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Topic:Equine Diseases

Equine diseases encompass a wide range of health conditions that can affect horses, including infectious diseases, metabolic disorders, and genetic conditions. These diseases can impact the overall health, performance, and well-being of horses. Common equine diseases include equine influenza, equine herpesvirus, laminitis, and equine metabolic syndrome. Diagnosis and management of these diseases often require a combination of clinical evaluation, laboratory testing, and appropriate treatment strategies. This page gathers peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment options for various equine diseases, providing valuable insights for veterinarians and researchers in the field.
Comparative studies on the histological characteristics of equine nasomaxillary aperture and paranasal sinus mucosa considering topographic and age-related differences.
Acta veterinaria Scandinavica    June 23, 2020   Volume 62, Issue 1 34 doi: 10.1186/s13028-020-00534-2
Schwieder A, Pfarrer C, Ohnesorge B, Staszyk C, Bienert-Zeit A.Horses may acquire a range of paranasal sinus diseases. Clinical studies show slight differences regarding anatomical regions and age. Histopathological examination of tissue samples could play an important role in the diagnostic process. Therefore, detailed knowledge of the histological appearance of the paranasal sinus mucosa (PSM) and the nasomaxillary aperture mucosa (NAM) is essential. The objective of this study was to determine topographic and age-related differences within the healthy equine PSM. In addition, we aimed to gain detailed knowledge of the histological appearance of the NAM...
Survey of Serum Amyloid A and Bacterial and Viral Frequency Using qPCR Levels in Recently Captured Feral Donkeys from Death Valley National Park (California).
Animals : an open access journal from MDPI    June 23, 2020   Volume 10, Issue 6 1086 doi: 10.3390/ani10061086
Jerele S, Davis E, Mapes S, Pusterla N, Navas González FJ, Iglesias Pastrana C, Abdelfattah EM, McLean A.Feral donkey removal from state land has raised concerns in terms of disease transmission between equine species. Disease outbreaks may occur as a result of the relocation of animals to new environments. Virus and bacteria DNA load and serum amyloid A derived from the pathogenic processes that they involve were measured in recently captured donkeys. Blood and nasal swabs were collected from 85 donkeys (Death Valley National Park, Shoshone, California); 24 were retested after 30/60 days in the Scenic (Arizona) long-term holding facility co-mingled with feral donkeys from Arizona and Utah. Quant...
Clinically and temporally specific diagnostic thresholds for plasma ACTH in the horse.
Equine veterinary journal    June 23, 2020   Volume 53, Issue 2 250-260 doi: 10.1111/evj.13292
Durham AE, Clarke BR, Potier JFN, Hammarstrand R, Malone GL.Pituitary pars intermedia dysfunction (PPID) is commonly investigated using plasma ACTH concentrations but problems exist with currently available diagnostic thresholds. Objective: To derive temporally specific diagnostic thresholds for equine plasma ACTH concentration to be used alongside clinical judgement in each individual week of the year and appropriate for the degree of clinical suspicion in any given case. Furthermore, to apply these thresholds to compare the prevalence of high and low ACTH in two subgroups of animals with high and low clinical suspicion of PPID. Methods: A retrospecti...
Replication of Equine arteritis virus is efficiently suppressed by purine and pyrimidine biosynthesis inhibitors.
Scientific reports    June 22, 2020   Volume 10, Issue 1 10100 doi: 10.1038/s41598-020-66944-4
Valle-Casuso JC, Gaudaire D, Martin-Faivre L, Madeline A, Dallemagne P, Pronost S, Munier-Lehmann H, Zientara S, Vidalain PO, Hans A.RNA viruses are responsible for a large variety of animal infections. Equine Arteritis Virus (EAV) is a positive single-stranded RNA virus member of the family Arteriviridae from the order Nidovirales like the Coronaviridae. EAV causes respiratory and reproductive diseases in equids. Although two vaccines are available, the vaccination coverage of the equine population is largely insufficient to prevent new EAV outbreaks around the world. In this study, we present a high-throughput in vitro assay suitable for testing candidate antiviral molecules on equine dermal cells infected by EAV. Using t...
Letter to the Editor: Venezuelan Equine Encephalitis virus 1B Invasion and Epidemic Control-South Texas, 1971.
