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Background: Little is known about the acquisition and use of equine analgesic drugs by horse owners in the United States (US)., Objectives: 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., Study Design: 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 VCPR noncompliant sources were analysed using logistic regression., Results: Responses from 389 US horse owners indicated that 96% have access to at least one type of equine analgesic medication and most are confident in their drug administration skills. Horse owners with ≥5 types of analgesic drugs were more likely to have managed >20 horses in their life (odds ratio [OR] = 3.1, 95% confidence interval [CI] = 1.7-5.6), have medical insurance for some horses (OR = 4.2, CI = 2.3-7.7), and have veterinary or human medical training (OR = 2.2, CI = 1.2-4.1) and were less likely to have a primary care veterinarian requiring >30 minutes travel time (OR = 0.5, CI = 0.3-0.9). Horse owners who obtained drugs through VCPR noncompliant sources were likely to be male (OR = 5.6, CI = 1.6-19.4), ≤40 years of age (OR = 2.0, CI = 1.2-3.2), and reside in the South or West regions of the US (OR = 2.4, CI = 1.4-4.0)., Main Limitations: Possible distribution, self-selection, response, and recall biases as a result of convenience sampling methodology., Conclusions: Discussion between veterinarians and horse owners regarding available analgesic drugs and owners' competence in administering those drugs may improve veterinary care recommendations and owner compliance., (© 2022 EVJ Ltd.)

Background: Understanding factors influencing assessment of pain in horses will facilitate communication between veterinarians and horse owners., Objectives: To compare estimates of pain experienced by horses as provided by veterinarians and horse owners and to determine factors associated with individuals who perceive horses to be experiencing extreme pain or minimal pain., Study Design: Cross-sectional study., Methods: Internet-based questionnaires for horse owners and veterinarians included items related to recognition of pain in horses, estimated degree of pain experienced by horses, and demographic information. Variables associated with perception of a high or low degree of pain were investigated using logistic regression analyses., Results: Final data sets included responses from 553 horse owners and 263 veterinarians. Pain scores varied widely and differences in median scores from horse owners and veterinarians were small. Horse owners providing high pain ratings were more likely to have <10 horses (odds ratio [OR] = 2.0, 95% CI = 1.1-3.5) and to not have a college degree (OR = 1.5, 95% CI = 1.0-2.2). Those providing low pain ratings were less likely to own <10 horses (OR = 0.6, 95% confidence interval [CI] = 0.4-0.9). Veterinarians providing high pain ratings were more likely to be employed in a mixed animal practice (OR = 2.8, 95% CI = 1.3-5.9) and to lack board-certification in a veterinary specialty (OR = 2.1, 95% CI = 1.1-4.2). Veterinarians providing low pain ratings were more likely to be male (OR = 2.4, 95% CI = 1.3-4.2)., Main Limitations: The respondent population may be biased because of the method of questionnaire distribution and associated sampling bias. Respondents were primarily from the United States., Conclusions: Assessments of the degree of pain horses are experiencing vary widely among horse owners and equine veterinarians., (© 2022 EVJ Ltd.)

Background: Exercise-induced pulmonary hemorrhage (EIPH) is diagnosed and its severity assessed by post-exercise tracheobronchoscopy, and enumeration of bronchoalveolar lavage fluid red blood cells (BALFRBC). Minimal information is available regarding the relationship of tracheobronchoscopy score to BALFRBC number., Objective: Evaluate the relationship between BALFRBC number and tracheobronchoscopy scores and determine their diagnostic sensitivities., Animals: Nine sedentary horses, 21 fit Thoroughbreds, 129 Barrel Racers., Methods: Normal BALFRBC number and the effect of bronchoalveolar lavage (BAL) on it were evaluated by performing 2 BALs 24 hours apart in sedentary horses. Tracheobronchoscopy followed by BAL was performed 247 times on 150 horses after treadmill, racetrack, or barrel racing exercise. Lastly, a BALFRBC diagnostic threshold number that optimized the geometric mean of the sensitivity and precision (F1-score) was determined using Bayesian analysis., Results: No increase in BALFRBC occurred after the second BAL (mean ± SD, 304 ± 173/μL). Tracheobronchoscopy scores ranged from 0 (n = 112) to 4 (n = 4) and BALFRBC ranged from 102 to 4605268/μL. Spearman correlation between tracheobronchoscopy score and BALFRBC was weak (P < .001; rs = 0.42) with large ranges of BALFRBC associated with each tracheobronchoscopy score. The highest F1-score occurred for a BALFRBC threshold number = 992/μL. Seventy-five tracheobronchoscopy scores equaled 0 although BALFRBC number was ≥992/μL. Sensitivity of tracheobronchoscopy for diagnosing EIPH was poor (0.59; 95% confidence intervals [CI], 0.49-0.68), compared to BALFRBC number ≥992/μL (0.93; 95% CI, 0.88-0.96)., Conclusions and Clinical Importance: False negatives are common with tracheobronchoscopy. Follow-up determination of BALFRBC may be indicated for tracheobronchoscopy scores = 0 before EIPH can be ruled out., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

A 25-year-old Appaloosa gelding was evaluated for chronic weight loss and diarrhea. A clinical diagnosis of protein loosing enteropathy was made and the gelding was euthanized. Histology revealed neoplastic lymphocytes infiltrating the mucosa of the small and large intestine. Immunohistochemistry was positive for CD3, consistent with epitheliotropic T-cell lymphoma.

