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Topic:Veterinary Care

Veterinary care in horses encompasses the medical and preventive measures taken to maintain and improve the health and well-being of equine patients. It includes a wide range of practices such as routine health examinations, vaccinations, dental care, parasite control, and management of injuries and diseases. Veterinary care also involves diagnostic procedures, surgical interventions, and therapeutic treatments tailored to the specific needs of horses. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of equine veterinary care, including advancements in diagnostic techniques, treatment protocols, and health management strategies to support the well-being and performance of horses.
Equine synovial fluid small non-coding RNA signatures in early osteoarthritis.
BMC veterinary research    January 9, 2021   Volume 17, Issue 1 26 doi: 10.1186/s12917-020-02707-7
Castanheira C, Balaskas P, Falls C, Ashraf-Kharaz Y, Clegg P, Burke K, Fang Y, Dyer P, Welting TJM, Peffers MJ.Osteoarthritis remains one of the greatest causes of morbidity and mortality in the equine population. The inability to detect pre-clinical changes in osteoarthritis has been a significant impediment to the development of effective therapies against this disease. Synovial fluid represents a potential source of disease-specific small non-coding RNAs (sncRNAs) that could aid in the understanding of the pathogenesis of osteoarthritis. We hypothesised that early stages of osteoarthritis would alter the expression of sncRNAs, facilitating the understanding of the underlying pathogenesis and potenti...
Equine nutrition in the post-operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons.
Equine veterinary journal    January 9, 2021   Volume 53, Issue 5 1015-1024 doi: 10.1111/evj.13381
Lawson AL, Sherlock CE, Ireland JL, Mair TS.Evidence is lacking concerning re-introduction of feed and water following colic surgery. Objective: To describe current approaches of European and American specialists to re-introduction of feed and water in adult horses following surgical treatment of common intestinal lesions, assuming an uncomplicated recovery. Methods: Cross-sectional survey. Methods: Electronic invitations, with a link to the online survey, were sent to 1,430 large animal specialists, including Diplomates of the ECVS, ACVS, ECEIM and ACVIM colleges. Results: The response rate was 12.6% including partial respondent data. ...
Feasibility, indications, and radiographically confirmed diagnoses of standing extremity cone beam computed tomography in the horse.
Veterinary surgery : VS    January 9, 2021   Volume 50, Issue 2 365-374 doi: 10.1111/vsu.13560
Pauwels FE, Van der Vekens E, Christan Y, Koch C, Schweizer D.To report on the feasibility, indications, and diagnostic yield of cone beam computed tomography (CBCT) of horses' extremities performed under standing sedation. Methods: Retrospective clinical case series. Methods: Fifty-nine CBCT examinations in 58 horses. Methods: Examinations were categorized for indications for CBCT dependent on a suspicion, presence, or absence of a diagnosis prior to CBCT. The number of acquisitions per examination, total time for the examination, diagnostic score of each acquisition (diagnostic, diagnostic-compromised, nondiagnostic), and additional diagnostic informat...
The influence of clinical severity and topical antimicrobial treatment on bacteriological culture and the microbiota of equine pastern dermatitis.
Veterinary dermatology    January 8, 2021   Volume 32, Issue 2 173-e41 doi: 10.1111/vde.12912
Sangiorgio DB, Hilty M, Kaiser-Thom S, Epper PG, Ramseyer AA, Overesch G, Gerber VM.Equine pastern dermatitis (EPD) is a common dermatological problem in horses, yet its aetiology and pathogenesis are poorly understood. Objective: This study aimed to investigate the effects of lesion severity and topical antimicrobial treatment on bacterial flora of EPD-affected skin. Methods: Sixteen horses with EPD were investigated. Methods: An observational study was conducted by assigning a clinical severity score ranging from 0 (macroscopically nonlesional) to 21 (severe), and sampling the most and least severely affected limbs of 16 horses (32 limbs) for bacteriological culture and 16S...
The Effects of Red Light on Mammalian Sperm Rely upon the Color of the Straw and the Medium Used.
