Disease severity in horses refers to the extent and impact of a disease on an equine patient's health and well-being. It encompasses various factors, including the intensity of clinical signs, the progression rate of the disease, and the overall effect on the horse's physiological functions. Disease severity is often assessed through clinical evaluations, laboratory tests, and imaging techniques to determine the appropriate treatment and management strategies. This topic includes research on the methods for assessing disease severity, the correlation between severity and treatment outcomes, and the implications for equine health management. This page compiles peer-reviewed research studies and scholarly articles that explore the assessment, implications, and management of disease severity in horses.
Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T.Horses with trigeminal-mediated headshaking (TMHS) exhibit different headshaking patterns (HSPs), electric shock-like jerking, signs of nasal irritation, and painful facial expressions. The History Rest and Exercise Score (HRE-S) was developed to objectively clarify the severity of the condition in affected horses. This score considers the history and severity of clinical signs at rest and exercise. This study aimed to assess the frequency of different clinical signs and their individual associations with diagnosis, treatment, and outcome in horses diagnosed with TMHS.The clinical records of h...
Sauer FJ, Hellige M, Beineke A, Geburek F.Few case reports describe equine coxofemoral joint osteoarthritis (CFJOA). Objective: To evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment. Methods: Retrospective case series. Methods: History, clinical signs, ultrasonographic, radiographic and intra-articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra- and inter-obse...
Igel P, Fürst AE, Jackson MA.Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is an increasingly diagnosed degenerative dental disease in aged horses. The primary aim of this retrospective study was to determine the prevalence of EOTRH in horses admitted to the Equine Hospital, University of Zurich, for dental procedures from 2004 to 2017. A secondary goal was to measure and compare interincisal angles on two-dimensional radiographs of horses with EOTRH to determine whether the interincisal angle is associated with age and severity of the disease. Radiographs were assessed for the presence of lysis and/or...
Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T.In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. Objective: To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). Methods: Retrospective observational study. Methods: Seven masked observers with different experience used HRE-S to score 40 video recordings taken d...
Occhiogrosso L, Capozza P, Buonavoglia A, Decaro N, Trotta A, Marin C, Corrente M.Equine periodontal disease (EPD) is a painful oral inflammatory syndrome characterized by multifactorial pathogenesis. Although it is well known that bacterial proliferation and consequent gingivitis are caused by the decomposition process of food residues, in hypsodont species, the pathogenetic role and the different bacterial species involved in the progression of EPD must be fully clarified. This study aimed to investigate the association of bacteria, including the complex red bacteria (RCB), with EPD, and to evaluate possible EPD risk factors. Bacterial species, including , , (belonging t...
Janssen P, Tosi I, Hego A, Maréchal P, Marichal T, Radermecker C.Asthma encompasses a spectrum of heterogenous immune-mediated respiratory disorders sharing a similar clinical pattern characterized by cough, wheeze and exercise intolerance. In horses, equine asthma can be subdivided into severe or moderate asthma according to clinical symptoms and the extent of airway neutrophilic inflammation. While severe asthmatic horses are characterized by an elevated neutrophilic inflammation of the lower airways, cough, dyspnea at rest and high mucus secretion, horses with moderate asthma show a milder neutrophilic inflammation, exhibit intolerance to exercise but no...
Fingerhut L, Yücel L, Strutzberg-Minder K, von Köckritz-Blickwede M, Ohnesorge B, de Buhr N.Equine recurrent uveitis (ERU) is a common ocular disease of horses and described as a model for human autoimmune uveitis. This immune-mediated, inflammatory condition progressively destroys the eye, ultimately leading to blindness. Genetic and autoimmune factors, next to infections with Leptospira, are discussed as key factors in the pathogenesis. Furthermore, a release of neutrophil extracellular traps (NETs) by activated neutrophils is involved. NETs are composed of decondensed chromatin and proteins that can immobilize invading pathogens. However, if NETs accumulate, they can contribute to...