Background: Ingestion of wilted red maple leaves by horses can result in severe hemolytic anemia and methemoglobinemia. Little is known about what factors influence the outcome of red maple leaf toxicosis in horses., Hypothesis: Our hypothesis was that physical examination findings, clinicopathologic variables or therapeutic modalities may predict outcome in horses with red maple leaf toxicity., Animals: Horses with red maple leaf toxicosis presented to referral hospitals in the southeast region of the United States., Methods: A multi-institutional retrospective study was designed to identify factors that predict mortality in horses with red maple toxicosis., Results: Thirty-two horses with red maple toxicosis were identified, 19 of which died. Twenty-nine horses presented with anemia and 24 had clinicopathologic evidence of systemic inflammation. Renal insufficiency was identified in 12/30 (41%) horses. Laminitis (9/28) and colic (13/30) also were identified in horses with red maple toxicosis, but development of these 2 conditions did not have a negative effect on short-term survival. Horses with red maple toxicosis that survived to discharge were likely to have developed pyrexia during hospitalization (P = .030). Horses that were treated with a corticosteroid had a significantly increased likelihood of death (P = .045). There was no significant relationship between initial serum hemoglobin concentration, methemoglobin concentration, or percentage methemoglobin and mortality in this horse series., Conclusions and Clinical Importance: This study suggests that information obtained on initial examination cannot be used to accurately predict survival in horses with red maple toxicosis, but horses that receive corticosteroids are unlikely to survive.

The objectives of these studies were to assess the diagnostic performance (sensitivity and specificity) of the IgM capture enzyme-linked immunosorbent assay (ELISA; MAC) for diagnosis of West Nile (WN) virus in horses and to examine the performance of this test by using different criteria for seropositivity. A total of 36 horses classified as WN virus infected (group 1) and 383 horses from 4 subpopulations of hoses classified as noninfected (groups 2, 3, 4, and 5) were used in the study. The sensitivity (proportion of infected horses that tested positive for WN virus IgM antibodies) and specificity (proportion of noninfected horses that tested negative) were calculated at different cutoff points by using receiver operating curve (ROC) analysis. Using a selected cutoff point = 2.0, the sensitivity and specificity of the MAC were 91.7 and 99.2%, respectively. The area under the ROC curve = 0.95 (95% confidence interval [CI], 0.89 to 1.0), suggesting that the MAC is a useful tool for diagnosis of recent WN virus exposure in horses. In fulfillment of the 2nd objective, 2 other indices were developed and these indices approached 1.0 for the AUC with smaller 95% CIs. These indices were then used to test 602 additional diagnostic samples submitted from suspect horses between 2002 and 2004. Using the standard cutoff, 194 (32%) of the horses were interpreted as positive. Utilizing newly predicted cutoff criteria from each index, additional horses were identified as positive. In conclusion, the MAC as used for identification of WN virus-diseased horses undergoing recent exposure performs reliably at the standard cutoff for seropositivity. A negative test might not completely rule out WN virus disease, but horses that test negative were most likely not exposed to WNV. Performance of the test can be further improved by investigation of other indexes of seropositivity.

Objective: To determine whether daily administration of pyrantel tartrate can prevent infection in horses experimentally challenged with Sarcocystis neurona., Animals: 24 mixed-breed specific-pathogen-free weanling horses, 10 adult horses, 1 opossum, and 6 mice., Procedure: Sarcocystis neurona-naïve weanling horses were randomly allocated to 2 groups. Group A received pyrantel tartrate at the labeled dose, and group B received a nonmedicated pellet. Both groups were orally inoculated with 100 sporocysts/d for 28 days, 500 sporocysts/d for 28 days, and 1000 sporocysts/d for 56 days. Blood samples were collected weekly, and CSF was collected monthly. Ten seronegative adult horses were monitored as untreated, uninfected control animals. All serum and CSF samples were tested by use of western blot tests to detect antibodies against S. neurona. At the end of the study, the number of seropositive and CSF-positive horses in groups A and B were compared by use of the Fisher exact test. Time to seroconversion on the basis of treatment groups and sex of horses was compared in 2 univariable Cox proportional hazards models., Results: After 134 days of sporocyst inoculation, no significant differences were found between groups A and B for results of western blot tests of serum or CSF There were no significant differences in number of days to seroconversion on the basis of treatment groups or sex of horses. The control horses remained seronegative., Conclusions and Clinical Relevance: Daily administration of pyrantel tartrate at the current labeled dose does not prevent S. neurona infection in horses.

