Equine health encompasses the study and management of diseases, disorders, and overall well-being of horses. It involves understanding various physiological systems, preventive care, and treatment strategies to maintain optimal health in equine populations. Common areas of focus include nutrition, infectious diseases, orthopedic conditions, and reproductive health. Research in equine health aims to advance knowledge on diagnostic methods, therapeutic interventions, and management practices that improve horse welfare and performance. This page collects peer-reviewed research studies and scholarly articles that explore the diverse aspects of equine health, offering insights into current findings and advancements in the field.
White NA, Dabareiner RM.Impactions have been reported in the stomach and all segments of the intestine. Impactions predominately occur just oral to sites of intestinal narrowing or active pacemakers. The most common sites of impaction are in the ileum, the cecum, and the large colon pelvic flexure. The treatment of gastrointestinal impactions depends on the segment affected and the amount of bowel damage which has occurred from distension. Many impactions respond to appropriate administration of analgesics, cathartics, and oral or intravenous fluids. The prognosis for impactions treated medically is better than for t...
Sieme H, Klug E, Bader H.Equine ejaculates are significantly characterized by widely varying parameters especially in those of practical relevance for equine Al. Therefore it is of interest for practical purposes to get subpopulations of concentrated, vital, and competent spermatozoa from the origin ejaculates. Special preparation of the donor stallions will stabilize sperm output. Fractionated semen collection from stallions supplies sperm enriched seminal fractions very useful to work with further in semen preservation. Most important to achieve a concentrated sperm subpopulation are semen manipulations post ejacula...
Westhoff D, Kamp G.Evidence is provided that the glycolytic enzyme glyceraldehyde 3-phosphate dehydrogenase is covalently linked to the fibrous sheath. The fibrous sheath is a typical structure of mammalian spermatozoa surrounding the axoneme in the principal piece of the flagellum. More than 90% of boar sperm glyceraldehyde 3-phosphate dehydrogenase activity is sedimented after cell disintegration by centrifugation. Detergents, different salt concentrations or short term incubation with chymotrypsin do not solubilize the enzyme, whereas digestion with trypsin or elastase does. Short term incubation with trypsin...
Freeman DE.Although earlier reports describe a poor prognosis for small intestinal surgery in the horse, there is growing evidence that the short-term survival rate can exceed 80%. In addition to advancements in surgery and aftercare, early referral contributes considerably to the improved prognosis. Surgical procedures that restore anatomic and physiologic continuity to close to normal can minimize postoperative complications. Jejunojejunostomy carries a better prognosis than jejunocecostomy, probably because the latter involves anastomosis between two intestinal segments with dissimilar functions. Care...
Aurich C, Lange J, Hoppen HO, Aurich JE.The aim of this study was to investigate the influence of oestradiol, melatonin and season on the opioid regulation of LH and prolactin release. Effects of the opioid antagonist naloxone (0.5 mg/kg) on LH and prolactin secretion were determined in ovariectomized pony mares. In experiment 1, mares in January (n = 6) were pretreated with oestradiol benzoate (5 micrograms/kg) for 20 days. In experiment 2, beginning in May, mares (n = 7) received melatonin (15 mg) for 15 days and subsequently a combination of melatonin plus oestradiol for 20 days. In experiment 3, beginning in May, mares (n = 6) w...
Dechan J.Medical management was unable to prevent the development of an extrapulmonary abscess in a 10-year-old Thoroughbred gelding with anaerobic pleuropneumonia. Intercostal thoracostomy achieved drainage of the abscess. Resolution of the abscess and subsequent bronchopleural fistulas was monitored by ultrasonography and video-endoscopy. The horse returned to training 4 mo after discharge.
Freeman DE, Inoue OJ, Eurell TE.To study the effect of flunixin meglumine on short circuit current (Isc) in equine right ventral colon in vitro. Methods: Intestinal mucosa from healthy horses and ponies. Methods: Isc was measured in mucosa from the right ventral colon mounted in Ussing chambers. In experiment 1, collection and incubation solutions were: control (no additions); flunixin meglumine, 4 micrograms/ml; indomethacin, 10(-6) M; and flunixin meglumine (4 micrograms/ml) with 10(-6) M prostaglandin E2. In experiment 2, incubation conditions were: control [plain Krebs-Ringer bicarbonate [KRB] solution]; flunixin meglumi...
