Veterinary medicine for horses encompasses the study and application of medical practices to diagnose, treat, and prevent diseases in equine species. This field involves a comprehensive understanding of equine anatomy, physiology, pathology, and pharmacology. Veterinary practitioners employ a range of diagnostic tools and therapeutic interventions to address health issues in horses, including lameness, gastrointestinal disorders, respiratory conditions, and infectious diseases. Preventative care, such as vaccination and deworming programs, is also a significant aspect of equine veterinary medicine. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of veterinary medicine as it pertains to horses, including advancements in diagnostic techniques, treatment protocols, and preventive health strategies.
Pearce SG, Firth EC, Grace ND, Fennessy PF.To evaluate standing, percutaneous, ultrasound-guided, transthoracic liver biopsy in mares, and transabdominal laparoscopically-guided, liver biopsy under general anaesthesia in foals, as techniques for obtaining tissue for assessment of copper status. The techniques were evaluated with respect to ease of use and effect on the animal. Methods: Twenty of 24 Thoroughbred mares and 21 of their foals were biopsied. The animals were part of a larger study of the effect of copper supplementation on copper status and the prevalence of developmental orthopaedic disease. Livers were also collected from...
Schott HC, McGlade KS, Molander HA, Leroux AJ, Hines MT.To investigate effects of prolonged exercise on fluid and electrolyte losses in horses competing in 50- and 100-mile endurance competitions, with emphasis on recovery. Methods: Changes in body weight (BW); PCV; serum osmolality; plasma total protein, lactate, aldosterone, and serum electrolyte concentrations; and exchangeable cation content were measured in 12 and 7 horses before and after and before, during, and after successful completion of 50- and 100-mile endurance rides, respectively. Methods: BW was measured by use of a portable load bar scale, and blood samples were collected during th...
Nicholson VM, Prescott JF.Restriction enzyme digestion patterns of the large virulence plasmids of 8 human and 37 foal isolates of virulence-associated protein (VapA)-positive Rhodococcus equi strains from different sources were compared. Foal isolates came from five continents. Digestion with EcoRI divided these plasmids into three closely related types, and digestion with BamHI divided them into three major types which corresponded to the EcoRI types. The only EcoRI and BamHI type 3 plasmid was from a single foal isolate obtained from Japan. There are thus two major but related virulence plasmids in isolates from foa...
Olson ME, Thorlakson CL, Deselliers L, Morck DW, McAllister TA.Giardia intestinalis and Cryptosporidium spp. are commonly identified intestinal pathogens in humans and animals. In light of the clinical disease, production losses and zoonotic potential of both Giardia and Cryptosporidium infections, a study was undertaken to investigate the prevalence of these parasites in cattle, sheep, pigs and horses in Canadian farms at different geographical locations. A total of 104 cattle, 89 sheep, 236 pigs and 35 horses were sampled from 15 different Canadian geographical locations. Fecal samples were examined after concentration and immunofluorescent staining. Gi...
Mazan MR.A 30-year-old Morgan-Quarter Horse gelding with hyperadrenocorticism was referred for treatment of a full-thickness tear of the retroperitoneal portion of the rectum. In older horses, the caudal end of the peritoneal space may be farther cranial than is commonly thought. Thus, there is a greater chance that full-thickness rectal tears will involve the retroperitoneal, rather than the peritoneal, portion of the rectum. This horse had a quick recovery and good outcome, despite underlying hyperadrenocorticism that would be expected to impair healing. Although relatively little is known about mana...
Frazer GS, Perkins NR, Blanchard TL, Orsini J, Threlfall WR.A retrospective investigation was performed to determine the population characteristics of horses presented for dystocia at 2 equine referral hospitals and the types of fetal maldispositions among these horses. The study population consisted of a similar number of Thoroughbreds (25%), Standardbreds (24%) and draft horses (22%). Most of the current literature pertaining to equine obstetrics is based on a predominately draft horse population (63%). The latter population appeared to have more transverse presentations (P = 0.06), possibly because of the higher number of draft mares. In our study, ...
