Analyze Diet

Topic:Veterinary Medicine

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.
Pulled-up race outcomes as welfare-relevant surveillance indicators in United States Steeplechase horses, 2023-2025.
Frontiers in veterinary science    October 2, 2026   Volume 13 1910221 doi: 10.3389/fvets.2026.1910221
Markowitz JS.Pulled-up race outcomes are routinely recorded but are nonspecific, potentially reflecting fatigue, poor performance, footing, rider judgment, suspected injury, or physiological compromise. We evaluated their association with subsequent participation disruption in United States steeplechase horses. Unassigned: National Steeplechase Association Race Results Reports from 2023 to 2025 were analyzed retrospectively at the horse-start level. Outcomes were time to the next later-date start, ≥60-day interruption, ≥183-day absence, and no recorded later-date start. Cox models were stratified by ra...
Jejunal Perforation Associated With a Horseshoe-Shaped Abdominal Contusion After a Horse Kick: A Case Report.
Clinical case reports    October 2, 2026   Volume 14, Issue 10 e73687 doi: 10.1002/ccr3.73687
Yoshida J, Hanaki T, Sakano Y, Fujiwara Y.A horseshoe-shaped abdominal contusion after a horse kick may indicate the site of underlying bowel injury. When accompanied by persistent abdominal pain or peritoneal signs, hollow viscus injury should be considered. Contrast-enhanced CT can identify free air and focal bowel abnormalities at the impact site, facilitating timely surgical management.
Novel serum biomarkers provide evidence for an involvement of the CCL3:CCL5 axis in fatal musculoskeletal injuries in Thoroughbred racehorses.
Journal of the American Veterinary Medical Association    October 2, 2026   1-10 doi: 10.2460/javma.26.06.0502
Wagner B, Pigott J, Palmer S, Rollins A.Fatal musculoskeletal (MSK) injuries in Thoroughbred (TB) racehorses adversely affect equine welfare, negatively impact public acceptance of horse racing, and cause severe economic losses for the racing industry. Biomarker assays predicting the risk of MSK injuries are currently not available. Our hypothesis was that immune system and inflammatory markers are indicators of fatal MSK injuries in TB racehorses. Unassigned: Serum samples from TB racehorses with fatal (n = 44) and nonfatal injuries (63) were collected. Serum from 2- to 5-year-old TBs submitted for annual equine infectious anemia t...
Comparison of arterial blood pressure and quality of induction and recovery in horses anesthetized with diazepam or guaifenesin co-induction combined with xylazine and ketamine and maintained on isoflurane.
Canadian journal of veterinary research = Revue canadienne de recherche veterinaire    October 1, 2026   Volume 90, Issue 4 145-155 
Valverde A, Moreira T, Torrent-Crosa A, Daw A, Koenig JB.The objective of this prospective alternating crossover study was to compare quality of induction and recovery and cardiopulmonary function in horses administered guaifenesin or diazepam as co-induction drugs. Six healthy horses were anesthetized twice to undergo an MRI and surgical biopsies, with 5 wk between treatments. Horses were sedated intravenously (IV) with xylazine, 0.6 mg/kg BW, and IV induction started 4 min later. Group G received guaifenesin, 100 mg/kg BW, over 2 min and ketamine, 2 mg/kg BW, within 1 to 2 min of starting the guaifenesin. Group D received diazepam, 0.1 mg/kg BW, w...
Mandibular fracture with subsequent sequestrum formation and tooth-root abscess in a 3-year-old mare.
The Canadian veterinary journal = La revue veterinaire canadienne    October 1, 2026   Volume 67, Issue 10 1112-1117 
Schmoyer KN.A 3-year-old quarter horse cross mare was presented to the Atlantic Veterinary College (Charlottetown, Prince Edward Island) for evaluation of a persistent draining tract on the ventral aspect of the left mandible, associated with a previous fracture. Radiography and ultrasonography confirmed the presence of a chronic sequestrum separated from the parent bone. Sequestrectomy and surgical debridement of the mandible were carried out, and the horse was discharged. Three months later, the mare was presented again to the Atlantic Veterinary College, as the draining tract had not resolved. A CT sca...
