaneous ingestion of Chamaecrista serpens, as well as to reproduce poisoning in sheep experimentally. Eleven photodermatitis outbreaks of unknown cause occurred in cattle, sheep and horses on nine farms in the semiarid region of Bahia, northeastern Brazil, between July 2017 and July 2020. Cutaneous lesions of photosensitization initiated until one week after the animals were introduced in paddocks invaded by the plant at the beginning of the rainy season. Th...
Host-directed therapy in foals can enhance functional innate immunity and reduce severity of Rhodococcus equi pneumonia. Pneumonia caused by the intracellular bacterium Rhodococcus equi is an important cause of disease and death in immunocompromised hosts, especially foals. Antibiotics are the standard of care for treating R. equi pneumonia in foals, and adjunctive therapies are needed. We tested whether nebulization with TLR agonists (PUL-042) in foals would improve innate immunity and reduce the severity and duration of pneumonia following R. equi infection. Neonatal foals (n = 48) were nebulized with either PUL-042 or vehicle, and their lung cells infected ex vivo. PUL-042 increased inflammatory cytokines...
Influence of osteochondrosis on the longevity and racing performance of standardbred trotters and pacers. To determine the influence of clinical osteochondrosis (OC) on the short-term (2, 3, and 4-year-old) and long-term racing performance and longevity of standardbred racehorses. Methods: Retrospective case-control study. Methods: Standardbred racehorses from a single breeding farm born between 2009 and 2017 that survived to racing age (n = 2711). Three hundred eighty-two (14%) horses were OC-affected (829 lesions confirmed arthroscopically during surgical treatment), and 2329 (86%) horses were nonaffected. Methods: Racing performance data were obtained from an online database and evaluated with ...
Detecting acute kidney injury in horses by measuring the concentration of symmetric dimethylarginine in serum. Acute kidney injury (AKI) in horses may develop as a complication of a primary disease or following the administration of nephrotoxic drugs, and may pose a diagnostic challenge. Hence, the main objective of this study was to evaluate the concentrations and diagnostic significance of serum symmetric dimethylarginine (SDMA) and conventional renal dysfunction biomarkers in healthy horses, horses at risk of developing AKI, and horses with clinically evident AKI. A second aim was to assess how gastrointestinal disease and exposure to potentially nephrotoxic drugs affected SDMA levels. Thirty health...
The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting. Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a 'normal' pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, usi...
Computed tomography identified mineralisation of the longitudinal odontoid ligament of the horse is associated with age and sex but not with the clinical sign of head shaking. Mineralisation of the longitudinal odontoid ligament has recently been identified in three horses undergoing computed tomographic (CT) examination, but published studies describing the clinical relevance of this finding are currently lacking. The objective of this retrospective, analytical, cross-sectional study was to investigate the relationship of this image finding to primary presenting complaint, age, breed, use and sex of the patient, and determine any association to the clinical signs of head shaking, neck pain or restricted range of neck motion. Computed tomographic images of 96 horses...
The Effect of Uterine Lavage on Soluble CD14, Chemokine Ligand 2, and Interleukin 10 Levels in Mares With Postpartum Metritis. Postpartum metritis in mares is a life-threatening condition associated with severe clinical signs due to endotoxemia, and it is often followed by complications such as laminitis. Repeated large-volume uterine lavages are commonly recommended as a part of the treatment protocol to remove endotoxin-laden contents from the uterus. It has, however, also been suggested that lavages may increase the uptake of endotoxin into the circulation, leading to a deterioration of clinical signs. Endotoxemia is associated with the release of a multitude of inflammatory mediators regulating the immune response...
Evaluation of a smartphone-based electrocardiogram device accuracy in field and in hospital conditions in horses. Due to compactness and cheapness, smartphone ECG (sECG) could be very useful to equine practitioners. However, previous studies have evaluated the accuracy of sECG in hospitalised horses only. Different conditions in the field could influence the accuracy of the device. The aim of this study is to compare the accuracy of sECG in field and in hospital conditions. Methods: This is a prospective study. Paired standard base-apex ECG (stECG) and sECG were recorded in hospitalised horses and in subjects examined in field conditions. ECGs were analysed for heart rate and rhythm, presence/type of arrh...