The Journal of heredityMarch 1, 1997
Volume 88, Issue 2 162-164 doi: 10.1093/oxfordjournals.jhered.a023079
Lear TL, Bailey E.The U2 linkage group of horses includes the genes albumin (ALB), vitamin D binding protein (GC), mitochondrial glutamate oxaloacetate transaminase 2 (GOT2), and haptoglobin (HP) which are found on two human chromosomes, namely, 4 (HSA 4) and 16 (HSA 16). Likewise these genes are also found on two different chromosomes in mice, rats, and cattle. Chromosome painting demonstrated that only horse chromosome 3 (ECA 3) hybridized with whole chromosome paints for both HSA 4 and HSA 16. This indicated that the equine U2 linkage group occurs on ECA 3, spanning the centromere. This technique will be use...
Keegan KG, Wilson DJ, Wilson DA, Frankeny RL, Loch WE, Smith B.To determine the effect of local anesthesia of the palmar digital nerves on forelimb kinematics in Quarter Horses with and without navicular disease. Methods: 12 adult Quarter Horses; 5 clinically normal (sound) and 7 with navicular disease. Methods: Kinematic measurements were made on adult horses trotting on a treadmill, before and after palmar digital nerve block (PDNB). Twenty-three displacement, joint angle, and temporal gait measurements of the right forelimb and head were made for 5 strides in each horse. Initial (before local anesthesia) right forelimb measurements were obtained after ...
Collinder E, Lindholm A, Rasmuson M.The equine rhabdomyolysis syndrome (RHA) is believed to be multifactorial in origin; and could be caused by an interaction between genetic and environmental factors. In order to analyse its genetic background an association study was undertaken. Two sample groups of Standardbreds (Stb) which had suffered from RHA were compared to the total population of Swedish Standardbred trotters using recorded polymorphic genetic markers. The results showed that gene frequencies for several markers in the RHA groups differed significantly from those estimated for the total population. A rhabdomyolysis risk...
Hilbe M, Meier D, Feige K.This article describes an eleven year old mare with apathy, fever, enlarged mandibular lymph nodes, skin lesions on the upper lip and edematous, grey-red mucous membranes in the nose, mouth and vulva. Histopathology revealed infiltrates with atypical lymphocytes forming Pautrier's microabscesses. The neoplastic cells had large, often indented nuclei. Immunohistology showed that some cells were CD3-positive (Pan T-cell-marker). The diagnosis of cutaneous epitheliotropic malignant lymphoma (Mycosis fungoides) was made. The etiology in the horse is unknown.
Thomas PG, Ball BA, Ignotz GG, Dobrinski I, Parks JE, Currie WB.Before fertilization, equine spermatozoa adhere to oviduct epithelial cells (OEC) of the mare. The biochemical basis for this adhesion has not been determined. Our objective was to produce an antiserum to block this interaction. Ejaculated spermatozoa were subjected to nitrogen cavitation and spermatozoal plasma membranes enriched by sucrose density gradient centrifugation; membrane enrichment was confirmed by comparative alkaline phosphatase analysis, electron microscopy, and one- and two-dimensional PAGE. Periacrosomal plasma membrane was used as an immunogen for the production of an antiser...
Garcia-Suarez O, Germanà G, Naves FJ, Ciriaco E, Represa J, Vega JA.The medial wall of the vomeronasal organ (VNO) is lined with a sensory epithelium that is closely related to the olfactory epithelium, which is developed from the olfactory placode. It undergoes continuous replacement during its life span. In other sensory epithelia, cell proliferation is under the control of some trophic factors. Whether these proteins are involved in the continuous turnover of the VNO epithelium is unknown. This study approaches this topic by analyzing the occurrence of signal-transducing receptor proteins for neurotrophins (Trk proteins) and epidermal growth factor (EGFr). ...
Holcombe SJ, Derksen FJ, Stick JA, Robinson NE.To determine the effect of bilateral tenectomy of the tensor veli palatini muscle on soft palate and nasopharyngeal function in exercising horses. Methods: 5 Standardbreds. Methods: Treadmill videoendoscopy was performed on 5 Standardbreds exercising at 50, 75, and 100% of the speed that produced maximum heart rate; tracheal and pharyngeal pressures were measured before and after surgery. Tenectomy of the tensor veli palatini muscle was performed bilaterally on each horse while under general anesthesia, using a transoral approach. Results: Peak inspiratory tracheal pressures were significantly...