Animals : an open access journal from MDPI    January 8, 2021   Volume 11, Issue 1 122 doi: 10.3390/ani11010122
Catalán J, Yánez-Ortiz I, Gacem S, Papas M, Bonet S, Rodríguez-Gil JE, Yeste M, Miró J.Previous research has determined that irradiation of mammalian sperm with red light increases motility, mitochondrial activity, and fertilization capacity. In spite of this, no study has considered the potential influence of the color of the straw and the extender used. Therefore, this study tests the hypothesis that the response of mammalian sperm to red light is influenced by the color of the straw and the turbidity/composition of the extender. Using the horse as a model, 13 ejaculates from 13 stallions were split into two equal fractions, diluted with Kenney or Equiplus extender, and stored...
The Impact of the Sex of Handlers and Riders on the Reported Social Confidence, Compliance and Touch Sensitivity of Horses in Their Care.
Animals : an open access journal from MDPI    January 8, 2021   Volume 11, Issue 1 130 doi: 10.3390/ani11010130
Anzulewicz A, Fenner K, Hyde M, Heald S, Burattini B, Romness N, McKenzie J, Wilson B, McGreevy P.Current evidence of how human sex-related differences in riders and handlers may influence horse behaviour is limited. The Equine Behaviour Assessment and Research Questionnaire (E-BARQ) was used to collect demographic data on riders and handlers ( = 1420) and behavioural data on their horses. It includes demographic items about the sex of the respondent and how frequently the horse has been ridden or handled by male and female humans. The questionnaire then gathers observations on the horse's behaviour on the ground and under saddle or when driven Using E-BARQ's battery of 97 questions, the c...
The imbalance of the Th17/Treg axis following equine ascending placental infection.
Journal of reproductive immunology    January 7, 2021   Volume 144 103268 doi: 10.1016/j.jri.2020.103268
Fedorka CE, El-Sheikh Ali H, Walker OF, Scoggin KE, Dini P, Loux SC, Troedsson MHT, Ball BA.Ascending placentitis is a leading cause of abortion in the horse, but adaptive immune response to this disease is unknown. To evaluate this, sub-acute placentitis was experimentally-induced via trans-cervical inoculation of S. zooepidemicus, and endometrium and chorioallantois was collected 8 days later (n = 6 inoculated/n = 6 control). The expression of transcripts relating to Th1, Th2, Th17, and Treg maturation was assessed via RNASeq. IHC of transcription factors relating to each subtype in the same tissues (Th1: TBX21, Th2: GATA3, Th17: IRF4, Treg: FOXp3). An immunoassay was utili...
Exogenous enzyme amendment accelerates maturity and changes microflora succession in horse and wildlife animal manure co-composting.
Environmental science and pollution research international    January 7, 2021   Volume 28, Issue 17 21610-21620 doi: 10.1007/s11356-020-11568-4
Du G, Feng W, Cai H, Ma Z, Liu X, Yuan C, Shi J, Zhang B.Composting has been a rational method to dispose of horse or wildlife animal manures, especially in the developed cities with horse clubs and wildlife parks. However, few studies have focused on the mechanism and improvement methods for composting the horse or wildlife animal manures. In this study, we investigated the effect of exogenous compound enzymes on thermophilic composting, which could potentially support the management of horse and wildlife animal manures. With the presence of exogenous enzymes, the duration of high temperature (> 60 °C) was significantly prolonged (p <â€...
External Loading Characteristics of Polo Ponies and Corresponding Player Heart Rate Responses in 16-Goal Polo.
Journal of equine veterinary science    January 7, 2021   Volume 98 103368 doi: 10.1016/j.jevs.2020.103368
Best R, Standing R.When compared with other equestrian sports, Polo players engage in a high number of player-pony interactions. To ensure optimal performance of the player-pony dyad, an understanding of the workloads performed by each pony and the physiological cost placed on the rider are required. This investigation examined the relationship and interaction between Polo pony performance (speeds attained, distance covered, and movements performed) and the corresponding heart rate responses in Polo players, within and between games across a 16-goal Polo tournament. Descriptive statistics revealed Polo is played...
Clinical and diagnostic findings, treatment, and short- and long-term survival in horses with peritonitis: 72 cases (2007-2017).
