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Topic:Diagnostic Technique

Diagnostic techniques in equine medicine encompass a range of procedures and tools used to identify diseases, injuries, or other health conditions in horses. These techniques include imaging methods such as radiography, ultrasonography, and magnetic resonance imaging (MRI), as well as laboratory tests like blood work and tissue biopsies. Each diagnostic method provides specific information that can aid in the assessment and management of equine health issues. Radiography is commonly used for evaluating bone structures, while ultrasonography is useful for soft tissue examination. MRI offers detailed images of both soft and hard tissues, though its use is limited by cost and availability. Laboratory tests can detect biochemical and hematological changes indicative of disease. This page compiles peer-reviewed research studies and scholarly articles that explore the development, application, and efficacy of various diagnostic techniques in equine veterinary practice.
Detection of Babesia caballi and Theileria equi in Blood from Equines from Four Indigenous Communities in Costa Rica.
Veterinary medicine international    November 16, 2015   Volume 2015 236278 doi: 10.1155/2015/236278
Posada-Guzmán MF, Dolz G, Romero-Zúñiga JJ, Jiménez-Rocha AE.A cross-sectional study was carried out in four indigenous communities of Costa Rica to detect presence and prevalence of Babesia caballi and Theileria equi and to investigate factors associated with presence of these hemoparasites. General condition of horses (n = 285) was evaluated, and hematocrits and hemoglobin were determined from blood samples of 130 horses, which were also analyzed using blood smears, nested polymerase chain reaction (PCR), and immunosorbent assay (c-ELISA). The general condition of the horses (n = 285) in terms of their body and coat was between regular and poor, and h...
Deep sequencing of the uterine immune response to bacteria during the equine oestrous cycle.
BMC genomics    November 14, 2015   Volume 16 934 doi: 10.1186/s12864-015-2139-3
Marth CD, Young ND, Glenton LY, Noden DM, Browning GF, Krekeler N.The steroid hormone environment in healthy horses seems to have a significant impact on the efficiency of their uterine immune response. The objective of this study was to characterize the changes in gene expression in the equine endometrium in response to the introduction of bacterial pathogens and the influence of steroid hormone concentrations on this expression. Methods: Endometrial biopsies were collected from five horses before and 3 h after the inoculation of Escherichia coli once in oestrus (follicle >35 mm in diameter) and once in dioestrus (5 days after ovulation) and analysed usi...
Effects of estradiol on uterine perfusion in anesthetized cyclic mares affected with uterine vascular elastosis.
Animal reproduction science    November 14, 2015   Volume 164 57-63 doi: 10.1016/j.anireprosci.2015.11.012
Esteller-Vico A, Liu IK, Vaughan B, Steffey EP, Brosnan RJ.Uterine vascular elastosis in mares is characterized by degeneration of uterine vasculature through thickening of the elastin layers. Factors commonly associated with this degeneration include age, parity, and chronic uterine endometritis. Affected mares have also been shown to exhibit decreases in uterine blood flow and perfusion of the uterus. Due to the increased thickness of the elastin layers, we hypothesize that vasodilatation of the uterine vasculature is also impaired. To test the functionality of these vessels, we evaluated the vasodilatory effects of estradiol on the uterine vascular...
Diagnostic application of recombinant equine merozoite surface antigen-1 in elisa for detection of Theileria equi specific antibodies.
The Japanese journal of veterinary research    November 14, 2015   Volume 63, Issue 3 129-137 
Kumar S, Rakha NK, Goyal L, Goel P, Kumar R, Kumar A, Kumar S.Theileria equi merozoite surface antigens have been an important candidate for development of diagnostics. We developed ELISA based on EMA-1 recombinant antigen, so as to widen our diagnostic confidence in detection of antibodies against T. equi in sero-surveillance studies. The 547 bp EMA-1 gene fragment encoding high hydrophilic antigenic region was expressed with glutathione-S-transferase tag in prokaryotic system and purified protein (43 kDa) was used for development of ELISA (EMA-1t/ELISA). The EMA-1t/ELISA clearly differentiated T. equi-infected from Babesia caballi-infected horse sera o...
Pregnancy-associated changes of serum biochemical values in Lipizzaner broodmares.