Geelen SN, Bernadina WE, Grinwis GC, Kalsbeek HC.A 15-year-old Dutch warmblood mare was presented because of lethargy, which had been present for several weeks, and severe anaemia. Total protein was high and serum electrophoresis revealed a monoclonal peak in the alpha-2 region. Monoclonal immunoglobulin, IgG(T), was detected by immuno-electrophoresis in serum and urine. Postmortem examination revealed a relatively large number of plasmacytoid cells in the bone marrow and a monotonous population of plasmacytoid cells in the spleen. These findings are suggestive of a plasma cell myeloma.
Card CE, Manning ST, Bowman P, Leibel T.Breeding or semen collection was attempted using: natural cover, manual stimulation, artificial vagina, pharmacologic induction of ejaculation, and electroejaculation. Sperm cells were recovered from the ductus deferens and epididymides post mortem. Only semen collected ex copula by imipramine and xylazine treatment resulted in conceptions (4/5). This is the first report of pregnancies in horses from ex copula semen collection.
Breit S.Ten horses, younger than 1 year, were used to investigate the articulatio interphalangea distalis of the pelvic limb. The expansion of the dorsal recess was compared to those of adult horses. The recessus dorsalis always formed a shape like the letter 'm' or like a triangle with oblique angles. Consequently the great proximo-distal expansion on the medial side of the dorsal recess very probably has nothing to do with the age of horses.
Chu JW, Sharom FJ, Oriol JG, Betteridge KJ, Cleaver BD, Sharp DC.The equine embryonic capsule, an acellular covering that envelops the conceptus during the second and third weeks of pregnancy, is composed of mucin-like glycoproteins. Its structure is consistent with a dual role during early pregnancy: protection of the conceptus, and communication between the embryo and the mother. Loss of sialic acid from the capsular glycoproteins at day 16 correlates with the time of "fixation," or loss of conceptus mobility throughout the uterine horns. This study investigated how the structure of the capsule is linked to the maintenance of pregnancy. Six pregnancies, c...
Rees WA, Harkins JD, Woods WE, Blouin RA, Lu M, Fenger C, Holland RE, Chambers TM, Tobin T.Amantadine is an antiviral agent effective against influenza A viruses. We investigated 1) the antiviral efficacy, 2) analytical detection, 3) bioavailability and disposition, 4) pharmacokinetic modelling and 5) adverse reactions of amantadine in the horse. In vitro, amantadine and its derivative rimantadine suppressed the replication of recent isolates of equine-2 influenza virus with effective doses (EDs) of less than 30 ng/ml. Rimantadine was more effective than amantadine against most viral isolates; we suggest a minimum plasma concentration of 300 ng/ml of amantadine for therapeutic effic...
Flaherty D, Reid J, Welsh E, Monteiro AM, Lerche P, Nolan A.The pharmacodynamics of infusions of propofol alone (group 1) were compared with the pharmacodynamics of infusions of propofol and ketamine together (group 2) in eight ponies undergoing castration. Anaesthesia was induced with detomidine, 20 micrograms kg-1, followed by ketamine, 2.2 mg kg-1. Subsequently, a bolus dose of propofol, 0.5 mg kg-1, was administered intravenously to both groups, and an infusion of propofol was given for an average of 74 minutes to group 1, and an infusion of propofol and ketamine was given for 60 minutes to group 2. The mean (SD) infusion rates of propofol were 0.3...
Hamm D, Turchi P, Johnson JC, Lockwood PW, Thompson KC, Katz T.To titrate a clinically effective eltenac dosage (0.1, 0.5, and 1.0 mg/kg of body weight), compared with vehicle only, and to compare efficacy of the most effective eltenac dosage with that of 1.1 mg of flunixin meglumine/kg. Methods: 40 healthy horses, ranked after model induction on the basis of lameness severity, were randomly assigned to 5 treatment groups, with 4 replicates of 10 horses each. Methods: On day -5, after surgical preparation of the left carpal region, 0.7 ml of Freund's complete adjuvant was injected into the intercarpal space. Horses were observed daily, from the day of car...