Rozario C, Martínez-Sobrido L, McSorley HJ, Chauché C.Influenza A viruses (IAVs) are important respiratory pathogens of horses and humans. Infected individuals develop typical respiratory disorders associated with the death of airway epithelial cells (AECs) in infected areas. Virulence and risk of secondary bacterial infections vary among IAV strains. The IAV non-structural proteins, NS1, PB1-F2, and PA-X are important virulence factors controlling AEC death and host immune responses to viral and bacterial infection. Polymorphism in these proteins impacts their function. Evidence from human and mouse studies indicates that upon IAV infection, the...
Oliveira T, Santos A, Silva J, Trindade P, Yamada A, Jaramillo F, Silva L, Baccarin R.In humans, hospitalisation, disease type, and environmental factors evidently affect the quality of sleep, further influencing patient recovery. The objective of the present study was to report the resting and lying behaviour of hospitalised horses, and whether lying behaviours differ depending on the physiological severity of joint damage. We hypothesised that the resting and lying behaviour can change during the hospitalisation and physiological severity of joint damage affect the time of rest in horses. A descriptive observational study was performed to evaluate the effect of hospitalisatio...
Douglas HF, Stefanovski D, Southwood LL.To evaluate, following colic admission during pregnancy, (1) broodmare survival; (2) the frequency of recurrent colic in broodmares and its associated variables, and (3) pregnancy outcome and the variables associated with a negative pregnancy outcome. Methods: Ambidirectional observational cohort study. Methods: One hundred and four client-owned broodmare admissions. Methods: Admissions of pregnant mares from June 2010 until October 2016 were included. Data were collected until November 2017. Cox proportional hazards regression analysis was performed to evaluate variables associated with brood...
Rings LM, Kamr AM, Kinsella HM, Hostnik LD, Swink JM, Burns TA, Christie K, David JB, Toribio RE.The enteroinsular axis (EIA) is an energy regulatory system that modulates insulin secretion through the release of enteroendocrine factors (incretins). Despite the importance of energy homeostasis in the equine neonate, information on the EIA in hospitalized foals is lacking. The goals of this study were to measure serum insulin and plasma incretin (glucose-dependent insulinotropic polypeptide [GIP], glucagon-like peptide-1 [GLP-1] and glucagon-like peptide-2 [GLP-2]) concentrations, to determine the insulin and incretin association, as well as their link to disease severity and outcome in ho...
Larson EM, Wagner B.Horses have many naturally occurring diseases that mimic similar conditions in humans. The ability to conduct environmentally controlled experiments and induced disease studies in a genetically diverse host makes the horse a valuable intermediate model between mouse studies and human clinical trials. This review highlights important similarities in the immune landscape between horses and humans using current research on two equine diseases as examples. First, equine herpesvirus type 1 (EHV-1) infection initiates a series of innate inflammatory signals at its mucosal entry site in the upper res...
Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE.Information on steroids derived from the adrenal glands, gonads, or fetoplacental unit is minimal in newborn foals. Objective: To measure androgen concentrations in serum and determine their association with disease severity and outcome in hospitalized foals. Methods: Hospitalized (n = 145) and healthy (n = 80) foals. Methods: Prospective, multicenter, cross-sectional study. Foals of ≤3 days of age from 3 hospitals and horse farms were classified as healthy and hospitalized (septic, sick nonseptic, neonatal maladjustment syndrome [NMS]) based on physical exam, medical history, and laborato...
Warlick LM, Léguillette R, Kogan C, Gold JR, Bayly WM.Diagnosis and assessment of severity of exercise-induced pulmonary hemorrhage (EIPH) relies on postexercise visualization of fresh blood in the airways via tracheobronchoscopic examination (TBE) and/or counting erythrocytes in bronchoalveolar lavage fluid (BALFRBC). Determining the BALFRBC is more sensitive than TBE but its usefulness is hampered by the need to have BALFRBC counted at a laboratory. We explored the feasibility of evaluating the severity of EIPH by using a color chart comprised of five shades of red and matching those colors with the color of BALF immediately following collectio...