The West Nile (WN) virus, present in the United States since 1999, is a cause of encephalomyelitis in birds, alligators, humans, and horses. No data exist regarding detection of anti-WN virus immunoglobins in equine cerebrospinal fluid (CSF). The aims of this study were to evaluate the blood-brain barrier (BBB) in WN virus-infected (WNE) horses, to compare diagnostic testing in serum and CSF, and to describe the immunoglobulin M (IgM) response in serum and CSF of vaccinated horses. CSF was collected from the lumbosacral (LS) space (n = 13) or the allanto-occipital (AO) space (n = 14) of WNE horses. The albumin quotient (AQ) and IgG index were calculated, and the IgM-capture-enzyme-linked immunosorbent assay (MAC-ELISA) was used to detect anti-WN virus IgM in serum and CSF. CSF collected from the LS site had a higher (P < .02) IgG index compared to the AO site (0.34 +/- 0.04 versus 0.22 +/- 0.04 [mean +/- SE], respectively). The mean AQ, irrespective of collection site, did not exceed reference values. There was 100% agreement between CSF and serum testing for IgM by MAC-ELISA testing. However, the positive to negative antigen ratios were higher (P < .001) in CSF (34.5) versus serum (8.5), indicating lower nonspecific reactivity in CSF samples. Horses vaccinated against WN virus did not develop an IgM response at 1:400 mg/dL in serum; however, a few horses developed a weak IgM response in serum but not in CSF. In conclusion, MAC-ELISA testing of serum and CSF were equivocal. Also, examination of CSF data from WNE horses suggests a normal BBB integrity and increased intrathecal production of antibodies.

Equine protozoal myeloencephalitis is a progressive neurologic disease of horses most commonly caused by infection with the apicomplexan parasite Sarcocystis neurona. Factors affecting neuroinvasion and neurovirulence have not been determined. We investigated the pathogenesis of infection with S. neurona in horses with severe combined immune deficiency (SCID). Two immunocompetent (IC) Arabian horses and two Arabian horses with SCID were infected orally with 5 x 10(5) sporocysts of S. neurona. Four IC horses and one SCID horse were infected intravenously (i.v.) with 5 x 10(8) merozoites of the WSU-1 isolate of S. neurona. Despite prolonged parasitemia and persistent infection of visceral tissues (skeletal muscle, cardiac muscle, lung, liver, and spleen) as demonstrated by PCR and culture, SCID horses did not develop neurologic signs after oral or i.v. infection. S. neurona was undetectable in the neuronal tissues of SCID horses by either PCR, immunohistochemistry, or culture. In contrast, although parasitemia was undetectable in orally infected IC horses and of only short duration in i.v. infected IC horses, four of six IC horses developed neurologic signs. S. neurona was detectable by PCR and/or culture of neural tissue but not visceral tissue of IC horses with neurologic disease. Infected SCID horses are unable to clear S. neurona from visceral tissues, but the infection does not result in neurologic signs; in contrast, IC horses rapidly control parasitemia and infection of visceral tissues but frequently experience neuroinvasion and exhibit clinical signs of neurologic disease.

A randomized, controlled, blinded clinical trial was performed to determine whether butorphanol administered by continuous rate infusion (CRI) for 24 hours after abdominal surgery would decrease pain and surgical stress responses and improve recovery in horses. Thirty-one horses undergoing exploratory celiotomy for abdominal pain were randomly assigned to receive butorphanol CRI (13 microg/kg/h for 24 hours after surgery; treatment) or isotonic saline (control). All horses received flunixin meglumine (1.1 mg/kg IV q12h). There were no significant differences between treatment and control horses in preoperative or operative variables. Treatment horses had significantly lower plasma cortisol concentration compared with control horses at 2, 8, 12, 24, 36, and 48 hours after surgery. Mean weight loss while hospitalized was significantly less for treatment horses than control horses, whether expressed as total decrease in body weight (13.9+/-3.4 and 27.9+/-4.5 kg, respectively) or as a percentage decrease in body weight (2.6+/-0.7 and 6.3+/-1.1%, respectively). Treatment horses were significantly delayed in time to first passage of feces (median times of 15 and 4 hours, respectively). Treatment horses had significantly improved behavior scores during the first 24 hours after surgery, consistent with the conclusion that they experienced less pain during that time. Butorphanol CRI during the immediate postoperative period significantly decreased plasma cortisol concentrations and improved recovery characteristics in horses undergoing abdominal surgery.