Tropical medicine and infectious disease    June 22, 2020   Volume 5, Issue 2 104 doi: 10.3390/tropicalmed5020104
McLean RG.The epidemic strain of Venezuelan equine encephalitis virus (VEE) 1B invaded south Texas in 1971. The success of the eventual containment and control of the virus invasion was the early recognition and immediate detection, cooperation, coordination, and participation among multiple federal agencies. There were 4739 wild vertebrate animals trapped on a ranch in the area with only 1 VEE virus isolation from a Virgina opossum (Didelphis virginiana). A large number of mosquitoes were also collected on the ranch and tested, resulting in 240 VEE virus isolations. Virus isolations were obtained from ...
First outbreak of autochthonous “surra” in horses in Santa Catarina State, Brazil: Parasitological, hematological and biochemical characteristics.
Veterinary parasitology, regional studies and reports    June 21, 2020   Volume 21 100427 doi: 10.1016/j.vprsr.2020.100427
Reck C, Menin Á, Pisetta NL, Batista F, Miletti LC.This study reports the first autochthonous "surra" outbreak in horses in the State of Santa Catarina, southern Brazil. Six horses with clinical suspicion of trypanosomosis had the natural infection by T. evansi confirmed by PCR and rapid serum agglutination test. Clinical, parasitological, and hematology evaluations were performed at initial observation (T0) and 90 days after (T1). At T0, all animals that tested positive for T. evansi in PCR presented with severe clinical signs and out of normal range hematological hematological (hematocrit, leukocytes, platelets, hemoglobin) and serum bioche...
Meta-analysis of the Effect of Treatment Strategies for Nephrosplenic Entrapment of the Large Colon.
Journal of equine veterinary science    June 20, 2020   Volume 92 103169 doi: 10.1016/j.jevs.2020.103169
Gillen A, Kottwitz J, Munsterman A.A variety of treatment strategies for nephrosplenic entrapment of the large colon are reported, with conflicting evidence in the published literature as to the preferred treatment option. The aim of this study is to provide a systematic meta-analytical assessment of the efficacy of different treatment strategies in horses with confirmed or suspected nephrosplenic entrapment. This study involves meta-analysis including nonrandomized studies. A comprehensive literature search was performed from January 1970 to January 2017. Inclusion criteria were retrospective studies involving horses with conf...
High Frequencies of TNC and COL5A1 Genotypes Associated With Low Risk for Superficial Digital Flexor Tendinopathy in Greek Indigenous Horse Breeds Compared With Warmblood Horses.
Journal of equine veterinary science    June 20, 2020   Volume 92 103173 doi: 10.1016/j.jevs.2020.103173
Giantsis IA, Diakakis NE, Avdi M.Tendinopathies constitute a very common category of musculoskeletal disorders, causing economic losses in the equine industry and animal welfare issues in horse populations. Sport and racehorses are in general sensitive to tendinopathies, whereas local indigenous horse populations are often more tolerant to various disorders. Particularly, indigenous Greek horse breeds have evolved and adapted in the rough topographic features of mountainous and semimountainous Greek terrain and are less prone to develop tendinopathies. Susceptibility to tendinopathy has been proposed to be associated with thr...
In slow pace towards the proteome of equine body fluids.
Journal of proteomics    June 19, 2020   Volume 225 103880 doi: 10.1016/j.jprot.2020.103880
Chiaradia E, Miller I.Equine medicine represents a relevant field of veterinary science and the horse industry generates a significant economic impact. Horses can be involved in different sport disciplines, meat production, work and recreational purposes. Horses are also important for human health as they can be used as animal models for studying human diseases and in equine-assisted therapy. This review summarizes the data related to body fluids such as plasma/serum, urine, cerebrospinal fluid, synovial fluid, saliva, bronchoalveolar lavage fluid and peritoneal fluid obtained using proteomic analysis. Horse body f...
Effect of gallium maltolate on a model of chronic, infected equine distal limb wounds.
PloS one    June 19, 2020   Volume 15, Issue 6 e0235006 doi: 10.1371/journal.pone.0235006
Lawless SP, Cohen ND, Lawhon SD, Chamoun-Emanuelli AM, Wu J, Rivera-Vélez A, Weeks BR, Whitfield-Cargile CM.Distal limb wounds are common injuries sustained by horses and their healing is fraught with complications due to equine anatomy, prevalence of infection, and challenges associated with wound management. Gallium is a semi-metallic element that has been shown to possess antimicrobial properties and aid in wound healing in various preclinical models. The effects of Gallium have not been studied in equine wound healing. Therefore, the objective of this study was to compare healing rates between gallium-treated and untreated wounds of equine distal limbs and to demonstrate the antimicrobial effect...