Gehlen H, Faust MD, Grzeskowiak RM, Trachsel DS.Heart rate variability (HRV) is a noninvasive technique to detect changes in the autonomous nervous system. It has rarely been investigated in horses with colic. Therefore, the objective was to assess the evolution of HRV parameters and cortisol concentrations in horses with colic. The 43 horses included in this study were categorized into three groups according to the treatment (1, surgical; 2, conservative; 3, euthanized). The HRV and laboratory variables were measured at admission (T1), the day after admission (T2), and at discharge (T3) and compared between groups and over time with an ANO...
Kamr AM, Dembek KA, Gilsenan W, Bozorgmanesh R, Hassan HY, Rosol TJ, Toribio RE.Hypocalcemia is a common finding in critically ill equine patients. Parathyroid hormone (PTH) helps to maintain calcium homeostasis in hypocalcemic patients by promoting renal calcium reabsorption and bone resorption. Increased serum PTH concentrations have been reported in critically ill people and animals, including horses and foals. It is unknown whether increased secretion of PTH is associated with markers of bone turnover in hospitalized foals. The goals of this study were to measure markers of bone resorption (C-terminal telopeptide of type I collagen [CTX-I]) and bone formation (osteoca...
Siwinska N, Zak A, Slowikowska M, Krupinska P, Niedzwiedz A.Asthma is one of the most common non-infectious respiratory diseases in horses. Ultrasound examination is a widely available non-invasive additional diagnostic tool. To date, there are no studies focusing on ultrasonographic findings in horses with asthma. The aim of this study was to analyse the prevalence and severity of ultrasound lesions in lung tissue in horses with asthma. Lung ultrasonography was carried out on six healthy horses (controls) and 12 horses with asthma (six with mild and six with severe asthma). The sonographic changes in three lung sections were assessed using a scoring s...
Kopper JJ, Kogan CJ, Cook VL, Schott HC.The objective of this study was to determine whether there was an association between type of colloid administered and survival of horses with enterocolitis (N = 92). A retrospective review of medical records of horses with enterocolitis treated with plasma or hetastarch (HES) between January 1, 2005 and December 31, 2011 was performed. Data collected included signalment, outcome, physical and clinicopathologic findings, and volume and type of colloid administered. Sixty-nine horses (75%) were treated with plasma and 23 horses (25%) were treated with HES. After accounting for confounding varia...
Prinsloo M, Hynd P, Franklin S, Weaver S, van den Boom R.Equine squamous gastric disease (ESGD) is common in horses and many factors, including stress, may play a role in lesion development. Hair cortisol concentration (HCC) provides a measure of medium to long-term stress and therefore, the relationship between HCC and ESGD was examined in this study. Hair samples were collected from 25 horses and gastroscopy was performed to determine the presence and severity of ESGD. Hair cortisol concentrations were lower in horses with ESGD (P = 0.014), and negatively correlated with lesion severity. Mares had lower HCC than geldings (P = 0.031), and a...
Dembek KA, Johnson LM, Timko KJ, Minuto JS, Hart KA, Barr BS, Toribio RE.The hypothalamic-pituitary-adrenal axis regulates the response to sepsis-associated stress. Relative adrenal insufficiency or adrenocorticotropic hormone (ACTH):cortisol imbalance, defined as a poor cortisol response to administration of ACTH, is common and associated with death in hospitalized foals. However, information on other adrenal steroid response to ACTH stimulation in sick foals is minimal. Objective: To investigate the response of multiple adrenocortical steroids to administration of ACTH in foals. Methods: Hospitalized (n = 34) and healthy (n = 13) foals. Methods: In this prospecti...
Contreras-Aguilar MD, Martínez-Subiela S, Cerón JJ, Martín-Cuervo M, Tecles F, Escribano D.Salivary biomarkers could be useful to objectively evaluate critical illness and prognosis for survival in horses with acute abdominal disease. Objective: To compare salivary alpha-amylase (sAA) activity and concentration in healthy horses and horses with acute abdominal disease, and evaluate the association between sAA activity and concentration with disease severity and outcome. Methods: A prospective cohort. Methods: sAA activity, measured using a colorimetric commercial kit, and concentration, measured using a Time-resolved immunofluorometric assay, in 25 healthy horses and in 33 horses wi...