Acta veterinaria Hungarica    November 10, 2015   Volume 63, Issue 3 303-316 doi: 10.1556/004.2015.028
Vincze B, Kutasi O, Baska F, Szenci O.The aims of this study were to detect physiological changes in blood biochemical parameters throughout gestation, to compare the findings in nonpregnant and pregnant Lipizzaner mares in early-mid and late pregnancy, and to provide reference values for clinical chemistry parameters in this horse breed. A total of 136 venous blood samples were collected from 20 pregnant and 10 nonpregnant (control) asymptomatic Lipizzaner broodmares for biochemical analyses. Twelve parameters (albumin, total protein, urea, triglycerides, glucose, creatinine, alkaline phosphatase, aspartate transaminase, glutamat...
Three new serotypes of Rhodococcus equi in Prescott’s serotyping system – Short communication.
Acta veterinaria Hungarica    November 10, 2015   Volume 63, Issue 3 265-270 doi: 10.1556/004.2015.024
Makrai L, Fodor L, Hajtós I, Varga J, Dénes B.Three new serotypes were found among Rhodococcus equi strains, which could not be assigned into any of the seven serotypes of Prescott's system. Fortythree R. equi strains out of 44 previously nontypable ones isolated in Hungary could be allocated into one of the three new serotypes using the agar gel immunodiffusion (AGID) test. The three new suggested serotypes are serotype 8 (proposed reference strain: HNCMB-138003), serotype 9 (proposed reference strain: HNCMB-138004) and serotype 10 (proposed reference strain: HNCMB-138005). Hyperimmune sera produced in rabbits against the new serotypes a...
Molecular changes in the equine follicle in relation to variations in antral follicle count and anti-Müllerian hormone concentrations.
Equine veterinary journal    November 6, 2015   Volume 48, Issue 6 741-748 doi: 10.1111/evj.12514
Claes A, Ball BA, Troedsson MH, Curry TE, Squires EL, Scoggin KE.The wide variation in circulating anti-Müllerian hormone (AMH) concentrations between mares is attributed to differences in antral follicle count (AFC) which may reflect follicular function. There are few data regarding variations in AFC and associated regulatory factors for AMH in the equine follicle during follicular development. Objective: To examine molecular and hormonal differences in the equine follicle in relation to variations in AFC and circulating AMH concentrations during follicular development and to identify genes co-expressed with AMH in the equine follicle. Methods: Observatio...
Association between inflammatory airway disease of horses and exposure to respiratory viruses: a case control study.
Multidisciplinary respiratory medicine    November 3, 2015   Volume 10 33 doi: 10.1186/s40248-015-0030-3
Houtsma A, Bedenice D, Pusterla N, Pugliese B, Mapes S, Hoffman AM, Paxson J, Rozanski E, Mukherjee J, Wigley M, Mazan MR.Inflammatory airway disease (IAD) in horses, similar to asthma in humans, is a common cause of chronic poor respiratory health and exercise intolerance due to airway inflammation and exaggerated airway constrictive responses. Human rhinovirus is an important trigger for the development of asthma; a similar role for viral respiratory disease in equine IAD has not been established yet. Methods: In a case-control study, horses with IAD (n = 24) were compared to control animals from comparable stabling environments (n = 14). Horses were classified using pulmonary function testing and bronc...
Fecal Ciliate Composition of Domestic Horses (Equus caballus Linnaeus, 1758) Living in Kyrgyzstan.
Zootaxa    November 3, 2015   Volume 4039, Issue 1 145-156 doi: 10.11646/zootaxa.4039.1.6
Gürelli G, Canbulat S, Aldayarov N.Species composition and distribution of intestinal ciliates were investigated in the feces from 15 domestic horses living in Bishkek, Kyrgyzstan. Twenty-three species belonging to 14 genera were identified. This is the first study on intestinal ciliates in domestic horses living in Kyrgyzstan. The mean number of ciliates was 14.1 ± 6.8 x10(4) cells ml(-1) of feces and the mean number of ciliate species per host was 6.0 ± 3.2. No endemic or new species were detected. Blepharocorys was the major genus as these ciliates were detected in high proportions. In contrast Holophryoides, Allantosoma w...