Detection of Theileria spp. in ticks, sheep keds (Melophagus ovinus), and livestock in the eastern Tibetan Plateau, China.
Parasitology research    June 18, 2020   Volume 119, Issue 8 2641-2648 doi: 10.1007/s00436-020-06757-6
Hao L, Yuan D, Li S, Jia T, Guo L, Hou W, Lu Z, Mo X, Yin J, Yang A, Zheng W, Li R.Theileria species, with a broad geographic distribution, infect a wide range of both domestic and wild animals and are transmitted by ixodid ticks. Currently, there is no comprehensive report regarding the distribution of Theileria spp. in the eastern Tibetan Plateau, especially in Ganze Tibetan autonomous prefecture (153,700 km) and Ngawa Tibetan and Qiang autonomous prefecture (84,242 km) of Sichuan province, China. In this study, we collected blood samples from yaks (n = 144) (Bos grunniens), Tibetan sheep (n = 92), and Tibet horses (n = 142) in Ganze and Ngawa.Theileria sinen...
Skin exhibits of Dark Ronald XX are homozygous wild type at the Warmblood fragile foal syndrome causative missense variant position in lysyl hydroxylase gene PLOD1.
Animal genetics    June 17, 2020   Volume 51, Issue 5 838-840 doi: 10.1111/age.12972
Zhang X, Hirschfeld M, Schafberg R, Swalve H, Brenig B.No abstract available
Molecular evidence of Babesia caballi and Theileria equi in equines and ticks in Nigeria: prevalence and risk factors analysis.
Parasitology    June 17, 2020   Volume 147, Issue 11 1238-1248 doi: 10.1017/S0031182020000992
Onyiche TE, Taioe MO, Ogo NI, Sivakumar T, Biu AA, Mbaya AW, Xuan X, Yokoyama N, Thekisoe O.Babesia caballi and Theileria equi are biological agents responsible for equine piroplasmosis (EP). We conducted a robust and extensive epidemiological study in Nigeria on the prevalence and risk factors of EP. Blood (468, both horses and donkeys) and ticks (201 pools) were screened using polymerase chain reaction (PCR). DNA of equine piroplasms was observed in tick pools with B. caballi amplified in Rhipicephalus evertsi evertsi only [minimum infection rate (MIR) of 7.6%] while T. equi was observed in R. e. evertsi (MIR, 61.6%), Hyalomma dromedarii (MIR, 23.7%) and H. truncatum (MIR, 50.0%). ...
A bitless bridle does not limit or prevent dynamic laryngeal collapse.
Equine veterinary journal    June 17, 2020   Volume 53, Issue 1 44-50 doi: 10.1111/evj.13287
Fretheim-Kelly Z, Fjordbakk CT, Fintl C, Krontveit R, Strand E.Bits have often been incriminated as a cause of upper respiratory tract obstruction in horses; however, no scientific studies are available to confirm or refute these allegations. Clinical signs of dynamic laryngeal collapse associated with poll flexion (DLC) are induced when susceptible horses are ridden or driven into the bit. Objective: To determine whether use of Dr Cook's™ Bitless Bridle, instead of a conventional snaffle bit bridle, would reduce the severity of DLC in affected horses measured objectively using inspiratory tracheal pressures. Methods: Intervention study using each horse...
Identification of monoclonal antibodies suitable for blocking IGF-1 receptors in the horse.
Domestic animal endocrinology    June 17, 2020   Volume 74 106510 doi: 10.1016/j.domaniend.2020.106510
Rahnama S, Vathsangam N, Spence R, Anderson ST, de Laat MA, Bailey S, Sillence MN.Prolonged hyperinsulinemia is thought to be the cause of equine endocrinopathic laminitis, a common and crippling disease of the foot, for which there are no pharmacologic treatments other than pain relief. It has been suggested that insulin causes its effects on the lamellae by activating IGF-1 receptors (IGF-1R), as insulin receptors (InsR) are scarce in this tissue, whereas IGF-1R are abundant and become downregulated after prolonged insulin infusion. As a first step toward confirming this mechanism and beginning to develop a therapeutic anti-IGF-1R monoclonal antibody (mAb) for horses, it ...