Recent Advances and Emerging Applications in Embryo Vitrification for Livestock.
Reproduction in domestic animals = Zuchthygiene    October 1, 2026   Volume 61 Suppl 3, Issue Suppl 3 e70269 doi: 10.1111/rda.70269
Vitrification has progressively supplanted conventional slow freezing as the method of choice for embryo cryopreservation in both human medicine and animal production, particularly for in vitro-produced embryos and for species or developmental stages highly sensitive to conventional freezing. By combining very high cooling and warming rates with concentrated cryoprotectant solutions and minimal sample volumes, it largely prevents intracellular ice formation and, in experienced hands, consistently yields post-warming survival and developmental rates that exceed those obtained with traditional ...
Layer-Specific Quantitative Assessment of Collagen Distribution in Equine Uteri Using Masson’s Trichrome and Digital Image Analysis: A Comparative Study.
Reproduction in domestic animals = Zuchthygiene    October 1, 2026   Volume 61 Suppl 3 e70279 doi: 10.1111/rda.70279
Cerveira-Pinto M, Santos C, Gomes N, Pinho M, Szóstek-Mioduchowska A, Amaral A.Equine endometrial fibrosis is a chronic and progressive equine uterine condition characterized by fibrosis that affects mares' fertility, with a wide range of fertility outcomes being reported for these mares. Therefore, assessing layer-specific collagen (COL) distribution is essential for a comprehensive understanding of endometrial remodelling and its impact on equine reproductive potential. Full-thickness uterine samples, including stratum functionalis (SF), stratum basalis (SB) and myometrium, were collected post-mortem from healthy control mares (Category I; n = 10) and those with mo...
Immunoglobulin E: From horses to myeloma.
Cleveland Clinic journal of medicine    October 1, 2026   Volume 93, Issue 10 589-591 doi: 10.3949/ccjm.93a.26078
Brown AJ.No abstract available
Proof of Concept for Open Flow Microperfusion for Intratumoural Drug Administration in Equine Cutaneous Neoplasia.
Animals : an open access journal from MDPI    October 1, 2026   Volume 16, Issue 19 3090 doi: 10.3390/ani16193090
Labens R, Reddell P, Birngruber T.Intratumoural drug delivery can achieve high local therapeutic exposure while limiting systemic effects, but heterogeneous distribution may compromise treatment efficacy and precision. This proof-of-concept study investigated open flow microperfusion (OFM) as a novel platform for local delivery of tigilanol tiglate (TT), an intratumoural antineoplastic agent with immunomodulatory and vascular-disrupting effects. Four horses with histologically confirmed cutaneous neoplasia (three sarcoids and one squamous cell carcinoma) underwent OFM using TT concentrations of 0.01-0.04 mg/mL delivered at 9 Â...
Predicting outcomes in equine peritonitis: Multivariable analysis of admission and post-admission data from a UK hospital population.
Equine veterinary journal    September 30, 2026   doi: 10.1002/evj.70339
Kopec EK, Carslake H, Archer DC, Morris B, Wilson A.Peritonitis is life-threatening, and limited information exists regarding outcomes and predictors of survival. Objective: To report short- and long-term outcomes in horses diagnosed with peritonitis and identify factors associated with survival. Methods: Retrospective observational. Methods: Data were obtained for horses admitted to a UK referral hospital between 2010 and 2024 diagnosed with peritonitis (peritoneal fluid nucleated cell count >10 × 10/L). Short- and long-term morbidity and mortality were assessed. Multivariable logistic regression was used to identify factors associated w...
Effect of volume for injection of the 15th to 16th thoracic interspinous space: An ex vivo study.
Equine veterinary journal    September 30, 2026   doi: 10.1002/evj.70341
Melly V, Brown KA, Engiles J, Stewart HL, Stefanovski D, Bills KW, Davidson E.Impinging (overriding) spinous processes (ISPs) are commonly identified in horses with back pain. Diagnostic analgesia is widely used as the clinical reference standard for confirming association with clinical signs of back pain, but the specificity of dorsal spinous region diagnostic analgesia remains poorly understood. Objective: To evaluate the specificity of a midline thoracic interspinous space injection in cadaveric horses using three injectate volumes, assessed by computed tomography (CT) and anatomical dissection. Methods: Ex vivo experimental study. Methods: The T15-T16 interspinous s...