Predictor variables for and complications associated with Streptococcus equi subsp equi infection in horses.
Journal of the American Veterinary Medical Association    November 1, 2015   Volume 247, Issue 10 1161-1168 doi: 10.2460/javma.247.10.1161
D○ LR, Stefanovski D, Boston RC, Boyle AG.To evaluate predictor variables for and complications associated with Streptococcus equi subsp equi infection (strangles) in horses. Methods: Retrospective case-control study. Methods: 108 horses with strangles (cases) and 215 horses without strangles (controls). Methods: Medical records from January 2005 through July 2012 were reviewed. Cases were defined as horses with clinical signs of strangles (pyrexia, retropharyngeal lymphadenopathy, and mucopurulent nasal discharge) that were associated with a confirmed strangles outbreak or had positive results for S equi on PCR assay or bacteriologic...
Frequent presence of hepaci and pegiviruses in commercial equine serum pools.
Veterinary microbiology    November 1, 2015   Volume 182 8-14 doi: 10.1016/j.vetmic.2015.10.032
Postel A, Cavalleri JM, Pfaender S, Walter S, Steinmann E, Fischer N, Feige K, Haas L, Becher P.Novel viruses belonging to the genera Hepacivirus and Pegivirus have recently been discovered in horses and other animal species. Viral genomes of non-primate hepaciviruses (NPHV), equine pegivirus 1 (EPgV 1) and Theiler's disease associated virus (TDAV) were detected in a horse serum routinely used for cell culture propagation in our laboratory. Therefore, a study was carried out to further investigate the presence of these human Hepatitis C virus (HCV) related viruses in equine serum based products used in veterinary medicine and for research and to characterize the viral genomes. Without ex...
Association between sesamoiditis, subclinical ultrasonographic suspensory ligament branch change and subsequent clinical injury in yearling Thoroughbreds.
Equine veterinary journal    October 29, 2015   Volume 48, Issue 5 543-547 doi: 10.1111/evj.12497
Plevin S, McLellan J, O'Keeffe T.Sesamoiditis is a common radiological finding in yearling Thoroughbreds. The condition is believed to be associated with suspensory ligament branch injury (SLBI), which is known to affect racing performance. The presence of subclinical suspensory ligament branch change (SSLBC) in untrained yearlings has not been investigated. Associations between sesamoiditis, SSLBC and subsequent SLBI would allow more accurate prognoses to be made regarding the development of SLBI. They could also provide opportunity for intervention and prevention of SLBI. Objective: To test our hypotheses that untrained yea...
The first reported outbreak of equine herpesvirus myeloencephalopathy in New Zealand.
New Zealand veterinary journal    October 29, 2015   Volume 64, Issue 2 125-134 doi: 10.1080/00480169.2015.1096853
McFadden AM, Hanlon D, McKenzie RK, Gibson I, Bueno IM, Pulford DJ, Orr D, Dunowska M, Stanislawek WL, Spence RP, McDonald WL, Munro G, Mayhew IG.On 9 January 2014 (Day 0) a mare from a stud farm in the Waikato region presented with urinary incontinence without pyrexia. Over the following 33 days 15 mares were clinically affected with neurological signs. All but one mare had a foal at foot. The most commonly observed clinical signs were hind limb paresis and ataxia. In some cases recumbency occurred very early in the course of disease and seven mares were subject to euthanasia for humane reasons. Results: Equid herpesvirus (EHV) type 1 was detected using PCR in various tissues collected post mortem from two mares with neurological signs...
Defective secretion of Prostaglandin F2α during development of idiopathic persistent corpus luteum in mares.
Domestic animal endocrinology    October 28, 2015   Volume 55 60-65 doi: 10.1016/j.domaniend.2015.10.004
Ginther OJ, Castro T, Baldrighi JM, Wolf CA, Santos VG.Five mares that developed idiopathic persistent corpus luteum (PCL) were compared with 5 mares with apparently normal interovulatory intervals (IOIs). Progesterone (P4) and a metabolite of prostaglandin F2α (PGFM) were assayed daily beginning on the day of ovulation (Day 0). Transition between the end of an initial progressive P4 increase and the beginning of a gradual decrease in P4 occurred on mean Day 6. The gradual decrease in P4 between Days 6 and 12 was less (approached significance, P < 0.06) in the PCL group than in the IOI group. The P4 concentration on Day 12 (before luteolysis i...