Huhtinen M, Peippo J, Bredbacka P.Embryo biopsy has been used to detect inherited disorders and to improve the phenotype by analyzing of linkages between marker loci and the desired characteristics. Unfortunately, early procedures required the removal of a large portion (one-half) of the embryo for analysis, and the transfer of bisected equine embryos has not been particularly successful. Recent discovery of the polymerase chain reaction (PCR) has made possible the detection of specific DNA sequences from only a few cells. We investigated whether the removal of a small biopsy would allow for successful PCR and normal embryonic...
Patterson-Kane JC, Parry DA, Goodship AE, Firth EC.One of the current concepts with regard to equine superficial digital flexor tendonitis is that cumulative subclinical microscopic damage weakens the structure, predisposing the tendon to partial or complete rupture. This microtrauma is likely to affect the waveform or crimp of the collagen fibrils, which are the units of tensile strength. Collagen fibril crimp morphology characteristics were determined in superficial digital flexor tendons of 18 horses presented for necropsy. Horses were separated into exercised (n = 9) and non-exercised groups (n = 9), based on recent function. Five of the e...
Hawkins JF, Lescun TB.A 4-month-old Quarter Horse was admitted for evaluation of infection that developed following bilateral hemicircumferential periosteal transection and elevation. Sepsis of the common digital extensor tendon sheath was diagnosed. Treatment included lavage of the tendon sheath, placement of an indwelling drain for lavage after surgery, establishment of drainage, and administration of antimicrobial and anti-inflammatory drugs. Three months after treatment, the foal was clinically normal.
Gilbert SA, Timoney PJ, McCollum WH, Deregt D.A nested PCR, developed for the detection of equine arteritis virus (EAV) in semen, detected less than 2.5 PFU of EAV per ml of naturally infected seminal plasma. Based on results from testing 88 semen samples from 70 stallions, the sensitivity and specificity of the test were 100 and 97%, respectively.
Alemu T, Luckins AG, Phipps LP, Reid SW, Holmes PH.A field study involving 309 horses was undertaken in the provinces of Arsi and Bale in the Ethiopian highlands to investigate the prevalence of Trypanosoma equiperdum infections using enzyme linked immunosorbent assays (ELISAs) for the detection of both trypanosomal antigen and antibody. Adult horses of both sexes were examined for clinical signs of T. equiperdum infection and serum samples were collected for the assays. One hundred and one horses showed the presence of trypanosomal antibodies in their serum and 70 animals showed typical clinical signs of dourine. Nineteen horses showed the pr...
Cunningham FM, Andrews M, Landoni MF, Lees P.Calcium ionophore A23187 induced time and concentration dependent production of immunoreactive leukotriene (LT) B4 by equine heparinized whole blood in vitro. Time dependent production of immunoreactive LTB4 by equine neutrophils and immunoreactive LTC4 by equine eosinophils in vitro was also demonstrated. The 5-lipoxygenase activating protein (FLAP) inhibitors, BAY X 1005 and BAY Y 1015, produced concentration dependent inhibition of ionophore-induced LTB4 synthesis by equine whole blood (mean +/- SEM IC50s n = 5; 6.14 +/- 0.28 microM vs. 12.30 +/- 0.75 microM for BAY Y 1015 and BAY X 1005, r...
Wang YX, Kotlikoff MI.We investigated the muscarinic activation of Ca(2+)-activated Cl- currents [ICl(Ca)] in voltage-clamped equine tracheal myocytes. The threshold of cytosolic free Ca2+ concentration ([Ca2+]i) required for activation of ICl(Ca) was 202 +/- 22 nM, and full activation of the current occurred at 771 +/- 31 nM. Hexahydro-sila-difenidol (M3 antagonist) inhibited the methacholine-induced phasic [Ca2+]i increase and ICl(Ca) in a concentration-dependent manner, whereas methoctramine (M2 antagonist) only slightly attenuated the [Ca2+]i increase and ICl(Ca) (14.8 and 21.4%, respectively), consistent with ...
