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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.
Genetic diversity of Theileria equi and Babesia caballi infecting horses of Central-Southern Italy and preliminary results of its correlation with clinical and serological status.
Ticks and tick-borne diseases    May 4, 2018   Volume 9, Issue 5 1212-1220 doi: 10.1016/j.ttbdis.2018.05.005
Manna G, Cersini A, Nardini R, Bartolomé Del Pino LE, Antognetti V, Zini M, Conti R, Lorenzetti R, Veneziano V, Autorino GL, Scicluna MT.Babesia caballi and Theileria equi are tick-borne pathogens causing equine piroplasmosis infecting the Equidae family in which they cause significant sanitary and economic losses. Furthermore, equine piroplasmosis is included in the World Animal Health Organization (OIE) notifiable diseases list with possible movement restrictions for positive horses. Thirty-nine EDTA and whole-blood samples collected during 2013 and 2014 from symptomatic and asymptomatic horses of Central-Southern Italy were included in the present study either because of their strongly positive results in Real Time (RT) PCRs...
[New drugs for horses and production animals in 2017].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    May 4, 2018   Volume 46, Issue 2 95-100 doi: 10.15653/TPG-180300
Emmerich IU.In 2017, no new active pharmaceutical ingredients were released on the German market for horses or food-producing animals. Four established veterinary active pharmaceutical ingredients became available for additional species: the ectoparasitic Fluralaner (Exzolt®) of the isoxazoline group was additionally authorized for chickens, the macrolide antibiotics Gamithromycin (Zactran®) and Tulathromycin (Draxxin®) for sheep and the nonsteroidal anti-inflammatory drug Tolfenamic Acid (Tolfedol®) from the fenamate group for cattle and pigs. Additionally, one drug with a new combination of active i...
Nutritional secondary hyperparathyroidism in two ponies.
Open veterinary journal    May 4, 2018   Volume 8, Issue 2 149-153 doi: 10.4314/ovj.v8i2.6
Lacitignola L, Luca P, Santovito R, Comite MSD, Crovace A.Nutritional secondary hyperparathyroidism (NSH) is uncommon in horses. Aim of this report is evaluate an alternative therapeutic approach and provide more information on the diagnostic procedures, through detailed microscopic findings of the bone lesions pony with NSH. Administration of tiludronate along with a balanced diet can be used in a treatment protocol for ponies with NSH. This case report suggests that tiludronate can be used to ameliorate the clinical signs of NSH.
Molecular characterization of Theileria equi infection in horse populations belonging to West Azerbaijan, Iran: insights into the importance of Equine Merozoite Antigen (EMA)-1 in its diagnosis.
Annals of parasitology    May 3, 2018   Volume 64, Issue 1 21-27 doi: 10.17420/ap6401.128
Ebrahimi M, Adinehbeigi K, Hamidinejat H, Tabandeh MR.The major agent of equine piroplasmosis (EP), Theileria equi, contributes to significant losses in the equine industry. This study was designed to evaluate T. equi infection among horses from West Azerbaijan by microscopy and molecular approaches. One hundred and twenty six blood samples were collected from the jugular vein and placed in sterile tubes containing EDTA; these tubes were either used immediately for blood smears or stored at –20°C for later examination by PCR. T. equi was detected in 3.2% and 27.7% of the animals examined using light microscopy and PCR methods, respectively. Th...
The in vitro effect of Ferula asafoetida and Allium sativum extracts on Strongylus spp.
Annals of parasitology    May 3, 2018   Volume 64, Issue 1 59–63 doi: 10.17420/ap6401.133
Tavassoli M, Jalilzadeh-Amin G, Fard VRB, Esfandiarpour R.The high incidence of equine gastrointestinal worms and their increased resistance against anthelmintics has encouraged research into the effectiveness of rational phytotherapy. This study investigates the in vitro anti-parasitic effects of extracts of Ferula asafoetida and Allium sativum, two native plants that are widespread in Iran on Strongylus spp. larvae. Faecal samples were collected from horses, examined by routine parasitology methods and positive samples were used for future examination. After incubation, the third-stage larvae were harvested by the Baermann technique. A hydroalcohol...