The effect of ertugliflozin on serum insulin and glucose in healthy horses receiving dexamethasone.
Journal of veterinary internal medicine    September 30, 2026   Volume 40, Issue 5 aalag204 doi: 10.1093/jvimsj/aalag204
Dupuis-Dowd F, Kass PH, Berryhill EH.Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) can be used to manage insulin dysregulation (ID). Their effect on corticosteroid-induced ID is unknown. Objective: Evaluate effects of ertugliflozin on serum insulin and glucose concentrations in horses receiving dexamethasone (DEX). We hypothesized that DEX would induce ID and ertugliflozin coadministration would mitigate that effect. Methods: Seven healthy horses. Methods: Randomized crossover design; horses received DEX (0.06 mg/kg IV q48h; DEX)or ertugliflozin (0.05 mg/kg PO q24h) plus DEX (SGLT-2i group) for seven days. Oral sugar (OST...
Validation of a novel instrumented hoof boot with pressure sensors using force plate gait kinetics in horses at walk and trot.
Equine veterinary journal    September 30, 2026   doi: 10.1002/evj.70332
Keller J, Hassenstein MJ, Jung K, Geburek F.Force plates (FP) are considered the gold standard for quantitative equine gait evaluation but are limited to experimental use. An instrumented hoof boot (IHB) with pressure sensors and an inertial measurement unit would allow clinicians to objectively assess kinetic parameters and gait symmetry. Objective: To validate the IHB by comparing kinetic parameters with obtained FP data. Methods: In vivo experiments. Methods: Twenty-seven horses were measured with IHBs on FPs at walk and trot. Mean value kinetic parameters recorded were: (1) peak vertical force (PVF) [N/kg]/peak vertical pressure (PV...
Low-Field Magnetic Resonance Imaging Features of Axial Proximal Sesamoid Osteomyelitis and Intersesamoidean Ligament Rupture in a Horse. Mageed M, Bobrowski P, Przewoźny M, Grabski M.A 7-year-old Warmblood mare used for show jumping was evaluated for progressive left hindlimb lameness of 5 weeks' duration, localized clinically to the metatarsophalangeal region. Radiography revealed ill-defined osteolysis of the axial apical regions of both proximal sesamoid bones (PSBs). Due to rapid clinical deterioration, low-field magnetic resonance imaging was performed and demonstrated aggressive axial osteomyelitis of both PSBs, partial rupture of the intersesamoidean ligament and proximal scutum with herniation of synovium of the plantar joint recess, and an occult penetrating tract...
Equine viral arteritis in horses undergoing pre-export testing in Spain (2016-2023): Seroprevalence estimates and diagnostic performance of a commercial indirect ELISA.
The Veterinary record    September 30, 2026   doi: 10.1002/vetr.71223
Gago P, Dorrego A, Pozo P, Raez A, Rivera B, de Juan L, Cruz-Lopez F.Equine viral arteritis (EVA) is a contagious disease that affects equine reproduction and international trade. Despite its importance, epidemiological data from Spain are limited. This study aimed to assess EVA seroprevalence and evaluate the diagnostic performance of a commercial ELISA in horses before export. Methods: From 2016 to 2023, 5000 serum samples from horses across 16 Spanish autonomous communities were tested using a commercial indirect ELISA. Samples with inconclusive results, or those submitted with specific requests, underwent virus neutralisation testing (VNT). Diagnostic perfo...
Effect of erythromycin and colistin ophthalmic ointment on post-race keratitis in Thoroughbred racehorses.
The Veterinary record    September 29, 2026   doi: 10.1002/vetr.71221
Ueshiba H, Kuroda T, Niwa H, Iimori M, Ohta M, Kurimoto S.This study investigated the prophylactic efficacy of administering an ophthalmic ointment containing erythromycin and colistin (EC ointment) after racing to prevent post-race keratitis in Thoroughbred racehorses. Methods: The incidence of post-race keratitis following turf and dirt races was compared between treatment groups (non-ointment group: eye flushing only; ointment group: eye flushing and application of EC ointment) and between two randomly assigned groups (non-antimicrobial group: application of ophthalmic white petrolatum; antimicrobial group: application of EC ointment). Results: Af...