Raeside JI, Christie HL.Large amounts of estrogens are secreted by the tests of the mature stallion. In a recent study by Claus et al. [Claus, Dimmick, T., Gimenez, T., Hudson, L.W., 1992. Estrogens and prostaglandin F2 alpha in the semen and blood plasma of stallions. Theriogenology 38, 687-693.], it was stated that high levels of estrogens were also present in semen. As a preliminary step to study possible implications for fertility in the stallion, we have measured estrone sulphate (E1S), the principal estrogen in blood, in both seminal plasma and spermatozoa. Semen was collected from four Standardbred stallions a...
Van Hoogmoed L, Snyder JR.The medical management of postoperative abdominal disorders remains a diagnostic and therapeutic challenge for the equine clinician. Recent advances in the development of techniques and medications to offset or attenuate ischemia-reperfusion injury, endotoxemia, and ileus are encouraging and potentially will decrease the incidence of additional complications.
Powell DG, Dwyer RM, Traub-Dargatz JL, Fulker RH, Whalen JW, Srinivasappa J, Acree WM, Chu HJ.To determine safety, immunogenicity, and efficacy of an inactivated equine rotavirus vaccine. Methods: Prospective randomized controlled trial. Methods: 316 pregnant Thoroughbred mares during the first year of the study and 311 during the second year. Methods: During the first year, mares received 3 doses of vaccine or placebo, IM, at 8, 9, and 10 months of gestation. Serum neutralizing antibody titers were measured before vaccination and 1 and 35 days after foaling. Antibody titers were measured in foals 1, 7, 35, 60, 90, and 120 days after birth. During the second year, mares that had been v...
Carson-Dunkerley SA, Hanson RR.To describe the short- and long-term survival rates in horses undergoing ovariectomy for granulosa cell tumors by use of the diagonal paramedian approach. Methods: Retrospective case study. Methods: 12 horses with granulosa cell tumors. Methods: A diagonal paramedian approach for unilateral ovariectomy was used for removal of each mare's granulosa cell tumor. Information about complications and outcomes was analyzed. Results: Only minimal complications were detected postoperatively when the diagonal paramedian approach was used, regardless of the preferred technique for ovarian pedicle ligatio...
Liang FT, Granstrom DE, Timoney JF, Shi YF.We report a simple, economical, and efficient protocol for protein purification from cells. First, proteins of cell lysates were separated by standard sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and electroblotted to protein-blotting membrane. The blots were stained with Coomassie blue or developed by immunoblotting to visualize specific proteins. The bands corresponding to those visible by immunoblotting were excised from the dye-stained blots and subjected to isoelectric focusing. The focused gel was stained with Coomassie blue. Finally, the stained bands were excise...
Ball MA, Rebhun WC, Gaarder JE, Patten V.To evaluate the efficacy of itraconazole-dimethyl sulfoxide ointment for treatment of keratomycosis in horses in the northeastern United States. Methods: Prospective clinical trial. Methods: 9 horses (10 affected eyes). Methods: All horses treated for keratomycosis at Cornell University between July 1994 and July 1996 were included in the study. The diagnosis of keratomycosis was confirmed by cytologic examination, and all horses were treated with 0.25 ml of a 1% itraconazole-30% dimethyl sulfoxide petrolatum-based ointment, applied to the affected eye every 4 hours. Results: Topical applicati...
Papaioannou KZ, Murphy RP, Monks RS, Hynes N, Ryan MP, Boland MP, Roche JF.An objective double-staining method was developed to evaluate viability and mitochondrial function of stallion spermatozoa using flow cytometry. Sperm viability was assessed by propidium iodide (PI) exclusion, and mitochondrial function was measured by the intensity of rhodamine 123 (R123) fluorescence. Flow cytometry estimates of sperm viability measured by PI were equivalent (P > 0.05) to estimates made using Hoechst 33258 stain and fluorescent microscopy (% dead: 25 +/- 2.4 vs 21.5 +/- 3.5). The use of both PI and R123 was validated by addition of various proportions of freeze-shocked (m...
Munroe GA, Cauvin E.The clinical, radiographic and ultrasonographic findings in a case of a comminuted articular fracture of the accessory carpal bone of a thoroughbred chaser are described, and its surgical treatment and aftercare are detailed. The horse made an uneventful recovery and successfully returned to racing.