Helcococcus ovis, a recently described organism cultured from sheep, was isolated in pure culture from a pulmonary abscess in a horse. This is the first report of this organism in horses and the first report in veterinary medicine to clearly demonstrate a pathogenic role for this organism.

Magnetic resonance (MR) imaging was used as a neurodiagnostic modality in the assessment of 12 horses with neurologic disease localized cranial to the foramen magnum. This retrospective study included a mixed population of horse breeds and consisted of three foals and nine adult horses. MR sequences of the head and central nervous system of each horse were acquired. Routine MR sequences included transverse T1 weighted (T1wt), T2 weighted (T2wt), and proton density images. Additional imaging sequences were obtained on a patient-dependent basis. Eight neurologic related diseases were diagnosed. MRI imaging of the horse head is a feasible and valuable neurodiagnostic modality in the assessment of equine neurologic diseases.

A retrospective study of the medical records of 33 horses was performed to determine the clinical and diagnostic abnormalities associated with temporohyoid osteoarthropathy. Data collected from medical records included signalment, presenting complaints, history, physical examination findings, laboratory data, results of diagnostic imaging studies, and treatments. Follow-up information was obtained from a review of case records; by telephone conversation with the owner, veterinarian, or trainer; or by both methods. Of 33 horses with temporohyoid osteoarthropathy, 29 presented with facial nerve (cranial nerve VII) deficits and 23 presented with vestibulocochlear nerve (cranial nerve VIII) deficits. Guttural pouch endoscopy was more reliable than radiography for diagnosis. Of horses with unilateral clinical signs, 22.6% actually had bilateral disease. Magnetic resonance imaging and computed tomography identified the lesions in all horses in which these tests were performed. Of 30 horses for which follow-up information was obtained, 20 (67%) were alive. Eight horses were euthanized and 1 died because of problems associated with temporohyoid osteoarthropathy. Nineteen of 20 surviving horses (95%) were considered by the owner or trainer to be suitable for athletic use. Twelve surviving horses (60%) had residual facial nerve deficits; 11 horses (55%) had residual vestibulocochlear nerve deficits. Horses with temporohyoid osteoarthropathy have a fair prognosis for return to some type of athletic function, but there is risk of acute death. The majority of horses would be expected to have some residual cranial nerve dysfunction, and it could take a year or longer for maximal improvement to occur.

The development of ultrapurified hemoglobin-based oxygen carriers has eliminated many problems associated with whole-blood transfusions in other species. We hypothesized that the administration of polymerized ultrapurified bovine hemoglobin (PUBH) would result in improved hemodynamic parameters in ponies with normovolemic anemia without adverse effects on renal function or coagulation times. Normovolemic anemia was induced in 6 healthy adult ponies. Over a 3-day period, at least 45 mL/kg of whole blood was withdrawn from each pony until a target PCV of <12% was attained. Plasma was separated from the red blood cells via centrifugation and readministered to the ponies on each day. After the final plasma transfusion, 15 mL/kg of hetastarch (control, n = 6) or 15 mL/kg of PUBH (treatment, n = 6) was administered at 10 mL/kg/h IV. Administration of PUBH at a rate of 10 mL/kg/h was not associated with any adverse effects in 5 of the 6 ponies. One pony experienced an anaphylactoid reaction during infusion of PUBH. The reaction, characterized by intense pruritus, tachycardia, and tachypnea resolved shortly after stopping the infusion. Ponies receiving PUBH had significantly lower cardiac indices (P = .03) and heart rates (P = .002) than control animals. A significantly greater increase in central venous pressure was observed in the PUBH group compared to the hetastarch group (P = .02). No adverse renal or coagulation effects were observed with PUBH infusion. These results suggest that PUBH improves hemodynamics and oxygen transport parameters in horses experiencing normovolemic anemia. Patients should be monitored closely during infusion for any adverse reactions.

Sarcocystis neurona was isolated from the blood of a 5-month-old Arabian foal with severe combined immunodeficiency. The foal had been inoculated approximately 3 weeks previously with 5 x 10(5) sporocysts that were isolated from the intestines of an opossum and identified by restriction enzyme analysis of PCR products as S. neurona. The isolate obtained from the blood of this foal was characterized by genetic, serologic, and morphologic methods and identified as S. neurona (WSU1). This represents the first time that S. neurona has been isolated from any tissue after experimental infection of a horse. This is also the first time a parasitemia has been detected during either natural or experimental infection. The severe combined immunodeficiency foal model provides a unique opportunity to study the pathogenesis of S. neurona infection in horses and to determine the role of the immune system in the control of infection with and development of neurologic disease.