Etiological and immunological aspects of equine hoof canker.
Veterinary research communications    September 29, 2026   Volume 50, Issue 6 606 doi: 10.1007/s11259-026-11548-y
Styková E, Mudroňová D, Gancarčíková S, Žert Z, Kačírová J, Valocký I.Chronic equine proliferative pododermatitis (canker) is a hypertrophic hoof disease characterized by excessive proliferation of horn-producing tissues resulting from dyskeratosis of keratinocytes. Since its etiology remains unknown, this study investigated potential etiological agents and evaluated biochemical and immunological profiles. Ten horses with hoof canker and ten healthy controls of the Norik of Muran breed were included. Dermatophytes and bovine papillomavirus 1 and 2 (BPV 1/2) were not detected. Candida glabrata was the most frequently identified species in both affected and health...
Multisystemic and cerebral infection associated with Halicephalobus gingivalis in Brazilian Criollo horses.
Veterinary research communications    September 29, 2026   Volume 50, Issue 6 602 doi: 10.1007/s11259-026-11522-8
Berger L, Echenique JVZ, Baggio-Souza V, Fagundes-Moreira R, Ribeiro PR, Barbosa FMS, Lamego EC, Bueno FU, Pavarini SP, Sonne L, Panziera W, Soares JF.Halicephalosis is a rare cosmopolitan disease affecting equids, cattle, and humans, manifesting as meningoencephalitis. This study reports the detection of Halicephalobus gingivalis infection in two adult horses with neurological clinical signs in Rio Grande do Sul state, in the Southern Brazil. It underscores the pathological main findings and phylogenetic analyses. In both cases, the horses exhibited severe neurological manifestations and were euthanized due to poor prognosis. Pathological findings revealed gross brain lesions, in addition, alterations in the kidneys and lymph nodes. Histopa...
Liposomal bupivacaine local analgesia reduces systemic inflammatory responses following equine laparoscopic surgery.
American journal of veterinary research    September 29, 2026   1-9 doi: 10.2460/ajvr.26.08.0341
Luedke L, Clark A, Hendrickson DA, Bass L, Kawahisa-Piquini G, Impastato R, Sabino I, Chow L, Dow S, Pezzanite LM, Griffenhagen GM.Liposomal local anesthetics have been shown to extend analgesia duration and improve pain scores dose-dependently in horses. Our objective was to assess concurrent impact on systemic inflammatory markers. Unassigned: 18 mares (age, 2 to 20 years) with normal ovarian anatomy were enrolled. Laparoscopic bilateral ovariectomies were performed standing with sedation. Local analgesia was: 80 mL bupivacaine hydrochloride (BHCl; n = 6), 30 mL 0.75% BHCl + 20 mL (low-dose) liposomal bupivacaine (LB) expanded to 80 mL with saline (LB20, n = 6), or 30 mL 0.75% BHCl + 40 mL (high-dose) LB expanded to equ...
First documented cases of equine leishmaniasis caused by Leishmania (Mundinia) martiniquensis in France.
Parasite (Paris, France)    September 28, 2026   Volume 33 53 doi: 10.1051/parasite/2026054
Alleaume C, Laloy E, Dupuis-Tricaud MC, Kuk N, Kariya E, Keck N, Depaquit J, Lachaud L, Ravel C.In this study, we describe the first documented cases of equine cutaneous leishmaniasis caused by Leishmania (Mundinia) martiniquensis in France and provide clinical and parasitological data relevant for the recognition of this emerging infection in horses. Three horses presenting localized cutaneous lesions were diagnosed with L. martiniquensis infection in different regions of France without spatial or temporal clustering. Lesions were clinically nonspecific and initially compatible with common equine dermatological conditions, including sarcoid-like tumors. Histopathological examination rev...
Case Report : Streptococcus equi subspecies zooepidemicus bacteriemia and spondylodiscitis following direct contact with a horse.