Kamr AM, Dembek KA, Hildreth BE, Morresey PR, Rathgeber RA, Burns TA, Zaghawa AA, Toribio RE.Fibroblast growth factor-23 (FGF-23) and klotho are key regulators of vitamin D and parathyroid hormone (PTH) synthesis as well as phosphorus and calcium homeostasis; however, information on the FGF-23/klotho axis in healthy and hospitalised foals is lacking. Objective: The aims of this study were to measure serum FGF-23 and klotho concentrations and determine their association with serum phosphorus, total calcium (TCa), vitamin D metabolite [25(OH)D, 1,25(OH)2 D], PTH, and aldosterone concentrations, disease severity, and mortality in hospitalised foals. Methods: Prospective, multicentre, cro...
Bullone M, Joubert P, Gagné A, Lavoie JP, Hélie P.The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. Objective: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia. Methods: Observational retrospective study. Methods: Pe...
Dembek KA, Timko KJ, Johnson LM, Hart KA, Barr BS, David B, Burns TA, Toribio RE.Hypothalamic-pituitary-adrenal axis (HPAA) dysfunction has been associated with sepsis and mortality in foals. Most studies have focused on cortisol, while other steroids have not been investigated. The objectives of this study were to characterise the adrenal steroid and steroid precursor response to disease and to determine their association with the HPAA response to illness, disease severity, and mortality in hospitalised foals. All foals (n=326) were classified by two scoring systems into three categories: based on the sepsis score (septic, sick non-septic [SNS] and healthy) and the foal s...
Secombe CJ, Lester GD, Krockenberger MB.Cryptococcus is the most common fungal respiratory pathogen in Australian horses, manifesting primarily as pulmonary granulomas. Disease severity at presentation is dependent on the athletic use of the horse. The diagnosis and estimation of disease severity are centred around clinical findings, cytological evaluation of respiratory tract secretions, diagnostic imaging, and antigen titre testing. Both the lateral flow assay and the latex cryptococcal antigen titre are used, and important similarities and differences between species are discussed. Cryptococcus gattii occurs with greater frequenc...
Lambert JL, Fernandez NJ, Roy MF.Band cells and toxic neutrophils are thought to indicate acute and severe systemic illness but no studies have investigated their importance in adult equine emergency admissions. Objective: The objective of this study was to evaluate the association of band cells and toxic neutrophils with systemic inflammatory response syndrome (SIRS) and outcome in horses. Methods: One hundred and five adult horses admitted on emergency basis to a private primary referral practice. Methods: Prospective observational study with sample collection. All horses admitted on emergency basis over the study period we...
Ven S, Decloedt A, Van Der Vekens N, De Clercq D, van Loon G.Aortic regurgitation (AR) in horses can lead to left ventricular (LV) eccentric hypertrophy, ventricular arrhythmia and heart failure. Objective quantification of the severity of regurgitation is difficult. The aim of this study was to evaluate dimensional measurements, systolic time intervals and blood flow velocities, acquired by standard 2D, M-mode and pulsed wave Doppler echocardiography, for quantification of AR. Echocardiography was performed in 32 healthy horses and 35 horses with AR that were subdivided in three groups (mild, moderate or severe AR). From the recorded images LV, left at...
Bauquier JR, Forbes G, Nath L, Tudor E, Bailey SR.Acute gastrointestinal disease occurs commonly in horses. Novel biomarkers might improve the understanding of SIRS and aid diagnosis and determination of prognosis. Objective: Increased plasma concentrations of the biomarkers HMGB-1 and nucleosomes are associated with severity of gastrointestinal lesions in horses; concentrations of these biomarkers will be greater in horses with lesions more likely to cause SIRS; and will provide additional information compared with standard biomarkers fibrinogen and SAA. Methods: Thirty horses with gastrointestinal disease, 22 healthy horses. Methods: Prospe...
Boado A, López-Sanromán FJ.Articular osteochondrosis (OC) is commonly reported in horses but there are no reports of its prevalence in the Spanish Purebred (SP). The objective of this study was to assess the prevalence and characteristics of OC of the tarsocrural, dorsal metacarpo-metatarsophalangeal and femoropatellar joints in the SP in a retrospective study. The data were obtained from the radiographs of 309 SP horses and the prevalence and characteristics of lesions were calculated. Osteochondral lesions at predilected sites were diagnosed in 48.8% of the horses. It was more common to find the presence of fragments ...