Total nucleated cell and leukocyte differential counts in canine pleural and peritoneal fluid and equine synovial fluid samples: comparison of automated and manual methods.
Veterinary clinical pathology    October 26, 2015   Volume 44, Issue 4 570-579 doi: 10.1111/vcp.12298
Brudvig JM, Swenson CL.Rapid and precise measurement of total and differential nucleated cell counts is a crucial diagnostic component of cavitary and synovial fluid analyses. Objective: The objectives of this study included (1) evaluation of reliability and precision of canine and equine fluid total nucleated cell count (TNCC) determined by the benchtop Abaxis VetScan HM5, in comparison with the automated reference instruments ADVIA 120 and the scil Vet abc, respectively, and (2) comparison of automated with manual canine differential nucleated cell counts. Methods: The TNCC and differential counts in canine pleura...
Accuracy and precision of oscillometric blood pressure in standing conscious horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    October 21, 2015   Volume 26, Issue 1 85-92 doi: 10.1111/vec.12411
Olsen E, Pedersen TL, Robinson R, Haubro Andersen P.Arterial blood pressure (BP) is a relevant clinical parameter that can be measured in standing conscious horses to assess tissue perfusion or pain. However, there are no validated oscillometric noninvasive blood pressure (NIBP) devices for use in horses. Methods: Seven healthy horses from a teaching and research herd. Objective: To evaluate the accuracy and precision of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) in conscious horses obtained with an oscillometric NIBP device when compared to invasively measured arterial BP. Methods: An ...
Effects of administration of a synthetic low molecular weight/low molar substitution hydroxyethyl starch solution in healthy neonatal foals.
The Canadian veterinary journal = La revue veterinaire canadienne    October 21, 2015   Volume 56, Issue 10 1069-1074 
Hepworth-Warren KL, Wong DM, Hay-Kraus BL, Wang C, Sun Y.This study compared the effects of IV administration of isotonic fluid therapy and colloidal fluid therapy in healthy neonatal foals. Fifteen healthy neonatal foals were used in a randomized blinded prospective clinical study. Foals were randomly assigned to receive a bolus of 20 mL/kg of tetrastarch (TES) or balanced crystalloid solution. Vital parameters, colloid osmotic pressure (COP), and various clinicopathologic variables were assessed prior to infusion and at various time points up to 120 h after infusion. The treatment group (TES) had a significant increase in both COP and percentage i...
A Novel Algorithm for Movement Artifact Removal in ECG Signals Acquired from Wearable Systems Applied to Horses.
PloS one    October 20, 2015   Volume 10, Issue 10 e0140783 doi: 10.1371/journal.pone.0140783
Lanata A, Guidi A, Baragli P, Valenza G, Scilingo EP.This study reports on a novel method to detect and reduce the contribution of movement artifact (MA) in electrocardiogram (ECG) recordings gathered from horses in free movement conditions. We propose a model that integrates cardiovascular and movement information to estimate the MA contribution. Specifically, ECG and physical activity are continuously acquired from seven horses through a wearable system. Such a system employs completely integrated textile electrodes to monitor ECG and is also equipped with a triaxial accelerometer for movement monitoring. In the literature, the most used techn...
Biological variation of thromboelastrography variables in 10 clinically healthy horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    October 19, 2015   Volume 26, Issue 1 80-84 doi: 10.1111/vec.12410
Scruggs JL, Flatland B, McCormick KA, Reed A.To assess the utility of population-based reference intervals (PRIs) for interpreting thromboelastography (TEG) variables in horses using biological variation data. Methods: Prospective cohort biologic variation study conducted over a 5-week period. Methods: Veterinary teaching hospital and research facility. Methods: Ten clinically healthy horses randomly selected from a veterinary school research and teaching herd. Methods: Horse health was determined using physical examination, CBC, and biochemical and coagulation profiles prior to the start of the study. Subsequently, once weekly blood sam...
Arrhythmogenic right ventricular cardiomyopathy secondary to adipose infiltration as a cause of episodic collapse in a horse.