Patterson-Kane JC, Wilson AM, Firth EC, Parry DA, Goodship AE.This study was undertaken to test the hypothesis that collagen fibrils, the submicroscopic units of strength in tendon, would hypertrophy in response to a specific defined training programme. Fibril diameters were measured in central and peripheral regions of superficial digital flexor tendon (SDFT) samples from five 18-month-old horses which underwent a subsequent 18 month training programme and 6 age- and sex-matched controls. Central region fibrils from the trained horses had a mass-average diameter (MAD) of 105.3 nm, which was significantly lower (P < 0.01) than that of 131.7 nm for the...
Basher AW, Severin GA, Chavkin MJ, Frank AA.Three horses were examined because of exophthalmos and others signs indicative of a space-occupying orbital mass. In 2 horses, exenteration was used to remove the orbital mass. In a third horse, an orbital tumor and lung metastases were found at necropsy. Routine histologic and Grimelius' histochemical staining were used on fixed tissues; immunohistochemical staining for chromogranin and electron microscopy also were performed. Masses were orbital neuroendocrine tumors. Horses that underwent exenteration were alive 19 and 24 months after surgery. Hypotension was encountered at surgery in both ...
Klonisch T, Mathias S, Cambridge G, Hombach-Klonisch S, Ryan PL, Allen WR.In situ hybridization employing a cRNA probe derived from a 428-bp fragment of equine relaxin was used to localize relaxin mRNA, and immunocytochemistry was used to localize relaxin itself, in tissues of the placenta-endometrium interface recovered between 33 and 153 days of gestation from mares carrying intraspecific horse, interspecific mule and extraspecific donkey conceptuses. Immunocytochemical staining was also used to localize trophoblast-specific and class I major histocompatibility complex (MHC) antigens on some specimens. Relaxin mRNA and relaxin were both present in the single-cell ...
Pleasant RS, Moll HD, Ley WB, Lessard P, Warnick LD.To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Methods: Experimental investigation. Methods: Six clinically normal horses. Methods: Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings we...
McD○ LA, Stover SM, Taylor KT.To determine the monotonic mechanical properties of osteotomized adult equine tibiae stabilized with two dynamic compression plates (DCP) and to compare the mechanical properties with those of intact tibiae and in vivo loads. Methods: The compressive, bending, and torsional mechanical properties of plated and intact tibiae were assessed in vitro. Methods: Twelve pairs of adult equine tibiae. Methods: Tibiae were loaded in axial compression, craniocaudal 3-point bending, or torsion in external rotation in a single cycle to failure. Mechanical properties were determined from load-displacement da...
Birch HL, Rutter GA, Goodship AE.Hypoxia has been suggested as a possible cause of tissue degeneration and subsequent rupture in equine tendons. To determine whether low oxygen tension is likely to be detrimental to tendon cell function, experiments were designed to investigate oxidative energy metabolism in freshly isolated and cultured equine tendon cells. Freshly isolated tenocytes and cultured fibroblasts possessed activities of the mitochondrial enzyme citrate synthase similar to those of other mammalian cells, with well defined oxidative metabolism. D-[6(-14)C]-glucose oxidation was measurable in both freshly isolated a...
Fordyce PS, Edington N, Bridges GC, Wright JA, Edwards GB.In 27 potential neuropathies an enzyme-linked immunosorbent assay, using P2 preparations from either bovine or equine myelin, detected all cases of cauda equina neuritis in which there was caudal involvement. The test was of limited value in differentiating neuropathies involving only cranial or other peripheral nerves.
Kennedy SA, Constable PD, Sen I, Couëtil L.To determine effects of syringe type and storage conditions on blood gas and acid-base values for equine blood samples. Methods: Blood samples obtained from 8 healthy horses. Methods: Heparinized jugular venous blood was equilibrated via a tonometer at 37°C with 12% O(2) and 5% CO(2). Aliquots (3 mL) of tonometer-equilibrated blood were collected in random order by use of a glass syringe (GS), general-purpose polypropylene syringe (GPPS), or polypropylene syringe designed for blood gas analysis (PSBGA) and stored in ice water (0°C) or at room temperature (22°C) for 0, 5, 15, 30, 60, or 120 ...