Neundorf RH, Lowerison MB, Cruz AM, Thomason JJ, McEwen BJ, Hurtig MB.To determine the prevalence and severity of osteoarthritis in the metacarpophalangeal joints of Thoroughbred racehorses via development and validation of a quantitative macroscopic evaluation system. Methods: Metacarpophalangeal joints from 50 Thoroughbred racehorses. Methods: Joints were collected from horses that died or were euthanized within 60 days of racing. Metacarpophalangeal joints were assessed for osteoarthritic degeneration by use of macroscopic and histologic scoring systems, polarized light microscopy, and cartilage biochemical analysis. The global macroscopic score for the entir...
Hart KA, Slovis NM, Barton MH.Transient hypothalamic-pituitary-adrenal (HPA) axis dysfunction occurs frequently in critically ill humans and impacts survival. The prevalence and impact of HPA axis dysfunction in critically ill neonatal foals are not well characterized. Objective: (1) HPA axis dysfunction occurs in hospitalized neonatal foals, and is characterized by inappropriately low basal serum cortisol concentration or inadequate cortisol response to exogenous adrenocorticotropic hormone (ACTH); (2) hospitalized foals with HPA axis dysfunction have more severe disease and are less likely to survive than hospitalized fo...
Bullone M, Joubert P, Gagné A, Lavoie JP, Hélie P.The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. Objective: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia. Methods: Observational retrospective study. Methods: Pe...
Dembek KA, Timko KJ, Johnson LM, Hart KA, Barr BS, David B, Burns TA, Toribio RE.Hypothalamic-pituitary-adrenal axis (HPAA) dysfunction has been associated with sepsis and mortality in foals. Most studies have focused on cortisol, while other steroids have not been investigated. The objectives of this study were to characterise the adrenal steroid and steroid precursor response to disease and to determine their association with the HPAA response to illness, disease severity, and mortality in hospitalised foals. All foals (n=326) were classified by two scoring systems into three categories: based on the sepsis score (septic, sick non-septic [SNS] and healthy) and the foal s...
Lambert JL, Fernandez NJ, Roy MF.Band cells and toxic neutrophils are thought to indicate acute and severe systemic illness but no studies have investigated their importance in adult equine emergency admissions. Objective: The objective of this study was to evaluate the association of band cells and toxic neutrophils with systemic inflammatory response syndrome (SIRS) and outcome in horses. Methods: One hundred and five adult horses admitted on emergency basis to a private primary referral practice. Methods: Prospective observational study with sample collection. All horses admitted on emergency basis over the study period we...
Secombe CJ, Lester GD, Krockenberger MB.Cryptococcus is the most common fungal respiratory pathogen in Australian horses, manifesting primarily as pulmonary granulomas. Disease severity at presentation is dependent on the athletic use of the horse. The diagnosis and estimation of disease severity are centred around clinical findings, cytological evaluation of respiratory tract secretions, diagnostic imaging, and antigen titre testing. Both the lateral flow assay and the latex cryptococcal antigen titre are used, and important similarities and differences between species are discussed. Cryptococcus gattii occurs with greater frequenc...
Hart KA, Barton MH, Ferguson DC, Berghaus R, Slovis NM, Heusner GL, Hurley DJ.Relative cortisol insufficiency occurs in septic foals and impacts survival. Serum free (biologically available) cortisol concentration might be a better indicator of physiologic cortisol status than serum total cortisol concentration in foals. Objective: In septic foals, (1) low free cortisol concentration correlates with disease severity and survival and (2) predicts disease severity and outcome better than total cortisol concentration. Methods: Fifty-one septic foals; 11 healthy foals; 6 healthy horses. Methods: In this prospective clinical study, foals meeting criteria for sepsis at admiss...