Irish veterinary journal    October 19, 2015   Volume 68 24 doi: 10.1186/s13620-015-0052-3
Raftery AG, Garcia NC, Thompson H, Sutton DG.A 15-year-old Clydesdale cross gelding was investigated and managed over a 2-year period for intermittent collapse. The horse presented initially after an observed episode of collapse at rest, and had a resting tachycardia, elevated Cardiac Troponin I and polycythaemia. Multiple dysrhythmias were detected on telemetric electrocardiography. Vital parameters, cardiac rhythm and red cell count returned to reference range with prolonged rest but further resting syncopal episodes were observed, and due to safety concerns and limited treatment options the horse was euthanased. Post mortem evaluation...
Stimulation of LH, FSH, and luteal blood flow by GnRH during the luteal phase in mares.
Theriogenology    October 19, 2015   Volume 85, Issue 4 740-746 doi: 10.1016/j.theriogenology.2015.10.019
Castro T, Oliveira FA, Siddiqui MA, Baldrighi JM, Wolf CA, Ginther OJ.A study was performed on the effect of a single dose per mare of 0 (n = 9), 100 (n = 8), or 300 (n = 9) of GnRH on Day 10 (Day 0 = ovulation) on concentrations of LH, FSH, and progesterone (P4) and blood flow to the CL ovary. Hormone concentration and blood flow measurements were performed at hours 0 (hour of treatment), 0.25, 0.5, 1, 2, 3, 4, and 6. Blood flow was assessed by spectral Doppler ultrasonography for resistance to blood flow in an ovarian artery before entry into the CL ovary. The percentage of the CL with color Doppler signals of blood flow was estimated from videotapes of real-t...
Plasma Procalcitonin Concentration in Healthy Horses and Horses Affected by Systemic Inflammatory Response Syndrome.
Journal of veterinary internal medicine    October 16, 2015   Volume 29, Issue 6 1689-1691 doi: 10.1111/jvim.13640
Bonelli F, Meucci V, Divers TJ, Jose-Cunilleras E, Corazza M, Tognetti R, Guidi G, Intorre L, Sgorbini M.The diseases most frequent associated with SIRS in adult horses are those involving the gastrointestinal tract. An early diagnosis should be the goal in the management of horses with SIRS. Objective: The objective of this study was to evaluate the plasma procalcitonin (PCT) concentration in healthy and SIRS horses to assess differences between the two groups. Methods: Seventy-eight horses (30 healthy and 48 SIRS). Methods: Prospective in vivo multicentric study. Horses were classified as SIRS if at least 2 of the following criteria were met: abnormal leukocyte count or distribution, hypertherm...
A review of traditional and contemporary assays for direct and indirect detection of Equid herpesvirus 1 in clinical samples. Balasuriya UB, Crossley BM, Timoney PJ.Equid herpesvirus 1 (EHV-1) is one of the most economically important equine viral pathogens. Its clinical manifestations in horses vary from acute upper respiratory tract disease, abortion, or neonatal death, to neurological disease termed equine herpesviral myeloencephalopathy, which may lead to paralysis and a fatal outcome. Successful identification of EHV-1 infection in horses depends on a variety of factors such as suitable case selection with emphasis on timing of sample collection, selection of appropriate sample(s) based on the clinical manifestations, application of relevant diagnost...
The Effect of Different Types of Musculoskeletal Injuries on Blood Concentration of Serum Amyloid A in Thoroughbred Racehorses.
PloS one    October 14, 2015   Volume 10, Issue 10 e0140673 doi: 10.1371/journal.pone.0140673
Turło A, Cywińska A, Czopowicz M, Witkowski L, Niedźwiedź A, Słowikowska M, Borowicz H, Jaśkiewicz A, Winnicka A.Training-induced muscle, skeletal and joint trauma may result in acute phase response reflected by the changes in the blood concentration of serum amyloid A (SAA) in racehorses. It remains yet unclear if such systemic reaction could be triggered by sport injuries and what is the impact of different types of musculoskeletal trauma on SAA concentrations in racehorses. This study aimed to determine changes in the SAA blood concentration in racehorses with different types of injuries of musculoskeletal system. Methods: The study involved 28 racehorses diagnosed after the race with bone fractures (...