Mizobe F, Mori M, Nagata SI, Yamashita S, Okada J, Kusano K.Ever since 'One Health' concept was introduced in early 2000s, judicious use of antimicrobials by veterinarians has become an issue of great concern. Recently, findings of anti-inflammatory effects in certain types of antimicrobials have raised a subject for discussion among racing authorities. Regulatory framework of antimicrobials in racing should be based on best interest of horse welfare and doping control perspective, but basic data on prevalence of antimicrobials are lacking. Analysis of 100 postrace urinary samples collected from 10 Japanese racecourses by targeting 21 antimicrobials us...
Swain O'Fallon EA.Foal emergencies can be intimidating to manage in the field, yet many conditions will respond well to the supportive care possible on the farm. Triage of the foal targets focused supportive care to stabilize the foal before referral to a hospital or to facilitate the management in the field. There are many diagnostic and therapeutic options available in the field setting to support a successful outcome on the farm.
Sellon DC, Sanz M, Kopper JJ.Little is known about the acquisition and use of equine analgesic drugs by horse owners in the United States (US). Objective: To determine factors associated with possession of analgesic drugs by horse owners in the US or with analgesic drug acquisition from sources noncompliant with a valid veterinarian-client-patient (VCPR) relationship. Methods: Cross-sectional survey. Methods: An internet-based questionnaire included items related to experiences with horses and equine analgesic drugs. Factors associated with possession of ≥5 types of analgesic drugs and with the acquisition of drugs from...
Sod GA, Mitchell CF, Hubert JD, Martin GS, Gill MS.To compare monotonic biomechanical properties and fatigue life of a broad locking compression plate (LCP) fixation with a broad limited contact dynamic compression plate (LC-DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. Methods: In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Methods: Cadaveric adult equine MC3 bones (n=12 pairs). Methods: MC3 were divided into 3 groups (4 pairs each) for: (1) 4-point bending single cycle to failure testing; (2) 4-point bending cyclic ...
Wagner PC, DeBowes RM, Grant BD, Kaneps AJ, Watrous BJ.Proximal growth plate fractures of the tibia in 4 foals were treated surgically. A medial approach was utilized in 3 cases and a lateral approach in the fourth. Bone screw fixation was achieved with cancellous screws and washers. In 3 cases, the screw shaft crossed the proximal tibial growth plate with no adverse effects. In all animals, there was rapid and cosmetic healing. At 8 to 18 months after surgery, all horses were sound at a walk, trot, and canter.
Kleijn WM, Sloet van Oldruitenborgh-Oosterbaan MM.Measuring the height of ponies at the withers is currently a prerequisite at Fédération Equestre Internationale (FEI) competitions. A pony measured at a competition site must not measure more than 151 cm with, or 150 cm without horse shoes. When a pony exceeds the regulated height, it is excluded from participation in the competition. Moreover, the sale value of a pony can decrease dramatically if by height measurement it is designated as a 'horse'. The aim of this study was firstly to determine whether measuring ponies at the withers with a laser device is repeatable; secondly, to evaluate ...
Granstrom DE.This article reviews recent advances in laboratory diagnosis of equine parasitic diseases. Laboratory diagnosis of most equine parasitic diseases continues to rely on standard methods. Only laboratory diagnostic tests for EPM, cryptosporidiosis, and giardiasis were included. The criteria for testing and interpretation of results for each new diagnostic method were explained. Western blot and PCR testing for EPM and immunofluorescent staining with monoclonal antibodies for cryptosporidiosis and giardiasis were reviewed.
Tinkler SH, Couëtil LL, Kennedy SA, Constable PD.To determine whether plasma total CO(2) concentrations would vary with the size of the evacuated tube used to collect blood samples. Methods: Randomized crossover study. Methods: Convenience sample of 20 healthy adult horses. Methods: Jugular venous blood was collected from horses in random order into 8 types of evacuated tubes: 2-mL glass, 2- or 3-mL plastic or plastic plasma separator, 4- or 6-mL plastic, and 10-mL glass or plastic. Total CO(2) concentrations in plasma were measured with a biochemistry analyzer. Data were analyzed via repeated-measures ANOVA and multivariate regression. Resu...
