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Topic:Veterinary Research

Veterinary research in horses encompasses the study of diseases, health management, and medical treatments specific to equine species. This field investigates various aspects of horse health, including infectious diseases, metabolic disorders, and musculoskeletal conditions. Researchers focus on understanding the pathophysiology of equine ailments, developing diagnostic tools, and evaluating therapeutic interventions. The study of horse health also involves examining preventive measures such as vaccination protocols and nutritional management to promote overall well-being. This page collects peer-reviewed research studies and scholarly articles that explore the diverse areas of veterinary science related to horses, providing insights into disease mechanisms, treatment strategies, and advancements in equine healthcare.
Molecular allergen profiling in horses by microarray reveals Fag e 2 from buckwheat as a frequent sensitizer.
Allergy    February 27, 2018   Volume 73, Issue 7 1436-1446 doi: 10.1111/all.13417
Einhorn L, Hofstetter G, Brandt S, Hainisch EK, Fukuda I, Kusano K, Scheynius A, Mittermann I, Resch-Marat Y, Vrtala S, Valenta R, Marti E, Rhyner C....Companion animals are also affected by IgE-mediated allergies, but the eliciting molecules are largely unknown. We aimed at refining an allergen microarray to explore sensitization in horses and compare it to the human IgE reactivity profiles. Methods: Custom-designed allergen microarray was produced on the basis of the ImmunoCAP ISAC technology containing 131 allergens. Sera from 51 horses derived from Europe or Japan were tested for specific IgE reactivity. The included horse patients were diagnosed for eczema due to insect bite hypersensitivity, chronic coughing, recurrent airway obstructio...
Absence of relationship between type-I interferon suppression and neuropathogenicity of EHV-1.
Veterinary immunology and immunopathology    February 25, 2018   Volume 197 24-30 doi: 10.1016/j.vetimm.2018.01.007
Oladunni FS, Sarkar S, Reedy S, Balasuriya UBR, Horohov DW, Chambers TM.Equine herpesvirus-1 (EHV-1) infection is an important and highly prevalent disease in equine populations worldwide. Previously we have demonstrated that a neuropathogenic strain of EHV-1, T953, suppresses the host cell's antiviral type-I interferon (IFN) response in vitro. Whether or not this is unique to EHV-1 strains possessing the neuropathogenic genotype has been undetermined. Here, we examined whether there is any direct relationship between neuropathogenic genotype and the induced IFN-β response in equine endothelial cells (EECs) infected with 10 different strains of EHV-1. The extent ...
Concentrations of follicle stimulating hormone associated with follicle selection, number of follicles, and ipsilateral vs contralateral relationships in mares.
Theriogenology    February 24, 2018   Volume 113 159-165 doi: 10.1016/j.theriogenology.2018.02.017
Ginther OJ, Domingues RR, Dangudubiyyam SV, Araujo ER.Diameter deviation or follicle selection during a follicular wave begins with continuous growth rate of F1 (dominant or selected follicle; DF) and decreasing growth rate of F2 (largest subordinate). Intraovarian patterns based on presence or absence of the DF and CL are DF-CL, DF, CL, and devoid (neither DF nor CL). The DF and CL relationships in a pair of ovaries are ipsilateral (DF-CL pattern and devoid pattern) and contralateral (DF pattern and CL pattern). The effects of patterns and relationships on F1, F2, and FSH during deviation were determined in 21 mares. Diameters of F1 and F2 at ex...
Ultrasonographic-based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong.
Equine veterinary journal    February 23, 2018   Volume 50, Issue 5 602-608 doi: 10.1111/evj.12810
Alzola R, Easter C, Riggs CM, Gardner DS, Freeman SL.Superficial digital flexor tendon (SDFT) injury is an important health and welfare concern in racehorses. It is generally diagnosed with ultrasonography, but predictive ultrasonographic features have not been reported. Objective: To determine ultrasonographic features of forelimb SDFT injury at initial presentation in Thoroughbred racehorses that could predict a successful return to racing (completing ≥5 races). Methods: Retrospective cohort study. Methods: Digitised ultrasonographic images of 469 horses with forelimb SDFT injuries from the Hong Kong Jockey Club (2003-2014) were evaluated, u...