Enhanced sensitivity of an antibody competitive blocking enzyme-linked immunosorbent assay using Equine arteritis virus purified by anion-exchange membrane chromatography. Chung CJ, Grimm AL, Wilson CL, Balasuriya UB, Chung G, Timoney PJ, Bandaranayaka-Mudiyanselage CB, Lee SS, McGuire TC.In an effort to improve a competitive blocking enzyme-linked immunosorbent assay (cELISA) for antibody detection to Equine arteritis virus (EAV), antigen purified by anion-exchange membrane chromatography capsule (AEC) was evaluated. Virus purification by the AEC method was rapid and easily scalable. A comparison was made between virus purified by the AEC method with that obtained by differential centrifugation based on the following: 1) the relative purity and quality of EAV glycoprotein 5 (GP5) containing the epitope defined by monoclonal antibody 17B7, and 2) the relative sensitivity of a c...
Detection of the selective androgen receptor modulator andarine (S-4) in a routine equine blood doping control sample.
Drug testing and analysis    October 12, 2015   Volume 8, Issue 2 257-261 doi: 10.1002/dta.1867
Cawley AT, Smart C, Greer C, Liu Lau M, Keledjian J.No abstract available
Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.
Veterinary surgery : VS    October 12, 2015   Volume 44, Issue 8 1036-1041 doi: 10.1111/vsu.12412
Stewart S, Richardson D, Boston R, Schaer TP.To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. Methods: Case series. Methods: Horses (n = 54). Methods: Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configu...
The complete mitochondrial genome of Oxyuris equi: Comparison with other closely related species and phylogenetic implications.
Experimental parasitology    October 9, 2015   Volume 159 215-221 doi: 10.1016/j.exppara.2015.09.013
Zhang Y, Xu WW, Guo DH, Liu ZX, Duan H, Su X, Fu X, Yue DM, Gao Y, Wang CR.The equine pinworm Oxyuris equi (Nematoda: Oxyuridomorpha) is the most common horse nematode, has a worldwide distribution, and causes major economic losses. In the present study, the complete O. equi mitochondrial (mt) genome was sequenced, and the mt genome structure and organization were compared with those of other closely related pinworm species, Enterobius vermicularis and Wellcomia siamensis. The O. equi mt genome is a 13,641-bp circular DNA molecule that encodes 36 genes (12 protein-coding genes, 22 tRNAs, and two rRNAs) and one non-coding region, which is slightly shorter than that ...
Radiographic, computed tomographic and surgical anatomy of the equine sphenopalatine sinus in normal and diseased horses.
Equine veterinary journal    October 9, 2015   Volume 48, Issue 5 578-584 doi: 10.1111/evj.12492
Tucker R, Windley ZE, Abernethy AD, Witte TH, Fiske-Jackson AR, Turner S, Smith LJ, Perkins JD.Knowledge of imaging anatomy, surgical anatomy and disorders affecting the sphenopalatine sinus are currently lacking. Objective: To describe the computed tomographic (CT) and surgical anatomy of the sphenopalatine sinus and diagnosis, treatment and outcome in clinical cases with sphenopalatine sinus disease. Methods: Cadaver observational study and retrospective case series. Methods: The sphenopalatine sinuses of 10 normal cadaver heads were examined with digital radiography, CT and sinoscopic examination prior to anatomical sectioning. Sphenopalatine sinus anatomy was described and compared ...
The effect of perineural anaesthesia and handler position on limb loading and hoof balance of the vertical ground reaction force in sound horses.
Equine veterinary journal    October 6, 2015   Volume 48, Issue 5 608-612 doi: 10.1111/evj.12491
Van de Water E, Oosterlinck M, Pille F.The effects of handler position and perineural anaesthesia in sound horses need investigation to facilitate interpretation of pressure plate analysis in lame horses. Objective: To evaluate the effect of handler position and perineural anaesthesia on limb loading and particularly hoof balance in sound horses. Methods: Nonrandomised crossover study. Methods: Six sound horses were walked and trotted over a pressure plate, with the handler on the left and subsequently on the right side, and finally after a bilateral low palmar digital nerve block. One week later this procedure was repeated before ...