Sustained intra-articular release of celecoxib in an equine repeated LPS synovitis model. Cokelaere SM, Plomp SGM, de Boef E, de Leeuw M, Bool S, van de Lest CHA, van Weeren PR, Korthagen NM.Synovial inflammation is an important characteristic of arthritic disorders like osteoarthritis and rheumatoid arthritis. Orally administered non-steroidal anti-inflammatory drugs (NSAIDs) such as celecoxib are among the most widely prescribed drugs to manage these debilitating diseases. Intra-articular delivery in biodegradable in situ forming hydrogels overcomes adverse systemic effects and prolongs drug retention in the joint. In this study two formulations of celecoxib (40 mg/g and 120 mg/g) in a propyl-capped PCLA-PEG-PCLA triblock copolymer were sequentially evaluated in a multiple L...
Normal microscopic anatomy of equine body and limb skin: A morphological and immunohistochemical study.
Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft    May 3, 2018   Volume 218 205-212 doi: 10.1016/j.aanat.2018.03.010
Jørgensen E, Lazzarini G, Pirone A, Jacobsen S, Miragliotta V.Information on microscopic anatomy of equine skin is sparse. In horses, limb wounds often become chronic and/or non-healing whereas body wounds heal normally. These dissimilarities in healing patterns might be a product of different phenotypic characteristics of body and limb skin. The objective of this study was to investigate microscopic anatomy, epidermal thickness, keratinocyte proliferation and differentiation as well as the presence of mast cells in normal equine skin of body and limb. Methods: The study involved body and limb skin biopsies from six horses. Histological characteristics o...
Effects of three-dimensional spheroid culture on equine mesenchymal stem cell plasticity.
Veterinary research communications    May 2, 2018   Volume 42, Issue 3 171-181 doi: 10.1007/s11259-018-9720-6
Park MJ, Lee J, Byeon JS, Jeong DU, Gu NY, Cho IS, Cha SH.Mesenchymal stem cells (MSCs) are useful candidates for tissue engineering and cell therapy fields. We optimize culture conditions of equine adipose tissue-derived MSCs (eAD-MSCs) for treatment of horse fractures. To investigate enhancing properties of three-dimensional (3D) culture system in eAD-MSCs, we performed various sized spheroid formation and determined changes in gene expression levels to obtain different sized spheroid for cell therapy. eAD-MSCs were successfully isolated from horse tailhead. Using hanging drop method, spheroid formation was generated for three days. Quantitative re...
In vivo confocal microscopy characteristics of equine epithelial and subepithelial nonulcerative keratomycosis.
Veterinary ophthalmology    May 2, 2018   Volume 22, Issue 2 168-176 doi: 10.1111/vop.12576
Ledbetter EC, Irby NL, Teixeira LBC.To describe the in vivo confocal microscopy features of horses with epithelial and subepithelial nonulcerative keratomycosis. Methods: Four horses with a clinical diagnosis of epithelial or subepithelial keratomycosis. Methods: Horses were examined on one or more occasions by in vivo laser scanning confocal microscopy of the cornea. Confocal microscopic examination characteristics were correlated with clinical, cytological, and histopathological findings for the horses. Results: All horses had an irregular corneal epithelial surface during slit-lamp biomicroscopy examination. Epithelial or s...
Equine strongyle communities are constrained by horse sex and species dipersal-fecundity trade-off.
Parasites & vectors    May 2, 2018   Volume 11, Issue 1 279 doi: 10.1186/s13071-018-2858-9
Sallé G, Kornaś S, Basiaga M.Equine strongyles are a major health issue. Large strongyles can cause death of horses while cyathostomins (small strongyles) have shown increased resistance to anthelmintics worldwide. Description of strongyle communities have accumulated but little is known about the diversity of these communities and underpinning environmental factors. Strongyles were recovered after ivermectin treatment from 48 horses located in six premises in Poland. Correlation between previously published species fecundity and the observed relative abundance and prevalence were estimated. Significance of horse sex was ...
Risk factors associated with clinical signs of vesicular stomatitis and seroconversion without clinical disease in Colorado horses during the 2014 outbreak.