Lipidomic analysis of immune activation in equine leptospirosis and Leptospira-vaccinated horses.
PloS one    February 23, 2018   Volume 13, Issue 2 e0193424 doi: 10.1371/journal.pone.0193424
Wood PL, Steinman M, Erol E, Carter C, Christmann U, Verma A.Currently available diagnostic assays for leptospirosis cannot differentiate vaccine from infection serum antibody. Several leptospiral proteins that are upregulated during infection have been described, but their utility as a diagnostic marker is still unclear. In this study, we undertook a lipidomics approach to determine if there are any differences in the serum lipid profiles of horses naturally infected with pathogenic Leptospira spp. and horses vaccinated against a commercially available bacterin. Utilizing a high-resolution mass spectrometry serum lipidomics analytical platform, we demo...
Molecular Genetic Manipulation of Sarcocystis neurona.
Current protocols in microbiology    February 22, 2018   Volume 48 20D.2.1-20D.2.14 doi: 10.1002/cpmc.48
Howe DK, Yeargan M, Simpson L, Dangoudoubiyam S.Sarcocystis neurona is a member of the important phylum Apicomplexa and the primary cause of equine protozoal myeloencephalitis (EPM). Moreover, S. neurona is the best-studied species in the genus Sarcocystis, one of the most successful parasite taxa, as virtually all vertebrate animals may be infected by at least one species. Consequently, scientific investigation of S. neurona will aid in the control of EPM and neurologic disease in sea mammals, while also improving our understanding of a prominent branch on the apicomplexan phylogenetic tree. These protocols describe methods that expand the...
10th Annual European College of Equine Internal Medicine Congress: 2-4 November, 2017.
Journal of veterinary internal medicine    February 22, 2018   Volume 32, Issue 2 867-878 doi: 10.1111/jvim.15044
No abstract available
Survey of Equine Referring Veterinarians’ Satisfaction with Their Most Recent Equine Referral Experience.
Journal of veterinary internal medicine    February 22, 2018   Volume 32, Issue 2 822-831 doi: 10.1111/jvim.15053
Best C, Coe JB, Hewson J, Meehan M, Kelton D.Little is known about the veterinary referral process and factors that contribute to positive outcomes. Objective: To investigate equine referring veterinarians' (rDVMs') satisfaction with their most recent referral experience and compare rDVM and specialist perspectives. Methods: 187 rDVMs and 92 specialists (referral care providers). Methods: Cross-sectional observational study. An online survey was administered to both rDVMs and specialists. Referring veterinarian satisfaction with their most recent referral experience was evaluated. Both rDVMs and specialists were asked to identify factors...
Genetic Diversity and Structure of Iranian Horses’ Population Based on Mitochondrial Markers.
Journal of equine veterinary science    February 22, 2018   Volume 64 107-111 doi: 10.1016/j.jevs.2018.02.011
Hedayat Evrigh N, Omri M, Boustan A, Seyedsharifi R, Vahedi V.The source and history of horse domestication have been studied for decades in biology and archeology. The aim of this study was to evaluate the genetic structure and the genetic relationship between six breeds of native horses using mitochondrial D-loop region. Blood samples were collected from 96 horses. Total DNA was extracted, and 430 bp of D-Loop region (hyper variable) was amplified and sequenced using Sanger sequencing methods. The analysis of data led to identify 48 polymorphic sites that create 52 haplotypes. The plotted phylogenic tree for haplotypes of Iranian native horses is plac...
Use of high-field and low-field magnetic resonance imaging to describe the anatomy of the proximal portion of the tarsal region of nonlame horses.
American journal of veterinary research    February 22, 2018   Volume 79, Issue 3 299-310 doi: 10.2460/ajvr.79.3.299
Biggi M, Dyson SJ.OBJECTIVE To use high-field and low-field MRI to describe the anatomy of the proximal portion of the tarsal region (proximal tarsal region) of nonlame horses. SAMPLE 25 cadaveric equine tarsi. PROCEDURES The proximal portion of 1 tarsus from each of 25 nonlame horses with no history of tarsal lameness underwent high-field (1.5-T) and low-field (0.27-T) MRI. Resulting images were used to subjectively describe the anatomy of that region and obtain measurements of the collateral ligaments of the tarsocrural joint. RESULTS Long and short components of the lateral and medial collateral ligaments of...