Vervuert I, Stratton-Phelps M.Equine nutraceuticals are promoted as useful therapies to help optimize health and athletic performance, often without the benefit of independent research to support product efficacy and safety. This review focuses on 4 main categories of equine supplements that are frequently used as nutraceuticals: (i) supplements to support metabolic health, (ii) gastric support products, (iii) common ingredients that are included in supplements designed to support hoof health, and (iv) supplements to support joint health.
Vatistas NJ, Meagher DM, Gillis CL, Neves JW.Twenty-two horses were examined because of firearm injuries. Nine had been shot with .22-caliber bullets, 2 with BB pellets, 6 with buckshot, 1 with a .35-caliber bullet, and 1 with an airgun pellet. Injury was confined to the skin or skeletal muscles in 8 horses. Of these, 7 returned to their previous use. In 14 horses, injuries to additional structures were incurred, including the sinus and pharynx (n = 2), mandible (n = 1), tooth (n = 1), aorta (n = 1), eye (n = 3), tibia (n = 1), gastrointestinal tract (n = 3), joint (n = 1), and trachea (n = 1). The 3 horses that had only eye injuries wer...
Marqués FJ, Waldner C, Reed S, Autet F, Corbeil L, Campbell J.The primary objective of this study was to investigate whether rider experience influences the assessment and grading of lameness in horses based on under-saddle gait analysis. Thirteen adult sports horses in active training were included in the study. After a baseline lameness and neurologic examination by the principal investigators, horses were videotaped while being ridden by an experienced and a less experienced rider. A 3-minute video was made for each horse and rider and 26 videos were randomly ordered and compiled on a DVD. Veterinarians with different levels of experience in evaluatin...
Muñoz A, Castejón-Riber C, Castejón F, Rubio DM, Riber C.Simulated hypoxic normobaric devices have been used in human beings in order to enhance endurance capacity. These devices are sealed chambers where the athletes are supposed to stay for at least 6-8 hr daily. The current research assesses the changes in time-domain, spectral and non-geometrical heart rate variability (HRV) parameters in 6 horses subjected to progressive duration periods inside of a hermetically sealed chamber. It was pursued, firstly to evaluate the intensity of the stress experienced by the animals and secondly to elucidate whether the horses might require an acclimation per...
Pullin JG, Collier MA, Das P, Smith RL, DeBault LE, Johnson LL, Walls RC.Comparison of perilesional cartilage, lesional repair tissue, and subchondral bone activity 6 months after application of holmium-yttrium-aluminum-garnet (Ho:YAG) laser energy to chronic (10 week) induced 10-mm full-thickness (FT) circular articular cartilage craters followed by 6 months' intermittent active motion (IAM) in a free exercise environment was investigated. The 2.1-microns wavelength was delivered in hand-controlled near-contact mode by arthroscopic surgery in a saline medium. Bilateral arthroscopy was performed on normal antebrachiocarpal, intercarpal, and metacarpophalangeal join...
Desantis S, Albrizio M, Ventriglia G, Deflorio M, Guaricci AC, Minoia R, De Metrio G.The presence of the mu-opioid receptor and the type of glycosylation in the third extra-cellular loop of this receptor was investigated in the isthmus of mare oviduct during oestrus by means of immunoblotting and immunohistochemistry combined with enzymatic (N-glycosidase F and O-glycosidase) and chemical (beta-elimination) treatments. Immunoblotting analysis showed that the mu-opioid receptor consists of two peptides with molecular weights of around 65 and 50 kDa. After N-deglycosylation with N-glycosidase F an additional immunoreactive peptide was observed at around 30 KDa. The cleavage of O...
Widders PR, Stokes CR, David JS, Bourne FJ.The immunoperoxidase technique was adapted for the identification of free immunoglobulin and immunoglobulin producing cells in equine tissues. Staining specific for free IgG, IgA and IgM was detected at all levels of the reproductive tract, and secretory component staining was present in the uterine epithelium but not in the oviduct, cervix or vagina. Immunoglobulin producing cells were present at all levels of the tract, with IgG and IgA cells at equivalent concentrations, but with fewer IgM cells. There was no cyclical trend in free immunoglobulin staining, or plasma cell numbers. IgG and Ig...