Mycotoxicoses in veterinary medicine: Aspergillosis and penicilliosis.
Veterinary research forum : an international quarterly journal    June 15, 2020   Volume 11, Issue 2 97-103 doi: 10.30466/vrf.2020.112820.2686
Malekinejad H, Fink-Gremmels J.Molds and mycotoxins are contaminants of animal feed causing spoilage and clinical intoxication. Animal exposure to mycotoxins reflects diet composition with major differences occurring between animals kept predominantly of pastures, i.e. ruminants and horses, and those consuming formulated feed like pigs and poultry. Mixed feeds are composed of several ingredients, often sourced from different continents. Subsequently, practitioners may confront endemic diseases and signs of toxin exposure related to toxins imported accidentally with contaminated feed materials from other countries and contin...
Assessment of the anti-inflammatory and engraftment potential of horse endometrial and adipose mesenchymal stem cells in an in vivo model of post breeding induced endometritis.
Theriogenology    June 14, 2020   Volume 155 33-42 doi: 10.1016/j.theriogenology.2020.06.010
Navarrete F, Saravia F, Cisterna G, Rojas F, Silva PP, Rodríguez-Alvarez L, Rojas D, Cabezas J, Mançanares ACF, Castro FO.Horse mesenchymal stem cells (MSC) are potential anti-inflammatory tools for post-breeding induced endometritis (PBIE). In this research MSCs isolated from the endometrium or subcutaneous fat of the same donors were infused iu into mares with PBIE for assessment of their anti-inflammatory action and engraftment. PBIE was induced in nine gynecologically healthy mares by iu infusion of 500 million dead sperm in saline. Inflammatory markers were analyzed in uterine lavages and biopsies immediately before (phase I) and 3 h after infusion of sperm (phase II). Measurements: polymorph nuclear cells ...
Expression of enzymes involved in polyunsaturated fatty acid synthesis in the stallion testis and epididymis.
Reproduction, fertility, and development    June 13, 2020   Volume 32, Issue 9 851-861 doi: 10.1071/RD19342
Gautier C, Scarlet D, Ertl R, Walter I, Wulf M, Nagel C, Aurich J, Aurich C.The aim of the present study was to characterise key enzymes involved in polyunsaturated fatty acid (PUFA) synthesis in the testis and epididymis collected from 2-year-old healthy warmblood stallions (n=10). The mRNA expression of fatty acid synthase, the Δ9-, Δ6-, Δ5- and Δ4-desaturases and elongases 6, 5 and 2 (encoded by the fatty acid synthase (FASN), the stearoyl-CoA desaturase (SCD), the fatty acid desaturase 2 (FADS2), the fatty acid desaturase 1 (FADS1), the delta 4-desaturase, sphingolipid 1 (DEGS1), ELOVL fatty acid elongase 6(ELOVL6), ELOVL fatty acid elongase 5 (ELOVL5), ELOVL ...
Science-in-brief: Risk assessment for reducing injuries of the fetlock bones in Thoroughbred racehorses.
Equine veterinary journal    June 12, 2020   Volume 52, Issue 4 482-488 doi: 10.1111/evj.13273
Colgate VA, Marr CM.No abstract available
Env diversity-dependent protection of the attenuated equine infectious anaemia virus vaccine.
Emerging microbes & infections    June 12, 2020   Volume 9, Issue 1 1309-1320 doi: 10.1080/22221751.2020.1773323
Lin Y, Wang XF, Wang Y, Du C, Ren H, Liu C, Zhu D, Chen J, Na L, Liu D, Yang Z, Wang X.Lentiviruses harbour high genetic variability for efficient evasion from host immunity. An attenuated equine infectious anaemia (EIA) vaccine was developed decades ago in China and presented remarkably robust protection against EIA. The vaccine was recently proven to have high genomic diversity, particular in . However, how and to what extent the high diversity relates to immune protection remains unclear. In this study, we compared immune protections and responses of three groups of horses stimulated by the high-diversity vaccine EIAV_HD, a single molecular clone of the vaccine EIAV_LD with ...