Histologic investigation of airway inflammation in postmortem lung samples from racehorses.
American journal of veterinary research    February 22, 2018   Volume 79, Issue 3 342-347 doi: 10.2460/ajvr.79.3.342
Ter Woort F, Caswell JL, Arroyo LG, Viel L.OBJECTIVE To describe histologic findings in the small airways during postmortem examination of actively racing horses and to quantify the degree of airway inflammation by use of a semiquantitative scoring system. SAMPLE Lung tissues obtained from 95 horses (Thoroughbreds, Standardbreds, and Quarter Horses) that had been actively racing or training. PROCEDURES 10 standardized lung sections were obtained during postmortem examination of 37 horses that had been actively racing or training, and 2 histologic sections of the caudodorsal lung lobes previously collected from each of 58 horses that di...
Effect of a syringe aspiration technique versus a mechanical suction technique and use of N-butylscopolammonium bromide on the quantity and quality of bronchoalveolar lavage fluid samples obtained from horses with the summer pasture endophenotype of equine asthma.
American journal of veterinary research    February 22, 2018   Volume 79, Issue 3 348-355 doi: 10.2460/ajvr.79.3.348
Bowser JE, Costa LRR, Rodil AU, Lopp CT, Johnson ME, Wills RW, Swiderski CE.OBJECTIVE To evaluate the effect of 2 bronchoalveolar lavage (BAL) sampling techniques and the use of N-butylscopolammonium bromide (NBB) on the quantity and quality of BAL fluid (BALF) samples obtained from horses with the summer pasture endophenotype of equine asthma. ANIMALS 8 horses with the summer pasture endophenotype of equine asthma. PROCEDURES BAL was performed bilaterally (right and left lung sites) with a flexible videoendoscope passed through the left or right nasal passage. During lavage of the first lung site, a BALF sample was collected by means of either gentle syringe aspirati...
Time required to achieve maximum concentration of amikacin in synovial fluid of the distal interphalangeal joint after intravenous regional limb perfusion in horses.
American journal of veterinary research    February 22, 2018   Volume 79, Issue 3 282-286 doi: 10.2460/ajvr.79.3.282
Kilcoyne I, Nieto JE, Knych HK, Dechant JE.OBJECTIVE To determine the maximum concentration (Cmax) of amikacin and time to Cmax (Tmax) in the distal interphalangeal (DIP) joint in horses after IV regional limb perfusion (IVRLP) by use of the cephalic vein. ANIMALS 9 adult horses. PROCEDURES Horses were sedated and restrained in a standing position and then subjected to IVRLP (2 g of amikacin sulfate diluted to 60 mL with saline [0.9% NaCl] solution) by use of the cephalic vein. A pneumatic tourniquet was placed 10 cm proximal to the accessory carpal bone. Perfusate was instilled with a peristaltic pump over a 3-minute period. Synovial ...
Comparison of Analgesic Effects of a Constant Rate Infusion of Both Tramadol and Acetaminophen Versus those of Infusions of Each Individual Drug in Horses.
Journal of equine veterinary science    February 22, 2018   Volume 64 101-106 doi: 10.1016/j.jevs.2018.02.015
Tavanaeimanesh H, Azarnoosh A, Ashar FS, Dehghan MM, Mohebbi Z, Akbarinejad V, Corley K.The choice of analgesic agents for the horse is limited, and many have side effects that can restrict their use for chronic and prolonged pain. Little information has been published on tramadol and acetaminophen use in the horse. The study evaluated the analgesic effects of coadministration of tramadol and acetaminophen compared to those of each drug individually in a crossover study. The study was performed on six healthy horses each infused with the following over 1 hour: control (normal saline), tramadol, acetaminophen, or both (acetaminophen and tramadol infused together). Nociception (usi...
A simple method of equine limb force vector analysis and its potential applications.