Diagnostic microbiology and infectious disease    September 28, 2026   Volume 117, Issue 1 117677 doi: 10.1016/j.diagmicrobio.2026.117677
Potvin É, De Rico L.Streptococcus equi subspecies zooepidemicus is a zoonotic pathogen that commonly colonizes the respiratory tract and oral cavity of horses. Human infections are rare and most frequently present as bacteremia, meningitis, or pneumonia. Methods: We report the case of an 88-year-old patient who developed Streptococcus equi subspecies zooepidemicus spondylodiscitis after direct and exclusive contact with a live horse. Clinical, microbiological, and radiological findings were reviewed. Results: Blood cultures identified Streptococcus equi subspecies zooepidemicus. Magnetic resonance imaging confirm...
Ursodeoxycholic Acid Oral Pharmacokinetics and Plasma Bile Acid Profile Changes in a Population of Healthy Neonatal Foals.
Journal of veterinary pharmacology and therapeutics    September 28, 2026   doi: 10.1111/jvp.70111
Burdette TN, Delvescovo B, Wise Bellin E, Divers TJ, Donnelly CG.Ursodeoxycholic acid (UDCA) is a secondary bile acid used in humans for the treatment of some cholestatic diseases. Interest in its potential use in equine patients with liver conditions has increased. Pharmacokinetic parameters in adult horses have recently been reported; however, they are not available for foals. The objective of this study was to characterize the pharmacokinetics of UDCA following a single oral dose of 15 mg/kg in six healthy neonatal foals and evaluate associated changes in bile acids (BA) profile. UDCA concentrations were measured using liquid chromatography-tandem mass...
Thymidine kinase 1 activity in serum and body cavity fluids of horses with lymphoma.
Journal of veterinary internal medicine    September 27, 2026   Volume 40, Issue 5 aalag207 doi: 10.1093/jvimsj/aalag207
Drozdzewska K, Burde S, Müller E, Merle R, Gehlen H.The accuracy of serum thymidine kinase 1 (TK1S) as a biomarker of lymphoma in horses is variable. The value of measurement in body cavity fluid (TK1F) has not been established. Objective: (1) TK1F and TK1S will be higher in horses with lymphoma compared to diseased controls (DCs); (2) TK1F will be higher than TK1S; and (3) there will be a strong correlation between both measurements. Methods: Twenty animals in the lymphoma and 31 animals with nonneoplastic, gastrointestinal/respiratory disorders in DC group. Methods: This was a cross-sectional study using prospectively collected data and sampl...
Association Between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Clinicopathological Features in Equine Melanoma.
Journal of equine veterinary science    September 27, 2026   106158 doi: 10.1016/j.jevs.2026.106158
Pimenta J, Moreira D, Prada J, Monteiro L, Garcez F, Delgado L, Cotovio M.Equine melanoma is one of the most important oncological diseases in horses and exhibits a distinct biological behavior compared with melanoma in other species. Matrix metalloproteinase-9 (MMP-9) has been associated with tumor aggressiveness and metastasis in human and canine melanoma, but its expression in equine melanoma remains unknown. Objective: Evaluate the immunohistochemical expression of MMP-9 in equine melanomas and investigate its association with clinicopathological features. Methods: 68 formalin-fixed, paraffin-embedded equine melanomas from 48 gray horses were evaluated immunohis...
Prior-informed population pharmacokinetic-pharmacodynamic modeling of dexamethasone in horses.
Journal of pharmacokinetics and pharmacodynamics    September 26, 2026   Volume 53, Issue 6 57 doi: 10.1007/s10928-026-10062-7
Yu R, Toutain PL, Ekstrand C, Jusko WJ.Dexamethasone (DEX) is widely used in equine practice with diverse studies having characterized its pharmacokinetics (PK) and pharmacodynamics (PD) including our published comprehensive meta-analysis. Individual DEX concentrations in plasma and urine and serum cortisol from five studies (n = 32 horses) were analyzed using a minimal physiologically-based PK (mPBPK) model and a circadian baseline-indirect response PD model. The previous meta-analysis provided complex structural models to assess sources of variability across an array of studies involving intravenous (IV), intramuscular (IM) a...
Bacterial isolates and antimicrobial susceptibility patterns in tracheal wash samples from horses with equine asthma in Poland.