Preventive veterinary medicine    May 2, 2018   Volume 156 28-37 doi: 10.1016/j.prevetmed.2018.05.002
Urie NJ, Lombard JE, Marshall KL, Digianantonio R, Pelzel-McCluskey AM, McCluskey BJ, Traub-Dargatz JL, Kopral CA, Swenson SL, Schiltz JJ.Vesicular stomatitis (VS) is caused by a contagious rhabdovirus that affects horses, cattle, and swine. Clinical signs of vesicular stomatitis virus (VSV) infection in pigs and cattle are indistinguishable from foot-and-mouth disease (FMD), a foreign animal disease and reportable disease in the United States (Rodriguez et al., 2000). A VS epidemic occurred in the Rocky Mountain region in 2014-15. A study was conducted in Colorado to evaluate horse- and management-level factors associated with VS. For a horse to be considered a clinical VS horse, there were two requirements. First, clinical VS ...
B-Cell Epitope Mapping Using a Library of Overlapping Synthetic Peptides in an Enzyme-Linked Immunosorbent Assay.
Methods in molecular biology (Clifton, N.J.)    May 2, 2018   Volume 1785 121-128 doi: 10.1007/978-1-4939-7841-0_8
Vanniasinkam T, Barton MD, Das TP, Heuzenroeder MW.This chapter describes a strategy for mapping linear B-cell epitopes of proteins using synthetic biotinylated peptides in an ELISA.A set of overlapping peptides were designed based upon a known amino acid sequence of the target protein, VapA (Virulence-associated Protein A) of the bacterium Rhodococcus equi, an important pulmonary pathogen in foals. The peptides synthesized as biotinylated peptides were coated directly onto micro titer plates which had been pre-coated with NeutrAvidin™ and used to screen sera from foals confirmed to have R. equi disease. A linear B-cell epitope was identifie...
Lower plasma trans-4-hydroxyproline and methionine sulfoxide levels are associated with insulin dysregulation in horses.
BMC veterinary research    May 2, 2018   Volume 14, Issue 1 146 doi: 10.1186/s12917-018-1479-z
Kenéz Á, Warnken T, Feige K, Huber K.Insulin dysregulation in horses is a metabolic condition defined by high insulin concentrations in the blood and peripheral insulin resistance. This hyperinsulinemia is often associated with severe damage in the hooves, resulting in laminitis. However, we currently lack detailed information regarding the potential involvement of particular metabolic pathways in pathophysiological causes and consequences of equine insulin dysregulation. This study aimed to assess the dynamic metabolic responses given to an oral glucose test (OGT) in insulin-sensitive and insulin-dysregulated horses by a targete...
Assessment of static posturography and pedobarography for the detection of unilateral forelimb lameness in ponies.
BMC veterinary research    May 2, 2018   Volume 14, Issue 1 151 doi: 10.1186/s12917-018-1462-8
Pitti L, Oosterlinck M, Díaz-Bertrana ML, Carrillo JM, Rubio M, Sopena J, Santana A, Vilar JM.Static posturography and pedobarography are based on the detection of postural imbalance and, consequently, the pressure redistribution between limbs in lame subjects. These techniques have proven to be useful for the detection of lameness in humans and dogs. The main objective of this study was to test the suitability of static posturography and pedobarography in diagnosing lameness in ponies. A pressure platform was used to obtain postural data (statokinesiograms, mean X and Y, length, LFS ratio, and mean velocity) from 10 sound ponies and 7 ponies with unilateral forelimb lameness. Static p...
Evolutionary Analysis Provides Insight Into the Origin and Adaptation of HCV.
Frontiers in microbiology    May 1, 2018   Volume 9 854 doi: 10.3389/fmicb.2018.00854
Forni D, Cagliani R, Pontremoli C, Pozzoli U, Vertemara J, De Gioia L, Clerici M, Sironi M.Hepatitis C virus (HCV) belongs to the genus and is genetically heterogeneous, with seven major genotypes further divided into several recognized subtypes. HCV origin was previously dated in a range between ∼200 and 1000 years ago. Hepaciviruses have been identified in several domestic and wild mammals, the largest viral diversity being observed in bats and rodents. The closest relatives of HCV were found in horses/donkeys (equine hepaciviruses, EHV). However, the origin of HCV as a human pathogen is still an unsolved puzzle. Using a selection-informed evolutionary model, we show that the c...