Townsend WM.Examination of the lens is critical, particularly when evaluating horses with visual impairment or performing prepurchase examinations. To adequately evaluate the lens, the pupil must be pharmacologically dilated. A cataract is any lens opacity. The size, density, and position of a cataract determine the impact on vision. Cataracts may be congenital or inherited or occur secondary to trauma or equine recurrent uveitis. Surgical removal is the only treatment option for vision impairing cataracts, but careful selection of surgical candidates is critical for successful outcomes.
McKane SA, Rose RJ, Evans DL.Twenty-four Thoroughbred and twelve Standardbred racehorses aged between 2 and 6 years, presented for reported poor racing performance, underwent clinical exercise testing. During the last 10 s of exercise at each speed throughout an incremental speed exercise test on a treadmill inclined at a 10% slope, samples of arterial blood and expired gases were collected. Maximum oxygen uptake and the partial pressures of oxygen and carbon dioxide in arterial blood were determined. These values were compared between the two breeds of horses and also with reference to cytological findings of bronchoalve...
Watson ED.Outbreaks of contagious equine metritis in Britain during 1996 emphasised the importance of preventing the disease through full and widespread implementation of the Horserace Betting Levy Board's code of practice. The provision of satisfactory samples for testing represents an integral part of applying the code. Here, in an article commissioned by the British Equine Veterinary Association, Dr Elaine Watson describes the techniques involved.
Canola PA, Cardenas JJ, Sá GC, de Paula VB.To evaluate the feasibility of performing needle arthroscopy of the scapulohumeral joint and bicipital bursa in standing horses by using the thoracic limbs of euthanized horses. To that purpose, this experimental study was designed. Ten thoracic limbs, five left and five right from euthanized horses were retained in an upright position to simulate a standing horse. The craniolateral and lateral scapulohumeral arthroscopic portals were used to access the articular structures. A third (caudal) portal was also identified and described. The degree of difficulty in accessing the articular space and...
Kornaś S, Cabaret J, Nowosad B.Faecal egg counts were performed in 187 foals of a large Polish stud farm between February and September 2007. Eggs of Parascaris equorum were present in faeces of 7% and those of cyathostomins in 13% of the foals aged less than 194 days. Information dealing with age of foals and/or efficiency of ivermectin treatment as well as the nematode parasite prepatent periods, it can be conducted that most of the infections recorded on the basis of faecal egg counts were false-infections in animals up to the age of six months, probably due to the ingestion of infected faeces of their dam or some other ...
Todhunter RJ, Brown CM, Stickle R.Five horses with retropharyngeal (RP) infections had clinical signs of dysphagia and/or dyspnea. Diagnosis was confirmed, using pharyngeal endoscopy and lateral radiography of the pharynx. One horse responded to surgical drainage of a RP abscess and was sound at light work. One horse responded to medical management after the site of infection was surgically explored. Two horses recovered after medical management; the RP abscess of 1 of these 2 horses ruptured spontaneously into the pharynx and the other horse became racing sound. The fifth horse remained dysphagic and had left laryngeal hemipl...
Green JH, Bolin RC, Carver RK, Gross H, Pigott N, Harrell WK.The serological response in burros and horses to the viable LVS strain of Pasteurella tularensis was studied. High-titered agglutinating antisera and fluorescent-antibody conjugates were obtained in both groups of animals. Maximum titers were obtained in horses 14 to 21 days after the start of vaccination and in burros 21 to 28 days after the start of vaccination. The use of Woodhour's adjuvants or booster inoculations did not result in increased titers.
Snowden RT, Schumacher J, Blackford JT, Cypher EE, Cox SK, Sun X, Whitlock BK.To determine whether therapeutic concentrations (> 0.5 to 1.0 μg/mL) of polymyxin B (PB) were achieved in the tarsocrural joint of horses when the drug was administered by IV regional limb perfusion (IV-RLP) via a saphenous vein at doses of 25, 50, and 300 mg and to describe any adverse systemic or local effects associated with such administration. Methods: 9 healthy adult horses. Methods: In the first of 2 experiments, 6 horses each received 25 and 50 mg of PB by IV-RLP via a saphenous vein with at least 2 weeks between treatments. For each treatment, a tourniquet was placed at the midmetata...