Protection against the New Equine Influenza Virus Florida Clade I Outbreak Strain Provided by a Whole Inactivated Virus Vaccine. Equine influenza virus (EIV) is a major cause of respiratory disease in horses. Vaccination is an effective tool for infection control. Although various EIV vaccines are widely available, major outbreaks occurred in Europe in 2018 involving a new EIV H3N8 FC1 strain. In France, it was reported that both unvaccinated and vaccinated horses were affected despite >80% vaccination coverage and most horses being vaccinated with a vaccine expressing FC1 antigen. This study assessed whether vaccine type, next to antigenic difference between vaccine and field strain, plays a role. Horses were vaccin...
Development and Pathology of the Equine Mammary Gland. An understanding of the anatomy, histology, and development of the equine mammary gland underpins study of the pathology of diseases including galactorrhoea, agalactia, mastitis, and mammary tumour development. This review examines the prenatal development of the equine mammary gland and the striking degree to which the tissue undergoes postnatal development associated with the reproductive cycle. The gland is characterised by epithelial structures arranged in terminal duct lobular units, similar to those of the human breast, supported by distinct zones of intra- and interlobular collagenous s...
Lack of Association Between Barometric Pressure and Incidence of Colic in Equine Academic Ambulatory Practice. Anecdotal accounts correlate equine colic onset to changing weather conditions; however, atmospheric effects on colic have not been studied extensively. We hypothesized that changes in barometric pressure would increase the likelihood of a colic diagnosis compared with other noncolic sick events. Multivariable logistic regression analysis was used to look for associations between colic diagnosis and barometric pressure. The University of Pennsylvania Field Service electronic medical records were searched by identifiable examination type via billing procedure codes collecting 3,108 emergent and...
Clinical assessment and grading of back pain in horses. The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objective: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP ...
Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses. Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comp...
Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses. The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until...
Deep pemphigus (pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus) in dogs, cats and horses: a comprehensive review. Pemphigus is the term used to describe a group of rare mucocutaneous autoimmune bullous diseases characterized by flaccid blisters and erosions of the mucous membranes and/or skin. When the autoantibodies target desmosomes in the deep layers of the epidermis, deep pemphigus variants such as pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus develop. In this article, we will review the signalment, clinical signs, histopathology and treatment outcome of pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus in dogs, cats and horses; where pertinent, we compare the a...
Reliable and clinically applicable gait event classification using upper body motion in walking and trotting horses. Objectively assessing horse movement symmetry as an adjunctive to the routine lameness evaluation is on the rise with several commercially available systems on the market. Prerequisites for quantifying such symmetries include knowledge of the gait and gait events, such as hoof to ground contact patterns over consecutive strides. Extracting this information in a robust and reliable way is essential to accurately calculate many kinematic variables commonly used in the field. In this study, optical motion capture was used to measure 222 horses of various breeds, performing a total of 82 664 steps...
Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study. It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures. To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture. Observational longitudinal study. Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by ...
The Yolk Sac of the Equine Placenta. Its Remnant and Potential Problems. This review details the current state of knowledge about the equine yolk sac and its remnant (YSR) in the pregnant mare, which, incidentally, is the only animal species known to exhibit large and/or ossified YSR. It also describes the clinical significance of the YSR and details a case of a strangulating YSR that caused fetal death and abortion.
Minimizing Equine Tooth Extraction Complications. Oral extraction has become the most popular extraction technique owing to its high rate of success with minimal major complication. Repulsion continues to produce unacceptably high iatrogenic complication rates. To avoid tooth repulsion, veterinary dentists have introduced procedures to facilitate difficult intraoral extractions and surgical extraction techniques. Minimizing complications is best achieved preoperatively. A comprehensive preoperative evaluation and treatment plan allows the dentist to predict intraoperative complication and prepare for procedures to produce the best outcome. Wi...
Equine Oral Extraction Techniques. This article serves as a template for equine veterinarians to become proficient in basic intraoral premolar and molar extraction techniques of Equidae. Indications, equipment, and methodology are described. Numerous photos and videos are included to achieve a more immersive learning experience than can be accomplished with the written word alone. Clinicians performing these techniques will continue to improve their skillsets to achieve positive outcomes as case specifics become more challenging.
Equine Standing Surgical Extraction Techniques. Dental repulsion techniques reported in the past decades have a high incidence of complications. Although the practice of surgical extractions in horses is limited because of the training, instrumentation, and experience required to perform these techniques, veterinarians should be aware these procedures are available, general anesthesia is not required, and when performed by skilled veterinary dentists they have low complication rates. Surgical techniques are often used after failure of other extraction techniques to remove retained tooth root and fragments or to debride chronically contamina...