Evaluation of a pictorial method to obtain subject-specific inertial properties in equine limb segments.
Journal of morphology    May 1, 2018   Volume 279, Issue 7 997-1007 doi: 10.1002/jmor.20829
Nauwelaerts S, Clayton HM.Data describing segmental masses and moments of inertia (MOI) of limb segments are required for inverse dynamic calculations. In horses, these values are usually calculated using regression equations that have been developed from a limited number of horses representing a small number of breeds. The objective of the present study was to evaluate the performance of a scaling method and a pictorial method for estimating of the values of segmental masses, lengths, and MOI in the equine limb segments by comparing their output with the standard technique involving direct measurements. Limbs of 30 ho...
Serum Thyroid Hormone and Thyrotropin Concentrations in Adult Horses as They Age.
Journal of equine veterinary science    April 30, 2018   Volume 68 21-25 doi: 10.1016/j.jevs.2018.04.006
Breuhaus BA.With more horses remaining active longer in life, it is important to characterize changes that occur normally with aging, so that these can be differentiated from development of disease. The objective of the study was to test the hypotheses that geriatric horses have lower circulating concentrations of thyroid hormones and/or higher serum thyrotropin (TSH) concentrations compared to younger horses. Serum thyroid hormone and TSH concentrations from 71 normal, healthy horses that had participated in prior research projects were analyzed for effects of age, sex, and season when samples were obtai...
Speckle-tracking analysis of myocardial deformation in correlation to age in healthy horses.
Journal of veterinary science    April 27, 2018   Volume 19, Issue 5 676-682 doi: 10.4142/jvs.2018.19.5.676
Gehlen H, Bildheim LM.An effect of aging on cardiac morphology and function has been shown in humans. In horses, cardiac wall motion analysis using two-dimensional speckle tracking (2D-ST) has not yet been reported. Our study included 57 horses of different warmblood breeds between 3 and 30 years old. Age had a significant influence on left ventricular free wall (LVFW) systolic strain rate ( ≤ 0.05) and early diastolic relaxation ( ≤ 0.01). In the interventricular septum (IVS), systolic ( ≤ 0.01) and late diastolic ( ≤ 0.05) contraction velocities also increased with age. In our study, 2D-ST revealed import...
Sequential concentrations of placental growth factor and haptoglobin, and their relation to oestrone sulphate and progesterone in pregnant Spanish Purebred mare.
Theriogenology    April 27, 2018   Volume 115 77-83 doi: 10.1016/j.theriogenology.2018.04.033
Satué K, Marcilla M, Medica P, Ferlazzo A, Fazio E.The objectives of this study were to establish reference values for serum concentrations of placental growth factor (PlGF) and haptoglobin (Hp), and to analyze whether the levels of oestrone sulphate (E1S) and progesterone (P4) are physiologically involved in the dynamic modifications of the above parameters in pregnant mares. A total of 30 healthy Spanish Purebred mares ranging in age 9.33 ± 3.31 years were studied during the 11 months of gestation. Serum concentrations of PlGF were detected by EIA, Hp using commercial Phase Haptoglobin assay and E1S and P4 levels through RIA. The serum ...
Horse embryo diameter is influenced by the embryonic age but not by the type of semen used to inseminate donor mares.
Theriogenology    April 27, 2018   Volume 115 90-93 doi: 10.1016/j.theriogenology.2018.04.023
Cuervo-Arango J, Claes AN, Stout TAE.The diameter of embryos recovered from mares on Day 8 after ovulation varies greatly, from as little as 130 μm to as much as 2500 μm. Several factors have been proposed to affect embryo size at recovery, one of which is the type of semen (frozen vs fresh or cooled-transported) used to inseminate the mare. In addition, it has been shown that smaller embryos (<300 μm) recovered on Day 8 are less likely than larger embryos to result in successful pregnancy after transfer. However, whether the actual age of the embryo (interval from fertilization to flushing) in relation to its size al...