PeerJ    February 21, 2018   Volume 6 e4399 doi: 10.7717/peerj.4399
Hobbs SJ, Robinson MA, Clayton HM.Ground reaction forces (GRF) measured during equine gait analysis are typically evaluated by analyzing discrete values obtained from continuous force-time data for the vertical, longitudinal and transverse GRF components. This paper describes a simple, temporo-spatial method of displaying and analyzing sagittal plane GRF vectors. In addition, the application of statistical parametric mapping (SPM) is introduced to analyse differences between contra-lateral fore and hindlimb force-time curves throughout the stance phase. The overall aim of the study was to demonstrate alternative methods of eva...
Cycle-specific female preferences for visual and non-visual cues in the horse (Equus caballus).
PloS one    February 21, 2018   Volume 13, Issue 2 e0191845 doi: 10.1371/journal.pone.0191845
Burger D, Meuwly C, Thomas S, Sieme H, Oberthür M, Wedekind C, Meinecke-Tillmann S.Although female preferences are well studied in many mammals, the possible effects of the oestrous cycle are not yet sufficiently understood. Here we investigate female preferences for visual and non-visual male traits relative to the periodically cycling of sexual proceptivity (oestrus) and inactivity (dioestrus), respectively, in the polygynous horse (Equus caballus). We individually exposed mares to stallions in four experimental situations: (i) mares in oestrus and visual contact to stallions allowed, (ii) mares in oestrus, with blinds (wooden partitions preventing visual contact but allow...
How is the Morphometry of Stallions and Mares Show-Winning and Nonwinning Campolina Brazilian Breed with Batida and Picada Gaits?
Journal of equine veterinary science    February 21, 2018   Volume 64 34-40 doi: 10.1016/j.jevs.2018.02.012
Sousa AS, Jesus IIC, Araújo Oliveira CA, Costa RB, de Godoi FN.The aim of this study was to evaluate the morphometric measurements of stallion and mares show-winning and nonwinning Campolina breed with batida and picada gaits. A total of 167 horses (74 stallions and 93 mares), consisting of 102 batida and 65 picada gait animals, were used. Among these horses, 96 were awarded and 71 were not. Twenty linear, seven angular, and 11 girth measurements were taken. Results from the judging sessions were collected, and awards were observed in both sexes and both gaits. A descriptive statistical analysis and an analysis of variance were performed using the MEANS s...
Effects of age and diet on glucose and insulin dynamics in the horse.
Equine veterinary journal    February 21, 2018   Volume 50, Issue 5 690-696 doi: 10.1111/evj.12812
Rapson JL, Schott HC, Nielsen BD, McCutcheon LJ, Harris PA, Geor RJ.Age and diet may affect insulin sensitivity (SI) but these factors have received limited investigation in horses. Objective: To measure minimal model parameters during an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT) after adaptation to a forage only diet (HAY) or forage supplemented with either starch/sugar-rich (SS) or oil/fibre-rich (FF) concentrate feeds; and to assess glucose and insulin responses to a standardised meal challenge (SMC, 4 g/kg BW of SS) after diet adaptation in adult and aged mares. Methods: Latin square design with eight adult (5-12 yea...
Hereditary Multiple Exostoses-A Comprehensive Examination of a 4-Year-Old Dutch Warmblood Male With Maternal Links to HME in First and Second Generations.
Journal of equine veterinary science    February 21, 2018   Volume 64 55-58 doi: 10.1016/j.jevs.2018.02.009
May-Davis S, Doveren A, Sweere R, Smak J, Vermeulen Z.Hereditary multiple exostoses (HME) is a condition rarely diagnosed in horses, which has not been previously reported in Dutch Warmblood horses. Its presentation resembles that diagnosed in humans, and it is predominantly active during periods of skeletal maturation. This case study reports a link between a granddam with no obvious HME lesions and its first and second generations presenting with HME, albeit with different sires. The severity in affected horses (n = 5) varied from one foreleg to the other with extensive multiple lesions of 123 of 205 bones in a half sibling in the first genera...
Cerebrospinal fluid Lyme multiplex assay results are not diagnostic in horses with neuroborreliosis.