Circulating melanin-containing cells and neutrophils with phagocytized melanin granules in a horse with disseminated melanoma. An 18-year-old, grey, Thoroughbred Cross gelding was referred to the Cummings School of Veterinary Medicine at Tufts University following a 3-week history of low-grade fever of unknown origin, distal limb swelling, and weight loss. Clinical examination identified a few black, round, smooth nodules along the ventral aspect of the proximal tail. Transabdominal ultrasound showed a markedly enlarged heterogenous spleen, hyperechoic liver nodules, and evidence of peritonitis with fibrin deposition. A mature neutrophilia was noted on complete blood count with variable numbers of phagocytized granule...
A new equine peripheral caries grading system: Are the caries likely active or inactive? Equine peripheral caries can be a significant welfare issue in affected horses. Recent work has shown that complete reversal of the condition may be possible if the primary risk factor can be identified and corrected. Determining whether caries are active (deteriorating) or inactive (improving) is of vital importance when formulating a management and treatment plan. A new grading system is proposed that looks at whether caries are likely active or inactive to assist clinicians deciding whether intervention is required. Objective: To examine the reliability of an alternative grading method for ...
First report of pulmonary disease associated with Nicoletella semolina in a horse in New Zealand. A 9-year-old warmblood gelding with a history of chronic intermittent tachypnoea and dyspnoea was presented for evaluation and removal of a mass on the left side of the neck. A fibrous mass adherent to the left jugular vein developed and was removed surgically 6 weeks later, at which time the owner requested an evaluation of the cause of the persistent respiratory signs first noted on primary admission. Clinical findings included coarse lung sounds on thoracic auscultation, tracheal wheeze, and an abnormal trans-tracheal aspirate. These findings, in addition to the results of ultrasonographi...
Equine dental and skeletal fluorosis induced by well water consumption. Two horses that consumed well water with high fluoride content exhibited clinical signs of chronic dental and skeletal fluoride toxicosis and were later euthanized and autopsied. Both horses had degenerative disease of multiple joints and multiple dental defects. Elevated fluoride concentrations were found in bone and tooth samples of both horses, well water, and feed. Microscopically, abnormalities were noted in bone and tooth samples, and consisted mostly of foci of cement necrosis and hypercementosis. Horses exhibiting bilateral, highly symmetrical dental and/or skeletal lesions, with chron...
Equine Nasal Endoscopy: Treating Bullae Disease and Sinus Disease. The nasal conchal bullae (dorsal and ventral) are separate, air-filled structures within their respective dorsal and ventral nasal conchae. Computed tomography scans have assisted with the increasing diagnosis of empyema of the nasal conchae. This condition is usually associated with dental or sinus disease. Drainage of affected bullae is considered critical for resolution of clinical signs. The ventral conchal bullae can be easily viewed with a standard 10 mm diameter flexible endoscopy via the middle nasal meatus. This approach can also be used for fenestration of the bullae, using a diode ...
Update on Equine Odontoclastic Tooth Resorption and Hypercementosis. Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive, painful disease, affecting incisors, canines, and cheek teeth. Examination findings include gingival inflammation, gingival recession and/or hyperplasia, subgingival swelling, bulbous enlargement of teeth, associated periodontal disease, pathologic tooth fracture, and/or tooth mobility and loss. Current hypotheses include biomechanical stresses and secondary bacterial involvement. Early recognition allows case management, but it is a progressive disease. Owner education is crucial; horses with complete or multi...
Improvement of the clinical signs of gait abnormality after treatment with levothyroxine in a horse with shivering and hypothyroidism. An 11-year-old Hanoverian gelding used for jumping was evaluated for gait abnormalities and hoof problems in the hindlimbs. Clinical examinations revealed signs consistent with shivers. A thyroid gland enlargement was noticed, baseline serum thyroid hormone (TH) concentrations were low, and a low response to thyrotropin-releasing hormone administration was observed. Hypothyroidism was suspected. The horse was treated with levothyroxine for 1 year. TH concentrations returned to the normal range by week 4 of treatment. Thirty weeks after the initiation of levothyroxine therapy, the gait abnormal...
Ceftiofur Side Effect in a Mare-Case Report. Adverse drug reactions in horses are rare. The antimicrobials are in the list of the most common drugs associated with reaction in horses. The aim of this report is to describe the clinical presentation of an adverse drug reaction after the intramuscular administration of ceftiofur hydrochloride. A 5-year-old crioulo broodmare at one day postpartum presented signs of difficulty to walk, positive pulse in the four limbs, and heart rate of 80 beats per minute (bpm), with a history of fighting with another mare. The clinical suspicions were rhabdomyolysis and laminitis. Initially a dose of flunix...