Technical note: Evaluation of a wireless pulse oximeter for measuring arterial oxygen saturation and pulse rate in newborn Holstein Friesian calves.
Journal of dairy science    April 26, 2018   Volume 101, Issue 7 6437-6442 doi: 10.3168/jds.2017-14266
Kanz P, Krieger S, Drillich M, Iwersen M.Pulse oximetry is a well-established technique in human and veterinary medicine. In farm animals, it could also be a useful tool for the detection of critical conditions relating to oxygen supply and the cardiovascular system. Among other uses, an innovative application could be the monitoring of fetuses during birth. This could help in the early identification of critical situations and support farmers and veterinarians in their decision to start obstetric or life-support interventions. Until now, however, its use in ruminant medicine was still limited to experimental applications. The object...
Seminal plasma influences the fertilizing potential of cryopreserved stallion sperm.
Theriogenology    April 26, 2018   Volume 115 99-107 doi: 10.1016/j.theriogenology.2018.04.021
Al-Essawe EM, Wallgren M, Wulf M, Aurich C, Macías-García B, Sjunnesson Y, Morrell JM.Seminal plasma (SP) contains proteins that may influence cryosurvival and prevent capacitation-like changes due to freezing and thawing. The objective of this study was to investigate the effect of adding pooled SP from "good" (GF) or "bad" (BF) freezer stallions on sperm cells' fertilizing ability. "Good freezers" refers to stallions that usually produce ejaculates which can withstand cryopreservation, whilst "bad freezer" stallions produce ejaculates which cannot tolerate the freezing process. A heterologous zona binding assay with in vitro matured bovine oocytes was used to assess the bind...
Towards European harmonisation of contagious equine metritis diagnosis through interlaboratory trials.
The Veterinary record    April 25, 2018   Volume 183, Issue 3 96 doi: 10.1136/vr.104556
Petry S, Breuil MF, Duquesne F, Laugier C.The performance of culture and PCR methods routinely used to diagnose contagious equine metritis (CEM) was evaluated and compared by two interlaboratory trials involving a total of 24 European laboratories, including 22 National Reference Laboratories for CEM. Samples were swab specimens artificially contaminated with bacteria present in the genital tract of Equidae, some with and some without Taylorella equigenitalis, the causative agent of CEM, and T asinigenitalis, responsible for possible misidentification as T equigenitalis Throughout both interlaboratory trials, PCR performed better in t...
Elevated urinary excretion of free pyridinoline in Friesian horses suggests a breed-specific increase in collagen degradation.
BMC veterinary research    April 25, 2018   Volume 14, Issue 1 139 doi: 10.1186/s12917-018-1454-8
Saey V, Tang J, Ducatelle R, Croubels S, De Baere S, Schauvliege S, van Loon G, Chiers K.Friesian horses are known for their high inbreeding rate resulting in several genetic diseases such as hydrocephaly and dwarfism. This last decade, several studies focused on two other presumed hereditary traits in Friesian horses: megaoesophagus and aortic rupture. The pathogenesis of these diseases remains obscure but an important role of collagen has been hypothesized. The purpose of this study was to examine possible breed-related differences in collagen catabolism. Urinary specimens from Friesian (n = 17, median age 10 years old) and Warmblood horses (n = 17, median age 10 years...
Comparison of angiographic dyes and injection techniques for ocular anterior segment angiography in horses.
American journal of veterinary research    April 25, 2018   Volume 79, Issue 5 562-567 doi: 10.2460/ajvr.79.5.562
Pirie CG, LoPinto AJ, Tenney WA.OBJECTIVE To assess and compare 2 injection techniques for conducting ocular anterior segment indocyanine green angiography (ASICGA) and sodium fluorescein (SF) angiography in horses. ANIMALS 3 healthy adult female horses (age range, 19 to 25 years). PROCEDURES Horses were sedated, jugular catheters were placed, and manual restraint was used to ensure proper positioning for the angiography procedure. Two injection techniques (IV and intra-arterial) were performed for each horse 1 week apart. Intravenous injections of 0.25% indocyanine green (ICG; 50 mg) and 10% SF (10 mg/kg) were administered ...