Journal of veterinary internal medicine    February 20, 2018   Volume 32, Issue 2 832-838 doi: 10.1111/jvim.15067
Johnson AL, Johnstone LK, Stefanovski D.The accuracy of the Lyme multiplex assay for the diagnosis of neuroborreliosis in horses is unknown. Objective: To describe Lyme multiplex results in horses with a postmortem diagnosis of neuroborreliosis. The hypothesis was that paired serum and cerebrospinal fluid (CSF) results and a CSF : serum ratio would allow differentiation of horses with neuroborreliosis from those with other neurologic diseases. Methods: Ninety horses that had neurologic examinations, serum and CSF Lyme multiplex analyses, and postmortem examination of the nervous system performed. Methods: Retrospective study. Data...
New Treatment for Urethral Rent in Stallions.
Journal of equine veterinary science    February 20, 2018   Volume 64 89-95 doi: 10.1016/j.jevs.2018.02.014
Sancler-Silva YFR, Silva-Junior ER, Fedorka CE, Scheeren VFC, Cavalero TS, Papa PM, Alvarenga MA, Dell'Aqua JA, Papa FO.The aim of this report is to describe a new methodology to successfully treat stallions diagnosed with urethral rent. Four stallions of ages ranging from 7 to 12 years (median 9) with hemospermia were admitted for clinical evaluation, breeding soundness examination, and urethroscopy for inspection of the urethra and vesicular glands. Once the presence of urethral rent was identified and/or other sources of hemorrhage were excluded, a topical treatment was performed with 4% Policresulen solution (Albocresil). The treatment was carried out by infusing 100 mL of the solution into the lumen of t...
Exercise-induced pulmonary hemorrhage in barrel racing horses in the Pacific Northwest region of the United States.
Journal of veterinary internal medicine    February 20, 2018   Volume 32, Issue 2 839-845 doi: 10.1111/jvim.15066
Gold JR, Knowles DP, Coffey T, Bayly WM.Exercise-induced pulmonary hemorrhage (EIPH) refers to bleeding from the lungs in association with strenuous exercise. It has been documented in race horses but little information exists on EIPH in barrel racing horses. Objective: Our goals were to evaluate the presence of EIPH in barrel racing horses and estimate its prevalence in the Pacific Northwest. Methods: 149 barrel racing horses enrolled at events in WA (11), ID (3), and MT (33). Methods: Observational cross-sectional study. Data collected included signalment, history of illness, respiratory disease, race division, and pre-race medica...
Effect of sotalol on heart rate, QT interval, and atrial fibrillation cycle length in horses with atrial fibrillation.
Journal of veterinary internal medicine    February 20, 2018   Volume 32, Issue 2 815-821 doi: 10.1111/jvim.15055
Decloedt A, Broux B, De Clercq D, Deprez P, Van Steenkiste G, Vera L, Ven S, van Loon G.Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long-term PO antiarrhythmic drug in horses. Objective: To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). Methods: Twenty-eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administ...
Review: The potential of seminal fluid mediated paternal-maternal communication to optimise pregnancy success.
Animal : an international journal of animal bioscience    February 19, 2018   Volume 12, Issue s1 s104-s109 doi: 10.1017/S1751731118000083
Bromfield JJ.Artificial insemination has been a landmark procedure in improving animal agriculture over the past 150 years. The utility of artificial insemination has facilitated a rapid improvement in animal genetics across agricultural species, leading to improvements of growth, health and productivity in poultry, swine, equine and cattle species. The utility of artificial insemination, as with all assisted reproductive technologies side-steps thousands of years of evolution that has led to the development of physiological systems to ensure the transmission of genetics from generation to generation. The ...
Analytical validation of a new point-of-care assay for serum amyloid A in horses.
Equine veterinary journal    February 19, 2018   Volume 50, Issue 5 678-683 doi: 10.1111/evj.12807
Schwartz D, Pusterla N, Jacobsen S, Christopher MM.Serum amyloid A (SAA) is a major acute phase protein in horses. A new point-of-care (POC) test for SAA (Stablelab) is available, but studies evaluating its analytical accuracy are lacking. Objective: To evaluate the analytical performance of the SAA POC test by 1) determining linearity and precision, 2) comparing results in whole blood with those in serum or plasma, and 3) comparing POC results with those obtained using a previously validated turbidimetric immunoassay (TIA). Methods: Assay validation. Methods: Analytical validation of the POC test was done in accordance with American Society o...