Journal of veterinary research    September 26, 2026   Volume 70, Issue 3 415-424 doi: 10.2478/jvetres-2026-0053
Siwińska N, Długopolska D, Żak-Bochenek A, Paszkowska M, Rudzki P, Kumiega E, Bogucka A.Equine asthma (EA) is a chronic inflammatory lower-airway disease. Bacterial growth from tracheal wash (TW) may occur in samples from horses with EA, but may represent colonisation rather than active infection. This study described cultivable bacterial isolates recovered from TW samples from horses with EA in Poland and assessed their antimicrobial susceptibility patterns and association with month/season of sampling and airway neutrophil percentage. Unassigned: In total, 165 adult horses diagnosed with EA according to American College of Veterinary Internal Medicine-based criteria underwent e...
Weigh tape more accurately estimates equine body weight than morphometric formula: a controlled technical assessment.
Journal of equine veterinary science    September 25, 2026   106156 doi: 10.1016/j.jevs.2026.106156
Pizzigatti D, Inocente B, Silva LCLC, Alcántara I.Accurate body weight (BW) estimation in horses is essential for clinical and nutritional management; however, calibrated scales are often unavailable under field conditions. Objective: To compare the longitudinal accuracy and consistency of a commercial weigh tape and the Carroll and Huntington morphometric formula against calibrated digital scale measurements in adult horses. Methods: In a prospective longitudinal experimental study, six clinically healthy adult crossbred horses (mean real body weight [Rbw] 355.5 ± 21.2 kg) were monitored weekly for 63 days under controlled management condit...
The Impact of Track Incline on Musculoskeletal Injuries in Thoroughbred Racehorses in Training: A Retrospective Cohort Study of Fractures on Flat and Uphill Woodchip Surfaces.
Journal of equine veterinary science    September 25, 2026   106157 doi: 10.1016/j.jevs.2026.106157
Mizobe F, Mita H.While race-day musculoskeletal injuries are well-documented, a considerable gap exists regarding fractures sustained during training, where Thoroughbred racehorses accumulate the majority of their high-speed exercise. In Japan, compliant woodchip tracks are frequently used, and uphill track geometries are a foundational element of conditioning. Objective: To quantify and describe the incidence and anatomical distribution of fractures occurring during training on flat versus uphill woodchip tracks over a 15-year period (2008-2022). Methods: A retrospective cohort study was conducted using centr...
Use of UV-Polymerizable Methacrylate Adhesive as a Post-Recovery Bandage Replacement for Transphyseal Screw Incisions in Horses: A Pilot Study.
Animals : an open access journal from MDPI    September 24, 2026   Volume 16, Issue 19 3010 doi: 10.3390/ani16193010
Lafin L, Tricaud C, Lechartier A.Surgical adhesives may provide an alternative to postoperative bandaging, but their use has not been evaluated in veterinary medicine. This prospective pilot study investigated the tolerance and postoperative adhesion of a UV-polymerizable methacrylate adhesive (UV-PMA) as a post-recovery bandage substitute following transphyseal screw placement in horses. A total of 153 sutured stab incisions from 102 horses were included; 75 received UV-PMA and 78 were protected with bandages. Surgical site infection (SSI) within 30 days and UV-PMA/bandage slippage within 14 days were compared between the tr...
Application of digital pathology to assess the effect of hormone treatment on placental histomorphometry in mares with induced ascending placentitis.
Theriogenology    September 24, 2026   Volume 267 118204 doi: 10.1016/j.theriogenology.2026.118204
Souza LS, Scalco R, Nogueira CEW, Silva GC, Pazinato FM, Corcini CD, Varela AS, Curcio BR.This study aimed to evaluate the effects of hormonal treatments with altrenogest (ALT) and estradiol cypionate (ECP) on placental histomorphometry in mares with experimentally induced ascending placentitis, using digital pathology as a quantitative tool. Thirty pregnancies from 27 Criollo-type mares were assigned to six groups: healthy controls (n = 5); basic treatment (n = 5), treated with trimethoprim-sulfamethoxazole (TSM), and flunixin meglumine (FM); ALT group (n = 5) + basic treatment; ECP group (n = 5) + basic treatment; ALT + ECP group (n = 5) in addition to basic treat...