Comparison of the efficacy of various concentrations and combinations of serum, ethylenediaminetetraacetic acid, tetracycline, doxycycline, minocycline, and N-acetylcysteine for inhibition of collagenase activity in an in vitro corneal degradation model.
American journal of veterinary research    April 25, 2018   Volume 79, Issue 5 555-561 doi: 10.2460/ajvr.79.5.555
Kimmitt BA, Moore GE, Stiles J.OBJECTIVE To compare the efficacy of various concentrations and combinations of serum, EDTA, 3 tetracyclines, and N-acetylcysteine (NAC) for collagenase inhibition in an in vitro corneal degradation model. SAMPLE Grossly normal corneas from recently euthanized dogs and horses and fresh serum from healthy dogs and horses. PROCEDURES Serum was pooled by species for in vitro use. For each species, sections of cornea were dried, weighed, and incubated with clostridial collagenase (800 U/mL) in 5 mL of a 5mM calcium chloride-saline (0.9% NaCl) incubation solution and 500 μL of 1 of 19 treatments (...
Virus-neutralising antibody responses in horses following vaccination with Equivac® HeV: a field study.
Australian veterinary journal    April 25, 2018   Volume 96, Issue 5 161-166 doi: 10.1111/avj.12694
Tan R, Hodge A, Klein R, Edwards N, Huang JA, Middleton D, Watts SP.To determine the antibody responses to a commercial Hendra virus vaccine (Equivac® HeV) in a field environment. Methods: A group of 61 horses received a primary vaccination course comprising two doses administered 3-6 weeks apart (V1, V2) and a 3rd dose (V3) given 6 months after the second. This was followed by booster vaccinations at 12 monthly intervals (V4, V5). Antibody titres were assessed using a virus-neutralisation test. Results: Neutralising antibodies against HeV were not detected prior to vaccination. Antibodies were detected in 54/57 horses at 3 weeks after V1 and 51/51 had ...
Antimicrobial labelling in Australia: a threat to antimicrobial stewardship?
Australian veterinary journal    April 25, 2018   Volume 96, Issue 5 151-154 doi: 10.1111/avj.12677
Hardefeldt LY, Gilkerson JR, Billman-Jacobe H, Stevenson MA, Thursky K, Browning GF, Bailey KE.Antimicrobial resistance is a public health emergency, placing veterinary antimicrobial use under growing scrutiny. Antimicrobial stewardship, through appropriate use of antimicrobials, is a response to this threat. The need for antimicrobial stewardship in Australian veterinary practices has had limited investigation. A 2016 survey undertaken to investigate antimicrobial usage patterns by Australian veterinarians found that antimicrobial dose rates were varied and often inappropriate. Doses of procaine penicillin in horses and cattle were often low, with 68% and 90% of respondents, respective...
Comparison of 3 corneal cytology collection methods for evaluating equine ulcerative keratitis: Cytobrush, kimura platinum spatula, and handle edge of scalpel blade.
Veterinary ophthalmology    April 24, 2018   Volume 22, Issue 2 153-160 doi: 10.1111/vop.12574
Proietto L, Beatty SS, Plummer CE.To compare corneal cytology samples from three common sampling techniques: cytobrush (CB), Kimura platinum spatula (KS), and the handle edge of a scalpel blade (SB). Methods: Equine patients presenting to the University of Florida College of Veterinary Medicine with ulcerative keratitis were included. Following diagnosis of corneal ulcer and sampling for microbial culture, two cytology samples per technique were collected with sterile CB, KS, and SB in a randomized order. Cytologic evaluation was performed by two observers masked to collection method. Objective measures of sample cellularity, ...
Pathological classification of equine recurrent laryngeal neuropathy.
Journal of veterinary internal medicine    April 24, 2018   Volume 32, Issue 4 1397-1409 doi: 10.1111/jvim.15142
Draper ACE, Piercy RJ.Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("d...