Differential Proteomic Expression of Equine Cardiac and Lamellar Tissue During Insulin-Induced Laminitis.
Frontiers in veterinary science    June 12, 2020   Volume 7 308 doi: 10.3389/fvets.2020.00308
Campolo A, Frantz MW, de Laat MA, Hartson SD, Furr MO, Lacombe VA.Endocrinopathic laminitis is pathologically similar to the multi-organ dysfunction and peripheral neuropathy found in human patients with metabolic syndrome. Similarly, endocrinopathic laminitis has been shown to partially result from vascular dysfunction. However, despite extensive research, the pathogenesis of this disease is not well elucidated and laminitis remains without an effective treatment. Here, we sought to identify novel proteins and pathways underlying the development of equine endocrinopathic laminitis. Healthy Standardbred horses ( = 4/group) were either given an electrolyte in...
Molecular Analysis and Risk Factors Associated With Theileria equi Infection in Domestic Donkeys and Mules of Punjab, Pakistan.
Journal of equine veterinary science    June 12, 2020   Volume 92 103164 doi: 10.1016/j.jevs.2020.103164
Shah MH, Ijaz M, Ahmed A, Aziz MU, Ghaffar A, Ghauri HN, Naveed M.Theileriosis is an important disease of economic significance which badly affects the equine husbandry of developing countries. The present study was planned to investigate the molecular prevalence of theileriosis, associated risk factors, and alterations in hematological parameters of donkeys and mules from district Mianwali, Punjab, Pakistan. Blood samples from 150 equids (n = 75 donkeys; n = 75 mules) were examined microscopically, and the genomic DNA from each sample was processed for the amplification of the 18S rRNA gene of Theileria. The polymerase chain reaction confirmed isolates we...
Genetics of Equine Orthopedic Disease.
The Veterinary clinics of North America. Equine practice    June 11, 2020   Volume 36, Issue 2 289-301 doi: 10.1016/j.cveq.2020.03.008
Metzger J, Distl O.Orthopedic diseases are a common cause for limited exercise capacity in the horse. They often underlie genetic risk factors, which can affect bone, articular cartilage, tendons, ligaments, and adnexal structures among others. The genetic effects can directly interfere with tissue development and skeletal growth or can trigger degenerative or inflammatory processes. Many of these diseases of the locomotor system like osteochondrosis are complex and can be affected by multifactorial influences. For this reason, it is important for those performing diagnostic procedures to have a comprehensive kn...
Genetics of Equine Endocrine and Metabolic Disease.
The Veterinary clinics of North America. Equine practice    June 11, 2020   Volume 36, Issue 2 341-352 doi: 10.1016/j.cveq.2020.03.011
Norton E, McCue ME.A role for a genetic contribution to equine metabolic syndrome (EMS) and pars pituitary intermedia dysfunction (PPID) has been hypothesized. Heritability estimates of EMS biochemical measurements were consistent with moderately to highly heritable traits. Further, genome-wide association analyses have identified hundreds of regions of the genome contributing to EMS and candidate variants have been identified. The genetics of PPID has not yet been proven. Continued research for the specific genetic risk factors for both EMS and PPID is crucial for gaining a better understanding of the pathophys...
Ectoparasites of feral horses [Equus ferus caballus (Linnaeus., 1758)] on Karadağ Mountain, Karaman, Turkey.
Journal of parasitic diseases : official organ of the Indian Society for Parasitology    June 11, 2020   Volume 44, Issue 3 590-596 doi: 10.1007/s12639-020-01234-4
Dik B, Ceylan O, Ceylan C, Tekindal MA, Semassel A, Sönmez G, Derinbay Ekici Ö.Approximately 250 feral horses [ (Linnaeus, 1758)] living on Karadağ Mountain near Karaman City were caught by Kazakh horse herdsmen with permission of the Turkish Ministry of Agriculture and Forestry and brought to a farm in Karkın village in Konya Province, 70 km from Karadağ, in November, 2017. This study was carried out to determine the presence of ectoparasites infesting a subsample of 36 feral horses. The horses were visually inspected, and then their bodies were checked by hand for ectoparasites. Thirty-five (97.2%) were infested with at least one of five species of ectoparasites: ...
Veterinary Regenerative Medicine for Musculoskeletal Disorders: Can Mesenchymal Stem/Stromal Cells and Their Secretome Be the New Frontier?