Veterinary surgery : VS    January 7, 2021   Volume 50, Issue 2 323-335 doi: 10.1111/vsu.13564
Arndt S, Kilcoyne I, Vaughan B, Dechant JE.To identify etiology, clinical findings, diagnostic results, treatment, and short- and long-term survival and to report factors associated with nonsurvival and survival in horses with peritonitis. Methods: Retrospective study. Methods: Horses (n = 72). Methods: Medical records at William R. Pritchard Veterinary Medical Teaching Hospital from 2007-2017 were reviewed for horses diagnosed with peritonitis. The essential inclusion criterion was a peritoneal nucleated cell count of ≥25 000 cells/μL. Gastrointestinal rupture and cases in which peritonitis occurred after abdominal surgery or cas...
Primary vaccination in foals: a comparison of the serological response to equine influenza and equine herpesvirus vaccines administered concurrently or 2 weeks apart.
Archives of virology    January 7, 2021   Volume 166, Issue 2 571-579 doi: 10.1007/s00705-020-04846-6
Allkofer A, Garvey M, Ryan E, Lyons R, Ryan M, Lukaseviciute G, Walsh C, Venner M, Cullinane A.This study compared concurrent and separate primary vaccination against equid alphaherpesviruses 1 and 4, genus Varicellovirus, subfamily Alphaherpesvirinae, family Herpesviridae, and equine influenza A virus, genus Alphainfluenzavirus, family Orthomyxoviridae. Their vernacular names are equine herpesvirus 1 and 4 (EHV1/4) and equine influenza virus (EIV). Infection with these respiratory pathogens is associated with loss of performance, interruption of training schedules, and on occasion, cancellation of equestrian events. Vaccination is highly recommended, and for some activities it is a man...
The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting.
BMC veterinary research    January 7, 2021   Volume 17, Issue 1 16 doi: 10.1186/s12917-020-02715-7
Meier A, McGree J, Klee R, Preuß J, Reiche D, de Laat M, Sillence M.Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a 'normal' pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, usi...
Effects of Intravenous Flunixin Meglumine, Phenylbutazone, and Acupuncture on Ocular Pain Scores in the Horse: A Pilot Study.
Journal of equine veterinary science    January 6, 2021   Volume 98 103375 doi: 10.1016/j.jevs.2021.103375
Makra Z, Csereklye N, Riera MM, McMullen RJ, Veres-Nyéki K.In this controlled, blinded, randomized block pilot study, the main objective was to evaluate the effectiveness of intravenous flunixin meglumine, phenylbutazone, and acupuncture on ocular pain relief using a multifactorial pain scale in the horse. Four experimental horses underwent corneal epithelial debridement in four sessions, when a randomly selected treatment or a control was used. All horses were pain scored before corneal wounding, then at 18 time points, when 11 parameters were allocated. Differences in the area under the curve of pain scores between the treatment groups were analyzed...
Nonclassified Lymphoma as a Cause of Radial Nerve Paralysis in a Horse.
Journal of equine veterinary science    January 6, 2021   Volume 98 103371 doi: 10.1016/j.jevs.2021.103371
Barba M, Groover ES, Bailey J, Cole R, Christopherson P, Cattley R.A 4-year-old American Quarter Horse gelding was evaluated for acute non-weight-bearing lameness of the right thoracic limb with swelling in the right shoulder region. Physical examination revealed radial nerve paralysis of unknown etiology. The primary differential diagnosis was musculoskeletal trauma. Ultrasonography of the right shoulder region identified a heterogeneous mass that extended from the point of the shoulder to the thoracic inlet. Cytologic analysis of fluid collected by fine needle aspirate of the mass was consistent with large cell lymphoma. Based on the cytological findings, l...
Validation of a point-of-care polymerase chain reaction assay for detection of Streptococcus equi subspecies equi in rostral nasal swabs from horses with suspected strangles.
The Canadian veterinary journal = La revue veterinaire canadienne    January 5, 2021   Volume 62, Issue 1 51-54 
Willis AT, Barnum S, Pusterla N.This study aimed to validate a point-of-care polymerase chain reaction (PCR) assay for detection of subsp. in rostral nasal swabs from horses with suspected acute strangles and to compare the results against the molecular gold standard of quantitative polymerase chain reaction (qPCR). Two hundred thirty-two individual swabs of rostral nasal passages were characterized by qPCR as positive, subsp. positive, or and negative. The specificity and sensitivity of the point-of-care PCR assay were 89% and 84%, respectively. The limits of detection of the qPCR assay and the point-of-care PCR anal...