Pregnancy Rates Following Low-Temperature Storage of Large Equine Embryos Before Vitrification.
Journal of equine veterinary science    February 16, 2018   Volume 64 12-16 doi: 10.1016/j.jevs.2018.01.009
Diaz FA, Gutierrez EJ, Cramer E, Paccamonti DL, Gentry GT, Bondioli KR.Satisfactory pregnancy rates can now be achieved following the cryopreservation of large equine embryos. Nonetheless, its wide application might be limited by the fact that the cryopreservation of large equine embryos requires a specialized micromanipulation equipment and micromanipulation/vitrification skills. Alternatives should be developed to increase its utilization and widespread application in the commercial equine industry. To determine if large equine embryos are able to remain viable during transport from farms to specialized centers for embryo cryopreservation, we evaluated pregnanc...
Effects of Feeding Frequency Using a Commercial Automated Feeding Device on Gastric Ulceration in Exercised Quarter Horses.
Journal of equine veterinary science    February 16, 2018   Volume 64 96-100 doi: 10.1016/j.jevs.2018.02.005
Bass L, Swain E, Santos H, Hess T, Black J.The objective of this study was to evaluate two feeding regimens: traditional grain feeding (twice a day, traditional fed [TF]) compared with horses fed with an automated feeder programmed to deliver grain in 20 equal aliquots (fractioned fed [FF]) and its effects on gastric ulceration, body weight, and body condition score (BCS). Thirty-one Quarter Horses were maintained in individual stalls during the 60-day experimental period and worked at moderate exercise intensity. Gastroscopies were performed before grain adaptation at 0, 30, and 60 days. Weight and BCS were evaluated biweekly. There ...
Genetic and subunit vaccines based on the stem domain of the equine influenza hemagglutinin provide homosubtypic protection against heterologous strains.
Vaccine    February 15, 2018   Volume 36, Issue 12 1592-1598 doi: 10.1016/j.vaccine.2018.02.019
Ibañez LI, Caldevilla CA, Paredes Rojas Y, Mattion N.H3N8 influenza virus strains have been associated with infectious disease in equine populations throughout the world. Although current vaccines for equine influenza stimulate a protective humoral immune response against the surface glycoproteins, disease in vaccinated horses has been frequently reported, probably due to poor induction of cross-reactive antibodies against non-matching strains. This work describes the performance of a recombinant protein vaccine expressed in prokaryotic cells (ΔHAp) and of a genetic vaccine (ΔHAe), both based on the conserved stem region of influenza hemagglut...
Species-specific regulation of angiogenesis by glucocorticoids reveals contrasting effects on inflammatory and angiogenic pathways.
PloS one    February 15, 2018   Volume 13, Issue 2 e0192746 doi: 10.1371/journal.pone.0192746
Morgan R, Keen J, Halligan D, O'Callaghan A, Andrew R, Livingstone D, Abernethie A, Maltese G, Walker B, Hadoke P.Glucocorticoids are potent inhibitors of angiogenesis in the rodent in vivo and in vitro but the mechanism by which this occurs has not been determined. Administration of glucocorticoids is used to treat a number of conditions in horses but the angiogenic response of equine vessels to glucocorticoids and, therefore, the potential role of glucocorticoids in pathogenesis and treatment of equine disease, is unknown. This study addressed the hypothesis that glucocorticoids would be angiostatic both in equine and murine blood vessels.The mouse aortic ring model of angiogenesis was adapted to assess...
Enteral/Parenteral Nutrition in Foals and Adult Horses Practical Guidelines for the Practitioner.
The Veterinary clinics of North America. Equine practice    February 14, 2018   Volume 34, Issue 1 169-180 doi: 10.1016/j.cveq.2017.11.012
Carr EA.Nutritional support is an important adjunct to medical therapy in the sick, injured, or debilitated equine patient. What is not clear is the optimal route, composition, or amounts of support. The enteral route should be chosen whenever possible to maximize the benefits to the gastrointestinal tract and the patient as a whole. Complete or partial parenteral nutrition is most useful as a bridge during recovery and transition to enteral feeding in the horse. The reader is encouraged to consider nutritional support whether enteral or parenteral in any anorexic, chronically debilitated, or sick equ...