Prinsloo M, Hynd P, Franklin S, Weaver S, van den Boom R.Equine squamous gastric disease (ESGD) is common in horses and many factors, including stress, may play a role in lesion development. Hair cortisol concentration (HCC) provides a measure of medium to long-term stress and therefore, the relationship between HCC and ESGD was examined in this study. Hair samples were collected from 25 horses and gastroscopy was performed to determine the presence and severity of ESGD. Hair cortisol concentrations were lower in horses with ESGD (P = 0.014), and negatively correlated with lesion severity. Mares had lower HCC than geldings (P = 0.031), and a...
Haralambus R, Burgstaller J, Klukowska-Rötzler J, Steinborn R, Buchinger S, Gerber V, Brandt S.Sarcoids are nonmetastasising, yet locally aggressive skin tumours that constitute the most frequent neoplasm in equids. Infection by bovine papillomaviruses types 1 and 2 (BPV-1, BPV-2) has been recognised as major causative factor in sarcoid pathogenesis, but a possible correlation of intralesional virus load with disease severity has not been established thus far. Objective: Given the pathogenic role of BPV-1 and BPV-2 in sarcoid disease, we suggest that intralesional viral DNA concentration may reflect the degree of affection. Methods: Severity of disease was addressed by recording the tum...
Contreras-Aguilar MD, Martínez-Subiela S, Cerón JJ, Martín-Cuervo M, Tecles F, Escribano D.Salivary biomarkers could be useful to objectively evaluate critical illness and prognosis for survival in horses with acute abdominal disease. Objective: To compare salivary alpha-amylase (sAA) activity and concentration in healthy horses and horses with acute abdominal disease, and evaluate the association between sAA activity and concentration with disease severity and outcome. Methods: A prospective cohort. Methods: sAA activity, measured using a colorimetric commercial kit, and concentration, measured using a Time-resolved immunofluorometric assay, in 25 healthy horses and in 33 horses wi...
Perkins GA, Yeager A, Erb HN, Nydam DV, Divers TJ, Bowman JL.The purpose of this study was to determine if colostrum-deprived foals with experimentally induced Rhodococcus equi pneumonia have a decreased severity of the disease and decreased mortality rate when given hyperimmune (HI) R. equi antibody plasma (R. equi titer at least 100 % and virulence-associated protein A [VapA] at least 10000) prophylactically versus when given normal equine plasma (R. equi titer less than 20 % and VapA less than 160). Sixteen colostrum-deprived foals (R. equi titer less than 5 %) each received normal equine plasma in the first 24 hours of life (R. equi titer less than ...
Himler M, Hurcombe SD, Griffin A, Barsnick RJ, Rathgeber RA, MacGillivray KC, Toribio RE.Hypothalamic-pituitary-thyroid (HPT) axis dysfunction is associated with morbidity and mortality in critically ill people. To date, investigations of HPT axis in critically ill foals are limited. Objective: To document the occurrence of low thyroid hormone concentrations (presumptive nonthyroidal illness syndrome; NTIS) in critically ill newborn foals and investigate whether NTIS is associated with severity of disease and outcome. Objective: NTIS occurs frequently in foals with sepsis and is associated with sepsis score and outcome. Reverse T3 (rT3) concentrations will be increased in septic f...
Tennent-Brown BS, Wilkins PA, Lindborg S, Russell G, Boston RC.Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point-of-care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses. Objective: It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory-based measurement of [LAC]. Methods: The study included adult horses presented for emergency evaluation. Methods: A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend...
Bauquier JR, Forbes G, Nath L, Tudor E, Bailey SR.Acute gastrointestinal disease occurs commonly in horses. Novel biomarkers might improve the understanding of SIRS and aid diagnosis and determination of prognosis. Objective: Increased plasma concentrations of the biomarkers HMGB-1 and nucleosomes are associated with severity of gastrointestinal lesions in horses; concentrations of these biomarkers will be greater in horses with lesions more likely to cause SIRS; and will provide additional information compared with standard biomarkers fibrinogen and SAA. Methods: Thirty horses with gastrointestinal disease, 22 healthy horses. Methods: Prospe...