Fibro-Osseous Lesions Of The Craniofacial Complex In Horses: 30 Cases (2001-2019).
Veterinary surgery : VS    January 5, 2021   Volume 50, Issue 2 383-392 doi: 10.1111/vsu.13559
Nottle BF, Tatarniuk DM, Caldwell FJ, Bell CD, Caston SS, Merkatoris PT, Gillen AM, Katzman SA.To describe the presentation, diagnosis, treatment, and outcome for horses with fibro-osseous lesions of the craniofacial complex. Methods: Retrospective multicenter case series. Methods: Thirty horses evaluated for fibro-osseous lesions of the skull from January 1, 2001 through December 31, 2019 in four centers. Methods: Medical records were reviewed for signalment, clinical presentation, histological and diagnostic imaging findings, treatment instituted, and outcome. Long-term outcome information was obtained by owner questionnaire or the medical record. Results: Diagnoses included ossifying...
Hand-assisted laparoscopic cystotomy for cystic calculus removal in male horses (3 cases).
The Canadian veterinary journal = La revue veterinaire canadienne    January 5, 2021   Volume 62, Issue 1 22-26 
Merchan A, Barrett EJ, Rodgerson DH.A technique for hand-assisted laparoscopic removal of cystic calculi in male horses is described. Three cystic calculi ranging from 5 to 10 cm in diameter were removed successfully using bilateral para-inguinal laparoscopic portals assisted by a human hand within the abdomen, effectively sealing the midline incision. Long-term follow-up information obtained from referring veterinarians and owners indicated that the patients returned to their previous activity level and had no recurrence of clinical signs in the following 6 to 12 months. Key clinical message: Hand-assisted recumbent laparoscopy...
Experimental crossover study on the effects of withholding feed for 24 h on the equine faecal bacterial microbiota in healthy mares.
BMC veterinary research    January 5, 2021   Volume 17, Issue 1 3 doi: 10.1186/s12917-020-02706-8
Willette JA, Pitta D, Indugu N, Vecchiarelli B, Hennessy ML, Dobbie T, Southwood LL.An association between equine gastrointestinal disease causing colic signs and changes in faecal bacterial microbiota has been identified. The reasons for these changes and their clinical relevance has not been investigated. Withholding feed, which is an integral part of managing horses with colic, may contribute to the observed changes in the microbiota and impact interpretation of findings in horses with colic. Study objectives were, therefore, to determine the effect of withholding feed for 24 h on equine faecal bacterial microbiota in healthy mares to differentiate the effects of withhol...
Grazing Mares on Pasture with Sycamore Maples: A Potential Threat to Suckling Foals and Food Safety through Milk Contamination.
Animals : an open access journal from MDPI    January 5, 2021   Volume 11, Issue 1 doi: 10.3390/ani11010087
Renaud B, François AC, Boemer F, Kruse C, Stern D, Piot A, Petitjean T, Gustin P, Votion DM.Equine atypical myopathy (AM) is seasonal intoxication resulting from the ingestion of seeds and seedlings of the sycamore maple (Acer pseudoplatanus) that contain toxins, among them, hypoglycin A (HGA). Literature mentions several cases of AM among gravid mares and in unweaned foals. The objective of this study was to determine whether HGA and/or its metabolite are present in milk from grazing mares exposed to sycamore maple trees as confirmed by detection of HGA and its metabolite in their blood. Four mare/foal couples were included in the study. Both HGA and its metabolite were detectable i...
MMP-9 Concentration in Peritoneal Fluid Is a Valuable Biomarker Associated with Endotoxemia in Equine Colic.
