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A preliminary study was performed in which a simple clinical technique for estimating appropriate levels of continuous distending pressure (CDP) in infants with respiratory distress syndrome (RDS) was used to compare two groups of infants; one group had CDP started very early in life (3.1 +/- 0.3 hours) while in the other treatment was started at a more conventional age (23 +/- 5.4 hours). Appropriate CDP was identified as the point at which transpulmonary transmission of airways pressure to the oesophagus was seen suddenly to increase, while serial measurements allowed CDP levels to be instituted and varied according to physiological signs during the course of each infant's disease. Oxygen requirements fell to less than 35% more rapidly in the early-treated group (10.6 +/- 1.2 v. 67.4 +/- 5.6 hours; P less than 0.001), as did the requirement for a CDP greater than 4 cmH2O (28.9 +/- 5.3 v. 87.6 +/- 14.2 hours; P less than 0.001). Better (P less than 0.01) values for pH, PaCO2, and A-aDO2 were observed in the early-treated group. We believe that the use of this simple technique has numerous advantages and that very early introduction of CDP can be realised in a manner selective enought for it to be used in those infants in whom intervention is justified. [ABSTRACT FROM AUTHOR]

A procedure is described for solving an open, fully exchanging, three-compartment model representing ruminal volatile fatty acids (VFA) kinetics in sheep. This model was solved using results from a published study in which labelled VFA, viz. 1-14C-acetate (Ac), 1-14C-propionate (Pr) and 1-14C-butyrate (Bu), were infused individually at a constant rate for 240 min into the rumen of sheep on different occasions. During the tracer infusions, the sheep were given 75 g of lucerne (Medicago sativa) every hour. The patterns of increasing specific radioactivity (SA) during the infusions were described by differential equations that were solved using the computer software, WinSAAM. This linear kinetic analysis gave estimates of the rates of synthesis and absorption of Ac, Pr and Bu and the carbon interconversions between each acid. The sizes of the Ac, Pr and Bu compartments (10.5, 3.9 and 2.1 g C respectively), were also estimated, which is not possible with commonly used algebraic analyses. The model output showed that tracer : tracee equilibrium (plateau SA) had not been reached in the Ac, Pr and Bu compartments during the 240 min of tracer infusion and the algebraic method of analysis used in the original study was therefore compromised. The procedures described here eliminated this source of error; in addition, confidence in the model solution was improved because all data representing the build-up to plateau SA were used, rather than just estimates of ‘plateau’ SA. After accounting for VFA interconversions, the rates of VFA absorption (or incorporation into other materials such as microbial polymers or methane) were 85, 48 and 49 g C/day, or 78%, 91% and 73% of the total production of each VFA, respectively. The variability in the observed SA responses to the tracer infusions was relatively large and this is discussed. Model solutions using the linear kinetic analysis and the previously widely used algebraic analyses are compared. The effect of positional labelling in tracer VFA is also discussed in the light of evidence that the rate of absorption of Pr may be overestimated when [1-14C]-Pr rather than [2-14C]-Pr or uniformly labelled [14C]-Pr is used as the Pr tracer. [ABSTRACT FROM AUTHOR]

Offering feed supplements to grazing dairy cows results in a reduction in grazing time. However, the effect differs depending on the time of day that feeds are offered. To understand the physiological basis for this, associations among circulating factors known to be associated with intake regulation in monogastric species and grazing behavior in the dairy cow were investigated. Seventeen multiparous cows at 28 ± 5 d in milk grazed together and consumed 4.4 kg of dry matter/d of a pelleted concentrate feed supplement, equally split, at the a.m. and p.m. milking. Grazing behavior was recorded over 4 consecutive days in all 17 cows. Blood was sampled from 10 of the 17 cows every 4 h over a 48-h period following the grazing behavior measurements; sampling times were staggered by 2 h to provide a diurnal profile of humoral factors. Grazing profiles illustrated major grazing bouts after the a.m. and p.m. milking; however, the p.m. grazing bout was characterized as the most intensive and time spent grazing was unaffected by supplementation. Associations among proportion of cows grazing and circulating hormones and metabolites differed throughout the day. During the a.m., relationships were consistent with those reported in monogastric species, with ghrelin and nonesterified fatty acids decreasing and insulin increasing with feeding. In comparison, during the major grazing bout predusk, ghrelin concentrations increased until sunset, despite the large proportion of cows grazing, before declining; this is consistent with ghrelin stimulating the predusk grazing bout. Results indicate that humoral factors known to affect hunger and satiety in monogastric animals may also have a potential role in the physiological regulation of diurnal and feeding behavior in ruminants. [ABSTRACT FROM AUTHOR]

Appropriate durations of perioperative antimicrobial therapy following exploratory coeliotomy in horses are controversial, and with the rising prevalence of multiresistant bacteria there is a strong incentive to use antimicrobials for the shortest time possible. Following exploratory coeliotomies, incisional infections are an important cause of morbidity in horses and could be influenced by the duration of systemic antimicrobial therapy. The aim of this study was to investigate whether 72 hours of perioperative antimicrobial therapy is as effective as 120 hours at preventing the development of postoperative incisional infections. Horses undergoing exploratory coeliotomy at two referral hospitals were assigned randomly into Group 1 (receiving 72 hours of perioperative antimicrobial therapy) and Group 2 (receiving 120 hours of perioperative antimicrobial therapy). Only horses recovering from surgery and surviving for >120 hours were included in the study. Ninety-two horses met the criteria for inclusion in the study, 42 in Group 1 and 50 in Group 2. The overall incisional complication rate was 42.2 per cent, and no significant difference in the number of incisional complications in the two groups was identified. Results of the study suggest that there is no benefit in using 120 hours over 72 hours of perioperative antimicrobial therapy to prevent incisional infections. [ABSTRACT FROM AUTHOR]