Dembek KA, Johnson LM, Timko KJ, Minuto JS, Hart KA, Barr BS, Toribio RE.The hypothalamic-pituitary-adrenal axis regulates the response to sepsis-associated stress. Relative adrenal insufficiency or adrenocorticotropic hormone (ACTH):cortisol imbalance, defined as a poor cortisol response to administration of ACTH, is common and associated with death in hospitalized foals. However, information on other adrenal steroid response to ACTH stimulation in sick foals is minimal. Objective: To investigate the response of multiple adrenocortical steroids to administration of ACTH in foals. Methods: Hospitalized (n = 34) and healthy (n = 13) foals. Methods: In this prospecti...
Tennent-Brown B.Admission blood lactate concentration is widely used as a prognostic indicator in equine medicine and can be a useful indicator of disease severity but typically fails to completely discriminate survivors from nonsurvivors. Increased admission lactate concentrations in adult horses typically return to normal within 12 to 24 hours. Lactate concentrations in neonatal foals are higher than adult concentrations for the first 24 to 72 hours of life. Serial measures reflecting both the magnitude and duration of hyperlactatemia might enable more accurate prognostication and provide insight into dis...
Ven S, Decloedt A, Van Der Vekens N, De Clercq D, van Loon G.Aortic regurgitation (AR) in horses can lead to left ventricular (LV) eccentric hypertrophy, ventricular arrhythmia and heart failure. Objective quantification of the severity of regurgitation is difficult. The aim of this study was to evaluate dimensional measurements, systolic time intervals and blood flow velocities, acquired by standard 2D, M-mode and pulsed wave Doppler echocardiography, for quantification of AR. Echocardiography was performed in 32 healthy horses and 35 horses with AR that were subdivided in three groups (mild, moderate or severe AR). From the recorded images LV, left at...
Doxey DL, Pogson DM, Milne EM, Gilmour JS, Chisholm HK.Damage to the neurons of selected autonomic ganglia was quantified in relation to the severity of the clinical signs shown in acute, subacute and chronic cases of dysautonomia (grass sickness). No connection between the clinical severity of acute or subacute dysautonomia and the amount of neuronal damage in the superior cervical, stellate and coeliaco-mesenteric ganglia could be demonstrated. However, a higher proportion of normal neurons were found in chronic cases. Jejunal submucosal neuronal damage was correlated with clinical severity but further work is required to confirm this finding an...
Krause JB, McKenzie HC.Adequate nutritional support of sick foals in critical care is an important aspect of treatment. When enteral feeding is contraindicated, parenteral nutrition (PN) provides a source of energy and protein. However, no study has critically assessed the use of PN in a large group of foals. Objective: The administration of PN to clinically ill foals was examined retrospectively to determine the effects of PN formulation and variables on the incidence of PN-associated complications and outcome. Objective: There was no effect of PN formula on 1) the occurrence or type of complications; 2) of PN form...
Collatos C, Barton MH, Prasse KW, Moore JN.Components of the coagulation and fibrinolytic cascades, prothrombin and activated partial thromboplastin times, endotoxin activity, and albumin concentration were measured in blood and peritoneal fluid from 20 healthy horses and from 153 horses with acute gastrointestinal tract diseases at admission. Overall, 77% (117/153) of affected horses survived to discharge from the hospital, and 85% (82/97) of horses discharged were reported to be normal 9 to 14 months later. Significant differences in hemostatic factors were more common in peritoneal fluid than in blood. Tissue plasminogen activator, ...
Swanson TD.The purpose of this article is to describe the clinical features present in the patient affected with acute laminitis. The variations in the stance and characteristic lameness of the acute disease are described in relation to the disease severity and limb involvement. The elements of establishing a diagnosis including clinical history, physical and radiologic evaluation, and differential diagnosis are discussed. Difficulties and criteria used in establishing a prognosis of the acute phase patient are defined.
Doxey DL, Milne EM, Woodman MP, Gilmour JS, Chisholm HK.The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribut...