Mediators of inflammation    January 5, 2021   Volume 2021 9501478 doi: 10.1155/2021/9501478
Barton AK, Richter IG, Ahrens T, Merle R, Alalwani A, Lilge S, Purschke K, Barnewitz D, Gehlen H.The purpose of the study was to compare the results of sepsis scoring (clinical examination and clinical pathology) to the concentrations of matrix-metalloproteinases (MMPs) -2, -8, and -9; tissue-inhibitor of metalloproteinases (TIMPs) -1 and -2; and inflammatory chemokines interleukin (IL) 1β and tumor-necrosis-factor-alpha (TNF-α) in plasma and peritoneal fluid of equine colic patients. A modified sepsis scoring including general condition, heart and respiratory rate, rectal temperature, mucous membranes, white blood cell count (WBC), and ionized calcium was applied in 47 horses presented...
Timed artificial insemination in crossbred mares: Reproductive efficiency and costs.
Reproduction in domestic animals = Zuchthygiene    January 5, 2021   Volume 56, Issue 3 459-466 doi: 10.1111/rda.13884
Macan RC, Camargo CE, Zielinski BL, Cardoso NGH, de Lara NSS, Bergstein-Galan TG, Weiss RR, Kozicki LE.Timed artificial insemination (TAI) has boosted the use of conventional artificial insemination (CAI) by employing hormonal protocols to synchronize oestrus and ovulation. This study aimed to evaluate the efficiency of a hormonal protocol for TAI in mares, based on a combination of progesterone releasing intravaginal device (PRID), prostaglandin (PGF2α ) and human chorionic gonadotropin (hCG); and compare financial costs between CAI and TAI. Twenty-one mares were divided into two groups: CAI group (CAIG; n = 6 mares; 17 oestrous cycles) and TAI group (TAIG; n = 15 mares; 15 oestrous cycle...
Evolution of laboratory discovery supporting progress in anesthetic management of horses: the 1950s and 1960s.
Veterinary anaesthesia and analgesia    January 4, 2021   Volume 48, Issue 2 160-166 doi: 10.1016/j.vaa.2020.12.004
Steffey EP.No abstract available
Radiographic assessment of carpal conformation in the horse, part 2: Finding acceptable limits to postural and rotational variations during radiography.
Anatomia, histologia, embryologia    January 3, 2021   Volume 50, Issue 3 467-492 doi: 10.1111/ahe.12651
Olusa TAO, Davies HMS.Finding an appropriate location for perpendicular positioning of the X-ray machine to produce zero lateromedial (ZLM) and zero dorsopalmar (ZDP) carpal images (views) and finding an acceptable range of rotational variations for measurement of carpal conformational parameters were two major challenges identified during field radiography of equine forelimbs. 16 cadaver forelimbs transacted at antebrachial midshaft from 10 horses (aged 9.13 ± 4.59 years) were axially mounted into a custom-built frame, and the radiographic machine and plate were perpendicularly aligned with the limb. Each limb...
Computed tomography identified mineralisation of the longitudinal odontoid ligament of the horse is associated with age and sex but not with the clinical sign of head shaking. Talbot AM, Rodrigues M, Maddox TW.Mineralisation of the longitudinal odontoid ligament has recently been identified in three horses undergoing computed tomographic (CT) examination, but published studies describing the clinical relevance of this finding are currently lacking. The objective of this retrospective, analytical, cross-sectional study was to investigate the relationship of this image finding to primary presenting complaint, age, breed, use and sex of the patient, and determine any association to the clinical signs of head shaking, neck pain or restricted range of neck motion. Computed tomographic images of 96 horses...
Skin Diseases in Donkeys and Mules-An Update.
Animals : an open access journal from MDPI    December 31, 2020   Volume 11, Issue 1 65 doi: 10.3390/ani11010065
Lima TS, Silva RAF, Pereira RMF, Soares KL, Santos NTA, Sousa MS, Mendonça FS, Lucena RB.The skin of donkeys and mules represents a promising source of income; however, cultural, productive, and infectious factors can directly interfere with the quality of the integumentary tissue and well-being of these species. The objective of this study is to present a literature review on equine dermatopathies. This literature review included scientific articles related to equine medicine and breeding according to pre-established search terms and expressions published in recently articles. The evaluation of the clinical and pathological behavior of dermatopathies implies the use of control st...
Equine Responses to Acceleration and Deceleration Cues May Reflect Their Exposure to Multiple Riders.