Cells    June 11, 2020   Volume 9, Issue 6 1453 doi: 10.3390/cells9061453
Mocchi M, Dotti S, Bue MD, Villa R, Bari E, Perteghella S, Torre ML, Grolli S.Regenerative medicine aims to restore the normal function of diseased or damaged cells, tissues, and organs using a set of different approaches, including cell-based therapies. In the veterinary field, regenerative medicine is strongly related to the use of mesenchymal stromal cells (MSCs), which belong to the body repair system and are defined as multipotent progenitor cells, able to self-replicate and to differentiate into different cell types. This review aims to take stock of what is known about the MSCs and their use in the veterinary medicine focusing on clinical reports on dogs and hors...
Serum Amyloid A (SAA) Concentration after Vaccination in Horses and Mules.
Journal of equine veterinary science    June 11, 2020   Volume 92 103165 doi: 10.1016/j.jevs.2020.103165
Duran MC, Dumrath CAC, Bartmann CP, Medina Torres CE, Moschos A, Goehring LS.Serum amyloid A (SAA) is a sensitive acute-phase response (APR) marker in equids. Prominent APRs with elevations of SAA concentrations ([SAA]) have been reported after vaccination. The authors hypothesized that vaccination with an inactivated EHV-1/-4 vaccine would cause increase in [SAA] and antibody responses and that higher [SAA] would be positively correlated with the antibody titer in both equids. Twelve Haflinger horses and 12 mules were included in this longitudinal prospective study. All horses and mules were vaccinated with a commercially available EHV-1/-4 vaccine. Blood was sampled ...
Pre-conditioning of Equine Bone Marrow-Derived Mesenchymal Stromal Cells Increases Their Immunomodulatory Capacity.
Frontiers in veterinary science    June 11, 2020   Volume 7 318 doi: 10.3389/fvets.2020.00318
Caffi V, Espinosa G, Gajardo G, Morales N, Durán MC, Uberti B, Morán G, Plaza A, Henríquez C.Mesenchymal stem/stromal cells (MSCs) are increasingly explored for the treatment of degenerative and inflammatory diseases in human and veterinary medicine. One of the key characteristics of MSCs is that they modulate inflammation mainly through the secretion of soluble mediators. However, despite widespread clinical use, knowledge regarding the effector mechanisms of equine MSCs, and consequently their effectiveness in the treatment of diseases, is still unknown. The objectives of this study were to determine the mechanisms underlying inhibition of lymphocyte proliferation by equine bone mar...
Dominant IgM synthesis against the soluble form of the prevailing variant surface glycoprotein from TeAp-N/D1 Trypanosoma equiperdum throughout the experimental acute infections of horses with non-tsetse transmitted Trypanozoon parasites.
Journal of immunoassay & immunochemistry    June 11, 2020   Volume 41, Issue 4 745-760 doi: 10.1080/15321819.2020.1778029
Uzcanga GL, Bubis J.Two horses were infected with distinct non-tsetse transmitted Venezuelan stocks, namely TeAp-N/D1  and TeAp-El Frio01 . Preceding reports have revealed that a 64-kDa antigenic glycopolypeptide (p64), which is the soluble form of the predominant variant surface glycoprotein from TeAp-N/D1 , can be used as a good antigen for immunodiagnosis of animal trypanosomosis. Here, the course of the experimental acute infection in both horses was monitored by evaluating total anti-p64 IgG and particular anti-p64 γ-specific IgG and μ-specific IgM isotypes in sera using indirect enzyme-linked immunoso...
Genetics of Equine Reproductive Diseases.
The Veterinary clinics of North America. Equine practice    June 10, 2020   Volume 36, Issue 2 395-409 doi: 10.1016/j.cveq.2020.03.013
Raudsepp T.Reproductive disorders are genetically heterogeneous and complex; available genetic tests are limited to chromosome analysis and 1 susceptibility gene. Cytogenetic analysis should be the first test to confirm or rule out chromosomal aberrations. No causative genes/mutations are known. The only available genetic test for stallion subfertility is based on a susceptibility gene FKBP6. The ongoing progress in equine genomics will improve the status of genetic testing. However, because subfertile phenotypes do not facilitate collection of large numbers of samples or pedigrees, and clinical causes o...