Tunón AM, Rodríguez-Martínez H, Hultén C, Nummijärvi A, Magnusson U.Undiluted uterine fluid from 20 Warmblood/Standardbred mares (5 to 14 yr old) was recovered by absorption to an intrauterine tampon. The mares were considered gynecologically healthy based on a clinical examination including uterine swabs for cytology and bacteriology as well as endometrial biopsy examinations. The protein profiles (SDS-PAGE) and concentrations of total protein, albumin, and immunoglobulins (Ig) A and G in the uterine fluid were examined and compared with the same proteins in serum. Major peaks were identified on the obtained protein profiles, and there was a clear similarity ...
Keenan DM.Changes in concentration of a number of blood metabolites in 30 thoroughbred horses were recorded after an 1110 metre race. No significant changes occurred in blood urea or aspartate aminotransferase during the three hours after racing. Plasma sodium, potassium and calcium levels were increased immediately after racing but had returned to normal one hour after racing. Plasma phosphate showed a significant fall in concentration one hour after racing. Creatinine and lactic acid concentrations were elevated ten minutes after racing and although they subsequently decreased, the level of lactic aci...
McCracken MJ, Schumacher J, Doherty TJ, Sun X, Nichols CL, Olivarez J.To determine the efficacy and duration of effect for liposomal bupivacaine following perineural administration to the medial and lateral palmar digital nerves of horses. Methods: 9 nonlame mares. Methods: For each horse, 2 mL of liposomal bupivacaine (13.3 mg/mL; total dose, 53.2 mg or approx 0.11 mg/kg) or sterile saline (0.9% NaCl) solution was injected adjacent to the medial and lateral palmar digital nerves at the level of the distal aspect of the proximal sesamoid bones of a randomly selected forelimb. Twenty-one days later, the opposite treatment was administered in the contralateral for...
Brinker EJ, Ceriotti S, Naskou MC, Spangler EA, Groover ES, Neto RLALT.A 25-y-old Percheron mare was admitted to the teaching hospital because of lethargy and intractable dyspnea. Thoracoabdominal ultrasound examination identified severe peritoneal effusion, mild bilateral pleural effusion, and a diffuse pulmonary nodular pattern. Cytology of peritoneal fluid revealed a hypercellular sample with clusters of neoplastic polygonal cells and admixed macrophages. Euthanasia was followed by postmortem examination; marked bi-cavitary effusion was present, and innumerable up to 4-cm diameter, round-to-floriform nodules were diffusely evident throughout serosal surfaces a...
Johnson CM, Cullen JM, Roberts MC.Ten ponies (160-250 kg, ages 17 months to 20 years) developed severe diarrhea within 24 hours of castor oil administration (2.5 ml/kg orally). The diarrhea was most severe between 24 and 48 hours post-dosing and subsided by 72 hours. Ponies were euthanatized at 24, 48, and 72 hours post-dosing and intestine was evaluated histologically and ultrastructurally. Twenty-four hours after dosing, the mucosa of the cecum and ventral colon had extensive superficial epithelial erosion and neutrophil infiltration. In the ileum, the epithelium of villous tips was separated from the lamina propria. Scannin...
Robinson MA, Stefanovski D, You Y, Boston RC, Soma LR.Capsaicinoids deter horses from chewing on bandages and are applied topically to provide analgesia to musculoskeletal injuries. They are banned during competition due to their nerve blocking properties. The pharmacokinetics of oral (PO) and direct gastric administration via nasogastric tube (NG), or topical (TOP) administration of two capsaicinoid-containing products were investigated, and the withdrawal times required prior to competition were estimated. Capsaicin (CAP) and dihydrocapsaicin (DCAP) were quantified in plasma, and both compounds were best described by a delayed absorption two co...
van der Vekens N, Decloedt A, de Clercq D, Ven S, Sys S, van Loon G.Studies on the use of atrial natriuretic peptide (ANP) as a biomarker for left atrial dilatation in horses have produced variable results. Few have been performed, and the results may have been influenced by ANP instability, differences in sampling protocol and changes in the assay over time. N-Terminal proANP (NT-proANP) is a more stable molecule and might be a good alternative for clinical use. Objective: To compare ANP and NT-proANP in terms of the detection of left atrial dilatation and to determine the influence of sample storage at temperatures of -80 and -20°C. Methods: Prospective cli...