Arens AM, Puchalski SM, Whitcomb MB, Bell R, Gardner IA, Stover SM.To define scintigraphic, physical examination, and scapular ultrasonographic findings consistent with bone fragility syndrome (BFS) in horses; develop indices of BFS severity; and assess accuracy of physical examination, scapular ultrasonography, and serum biomarkers for BFS diagnosis. Methods: Prospective case-control study. Methods: 48 horses (20 horses with BFS and 28 control horses). Methods: Horses underwent forelimb scintigraphic evaluation, physical examination, scapular ultrasonography, and serum collection. Scintigraphy was used as a reference standard to which physical examination, s...
Wilkinson JS.The normal plasma osmotic pressure was established in 205 Thoroughbred horses. Samples taken from horses suffering from a variety of diseases showed that measurement of this parameter might prove a valuable non specific test for assessing the severity of some diseases in which there are alterations in metabolism.
Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE.Information on steroids derived from the adrenal glands, gonads, or fetoplacental unit is minimal in newborn foals. Objective: To measure androgen concentrations in serum and determine their association with disease severity and outcome in hospitalized foals. Methods: Hospitalized (n = 145) and healthy (n = 80) foals. Methods: Prospective, multicenter, cross-sectional study. Foals of ≤3 days of age from 3 hospitals and horse farms were classified as healthy and hospitalized (septic, sick nonseptic, neonatal maladjustment syndrome [NMS]) based on physical exam, medical history, and laborato...
Higgins JC, Pusterla N, Pappagianis D.A retrospective study was performed to determine if there is an association between serological Coccidioides immitis antibody titres (IgG) and form/severity of coccidioidal disease in horses, and to identify trends in survival and treatment success based on the form of the disease. Data were obtained on horses with positive serological titres tested at the Coccidioidomycosis Serology Laboratory, School of Medicine, University of California, Davis from 1981 to 2004. Thirty-nine cases in which a diagnosis of coccidioidomycosis had been made were selected for inclusion. Six distinct categories we...
Close K, Epstein KL, Sherlock CE.To (1) compare postoperative complications and survival in horses after small intestinal resection and anastomosis using 2 anastomosis techniques (single layer Lembert; double layer simple continuous oversewn with Cushing), and (2) to compare outcome by anastomosis type (jejunoileostomy; jejunojejunostomy). Methods: Retrospective case series. Methods: Horses (n = 53). Methods: Medical records (July 2006-July 2010) of all horses that had small intestinal resection and anastomosis. Horses were divided into groups based on technique and type of anastomosis. Comparisons of pre- and intraoperative ...
Naylor RJ, Livesey L, Schumacher J, Henke N, Massey C, Brock KV, Fernandez-Fuente M, Piercy RJ.Equine type 1 polysaccharide storage myopathy (PSSM1), a common glycogenosis associated with an R309H founder mutation in the glycogen synthase 1 gene (GYS1), shares pathological features with several human myopathies. In common with related human disorders, the pathogenesis remains unclear in particular, the marked phenotypic variability between affected animals. Given that affected animals accumulate glycogen and alpha-crystalline polysaccharide within their muscles, it is possible that physical disruption associated with the presence of this material could exacerbate the phenotype. The aim ...
Larson EM, Wagner B.Horses have many naturally occurring diseases that mimic similar conditions in humans. The ability to conduct environmentally controlled experiments and induced disease studies in a genetically diverse host makes the horse a valuable intermediate model between mouse studies and human clinical trials. This review highlights important similarities in the immune landscape between horses and humans using current research on two equine diseases as examples. First, equine herpesvirus type 1 (EHV-1) infection initiates a series of innate inflammatory signals at its mucosal entry site in the upper res...
Siwinska N, Zak A, Slowikowska M, Krupinska P, Niedzwiedz A.Asthma is one of the most common non-infectious respiratory diseases in horses. Ultrasound examination is a widely available non-invasive additional diagnostic tool. To date, there are no studies focusing on ultrasonographic findings in horses with asthma. The aim of this study was to analyse the prevalence and severity of ultrasound lesions in lung tissue in horses with asthma. Lung ultrasonography was carried out on six healthy horses (controls) and 12 horses with asthma (six with mild and six with severe asthma). The sonographic changes in three lung sections were assessed using a scoring s...