Animals : an open access journal from MDPI    December 31, 2020   Volume 11, Issue 1 doi: 10.3390/ani11010066
McKenzie J, Fenner K, Hyde M, Anzulewicz A, Burattini B, Romness N, Wilson B, McGreevy P.It is logical to assume that horses with multiple riders encounter variation in application of training cues. When training cues are inconsistent, we expect to see a decrease in trained responses or an increase in conflict behaviours. This study investigated the relationship between the number of people that regularly ride or handle a horse and the horse's response to operant cues. Data on 1819 equids were obtained from the Equine Behavior Assessment and Research Questionnaire (E-BARQ), an online global survey of horse owners and caregivers. Three mutually independent indices (acceleration, de...
Treatment effects of intra-articular triamcinolone acetonide in an equine model of recurrent joint inflammation.
Equine veterinary journal    December 30, 2020   Volume 53, Issue 6 1277-1286 doi: 10.1111/evj.13396
Kearney CM, Korthagen NM, Plomp SGM, Labberté MC, de Grauw JC, van Weeren PR, Brama PAJ.Intra-articular triamcinolone acetonide is a widely used treatment for joint inflammation despite limited scientific evidence of its efficacy. Objective: To investigate if intra-articular triamcinolone acetonide has sustained anti-inflammatory effects using an equine model of repeated joint inflammation. Methods: Randomised controlled experimental study. Methods: For three consecutive cycles 2 weeks apart, inflammation was induced in both middle carpal joints of eight horses by injecting 0.25 ng lipopolysaccharide (LPS). After the first LPS injection only, treatment with 12 mg triamcinolone...
Stored Stallion Sperm Quality Depends on Sperm Preparation Method in INRA82 or INRA96.
Journal of equine veterinary science    December 30, 2020   Volume 98 103367 doi: 10.1016/j.jevs.2020.103367
Papin J, Stuhtmann G, Martinsson G, Sieme H, Lundeheim N, Ntallaris T, Morrell JM.Removal of seminal plasma facilitates stallion sperm survival during storage, but washing may damage sperm chromatin. Therefore, sperm quality was compared in samples following single-layer centrifugation (SLC) or sperm washing and controls (extension only) in two extenders, INRA82 and INRA96. Ejaculates from six stallions were split among six treatments: SLC, sperm washing, and controls, in INRA82 and INRA96. Sperm motility and acrosome status were evaluated at 0, 24, 48, 72 and 96 hours; morphology at 0, 24, 48, 72 hours and chromatin integrity at 0 and 96 hours, with storage at 6°C. Sperm ...
Suspensory Ligament Desmitis Caused by Onchocerca sp. in Three Donkeys.
Veterinary pathology    December 28, 2020   Volume 58, Issue 2 401-404 doi: 10.1177/0300985820978312
Paraschou G, Adako GM, Priestnall SL, Burden FA.Three donkeys were presented with progressive lameness and distal suspensory ligament breakdown in multiple limbs. Treatment with nonsteroidal anti-inflammatory drugs was only partially effective and eventually the donkeys were euthanized due to further progression of the lameness and concerns for their welfare. At necropsy, the distal part of the suspensory ligaments in multiple limbs, including the suspensory ligament branches, was markedly thickened, enlarged, and mottled white and brown on cut section. In one case, adult sp. nematodes were grossly identified embedded within the suspensory...
Cutaneous habronemosis in horses: First molecular characterization of Habronema muscae in Israel.
Comparative immunology, microbiology and infectious diseases    December 28, 2020   Volume 75 101608 doi: 10.1016/j.cimid.2020.101608
Salant H, Rojas A, Yardeny D, Brenner O, Schvartz G, Baneth G, Dvir E.Draschia megastoma, Habronema microstoma, and Habronema muscae are the etiological agents of cutaneous habronemosis, commonly known as summer sores, an inflammatory cutaneous and ocular parasitic disease of horses and other equids transmitted by flies. Here, we describe a cluster of cutaneous habronemosis in five horses that showed single or multiple typical cutaneous ulcerative wounds located on the face, lower forelegs or hindquarters in Israel with the presence of typical "sulphur granules." All affected animals were confirmed by histopathological and/or molecular methods to be infected by ...
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