Honoré ML, Pihl TH, Nielsen LN.Critically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses. Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group co...
Pyles MB, Fowler AL, Bill VT, Crum AD, Hayes SH, Harlow BE, Flythe MD, Lawrence LM.Dietary starch source has been shown to affect fecal bacterial communities of horses fed minimally processed cereal grains. However, processing may increase foregut starch digestibility, reducing effects of starch source on fecal bacterial communities. This study aimed to determine the effect of starch source in pelleted concentrates on fecal Lactobacillus spp., amylolytic bacteria, and cellulolytic bacteria in broodmares mares, during the prepartum and postpartum period. Thoroughbred mares (n = 18) were paired by last breeding date then randomly assigned to either an oat-based or a corn and ...
Rigg DL, Reinertson EL, Buttrick ML.Splenectomy was performed electively on 80 ponies, horses, and donkeys for preparation in collecting Babesia antigens. Access to the abdomen was by resection of the sixteenth left rib and incision of the diaphragm. The technique afforded good exposure of the splenic vessels and attachments. Closure was facilitated by preservation of the periosteum of the resected rib. Difficulty was encountered both in surgical technique and postoperative complications in obese animals. The transthoracic approach was found to be a useful technique for equine splenectomy.
Schulze N, Ehrle A, Noguera Cender AC, Lischer C.To report surgical treatment of a complete luxation of the atlantoaxial articulation with a 4.5-mm T-locking compression plate (T-LCP) in a horse. Methods: Case report. Methods: A one-year-old American quarter horse filly. Methods: A one-year-old American quarter horse filly presented with a complete luxation of the atlantoaxial articulation. Closed and open reduction of the luxation were attempted under general anesthesia with the aid of a pulley system. Because the manual reduction was unsuccessful, the dens axis was excised, and the atlas and axis were stabilized with a 4.5-mm T-LCP. Fo...
Carter BT, Richardson MD.The aim of the study was to examine helmet use, incidence of injury, and patient outcomes in a rural cohort of equestrian accidents. Unassigned: EHR records of patients admitted to a Level II ACS trauma center in the North-west United States were reviewed for helmet use. Injuries were categorized according to International Classification of Diseases-9/10 code. Unassigned: Of 53 identified cases, helmets only reduced superficial injury (χ (1) = 4.837, = 0.028). Intracranial injury rates were not different between those with and without helmets ( > 0.05). Unassigned: In equine related injur...
Oliveira Spila D, Maranhão RPA, Ocarino NM, de Lima JTB, Melo FG, Boeloni JN, Serakides R.The effects of two concentrations of triiodothyronine (T3; 0.01 and 1,000 nM) on the osteogenic and chondrogenic differentiation abilities of equine adipose-derived mesenchymal stem cells (AD-MSCs) were evaluated. The osteogenic study evaluated the effect of T3 using alkaline phosphatase activity (ALP) assay; cell viability and density; and formation of mineralized nodules at Days 7, 14, and 21 in culture. The chondrogenic study tested the effect of T3 through ALP assay, mitochondrial metabolism, cell density, and periodic acid-Schiff-positive (PAS+) matrix percentage at Days 7 and 14. In bot...
Elzinga S, Reedy S, Barker VD, Chambers TM, Adams AA.Obesity is an increasing problem in the equine population with recent reports indicating that the percentage of overweight horses may range anywhere from 20.6-51%. Obesity in horses has been linked to more serious health concerns such as equine metabolic syndrome (EMS). EMS is a serious problem in the equine industry given its defining characteristics of insulin dysregualtion and obesity, as well as the involvement of laminitis. Little research however has been conducted to determine the effects of EMS on routine healthcare of these horses, in particular how they respond to vaccination. It has...
Parente EJ.The many testing methods available and the increasing sophistication of diagnostic equipment have enhanced greatly our capabilities to diagnose causes of exercise intolerance in the equine athlete during the last several years. High-speed treadmill examination has become the focus of this form of evaluation. Not all clinicians perform or have access to high-speed treadmill examinations. Testing methods that require the use of the high-speed treadmill, as well as methods that do not, are discussed.