Fifteen obese ponies were used in a body weight (BW) reduction programme (BWRP, daily energy intake: 7.0-8.4 MJ/100 kg BW). A frequently sampled intravenous glucose tolerance test was used to assess insulin sensitivity. Subcutaneous adipose tissue biopsies of the tail head were obtained for mRNA gene expression profiles of adiponectin, retinol-binding protein 4 (RBP4), interleukin 6 (IL-6) and macrophage activation marker (CD68) before and after BWRP. Blood samples were analysed for serum leptin, serum RBP4 and plasma adiponectin. Significant BW losses occurred with 7 MJ DE/100 kg BW. Serum leptin and RBP4 were initially similar between insulin-resistant (IR) and insulin-sensitive (IS) ponies, and both significantly decreased during BWRP. Compared with IS ponies, IR ponies initially had significantly lower plasma adiponectin levels. At the beginning of BWRP, mRNA expression of RBP4, adiponectin, IL-6 and CD68 was similar between IR and IS ponies. Plasma adiponectin was strongly related to IR, whereas serum leptin and RBP4 were closely linked to adiposity, independent of insulin sensitivity. Adipose tissue mRNA expression profiles did not clearly reflect these differences. However, the role of subcutaneous adipose tissue in IR remains open. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Obesity and insulin resistance are risk factors for laminitis in equids and supplements containing chromium and magnesium might improve insulin sensitivity. Hypothesis: A supplement containing chromium, magnesium and other nutraceuticals would alter morphometric measurements, blood variables, and insulin sensitivity in laminitic obese horses. Methods: Twelve previously laminitic obese (body condition score ≥ 7/9) horses were randomly allocated to treatment (n = 6) and control (n = 6) groups and 2 obese horses with clinical laminitis were included in the treatment group. Treated animals received 56 g supplement with 0.25 kg oats once daily for 16 weeks. The supplement contained chromium (5 mg/day as yeast), magnesium (8.8 g/day as oxide/proteinate), and other nutraceuticals. Insulin-modified frequently sampled i.v. glucose tolerance tests were performed with hay provided at 0, 8 and 16 weeks, and insulin sensitivity was estimated by minimal model analysis. Physical measurements were collected at the same points. Horses were not exercised. Results: Hyperinsulinaemia (>30 µu/ml) was detected in 12 of 14 horses prior to treatment. Glucose and insulin data from one mare with clinical laminitis were excluded because of persistent pain. Mean ± s.d. insulin sensitivity was 0.64 ± 0.62 × 10 [ABSTRACT FROM AUTHOR]

Central venous pressure (CVP) is used in many species to monitor right-sided intravascular volume status, especially in critical care medicine. That hypohydration in adult horses is associated with a proportional reduction in CVP. Ten healthy adult horses from the university teaching herd. In this experimental study, horses underwent central venous catheter placement and CVP readings were obtained by water manometry. The horses were then deprived of water and administered furosemide (1 mg/kg IV q6h) for up to 36 hours. Weight, CVP, vital signs, PCV, total protein (TP), and serum lactate were monitored at baseline and every 6 hours until a target of 5% decrease in body weight loss was achieved. The spleen volume was estimated sonographically at baseline and peak volume depletion. Linear regression analysis was used to assess the association of CVP and other clinical parameters with degree of body weight loss over time. There was a significant association between CVP and decline in body weight ( P < .001), with a decrease in CVP of 2.2 cmHO for every percentage point decrease in body weight. Other significant associations between volume depletion and parameters measured included increased TP ( P= .007), increased serum lactate concentration ( P= .048), and decreased splenic volume ( P= .046). There was no significant association between CVP and vital signs or PCV. These findings suggest that CVP monitoring might be a useful addition to the clinical evaluation of hydration status in adult horses. [ABSTRACT FROM AUTHOR]

Hypohydration causes transient echocardiographic changes in pigs, dogs, humans, and cats. These changes mask the diagnosis of some cardiac diseases (valvular regurgitation, dilated cardiomyopathy) and promote the diagnosis of others (hypertropic cardiomyopathy and infiltrative disease), thus inhibiting accurate echocardiographic evaluation. To describe the echocardiographic changes associated with hypohydration in normal horses. Ten adult horses without detectable cardiac disease. Experimental study. Echocardiographic examinations were performed on horses in the euhydrated and hypohydrated states. Horses were hypohydrated by combined water deprivation and furosemide administration until a 4-7% reduction in bodyweight was achieved. Statistical analyses were performed by paired t-tests. Hypohydration decreased left ventricular internal diameter in systole (0.8 ± 0.6 cm) and diastole (1.7 ± 0.9 cm), left atrial diameter (1.5 ± 0.4 cm) and left ventricular volume (490 ± 251 mL) ( P-values < .01), and increased septal wall thickness in diastole (0.6 ± 0.3 cm), free wall thickness in diastole (0.5 ± 0.3 cm), mean wall thickness (0.5 ± 0.2 cm) and relative wall thickness (0.2 ± 0.1 cm) ( P-values < .01). Hypohydration produces changes in left ventricular and atrial size that could mask or promote the severity of cardiac disease. The thickened, 'pseudohypertrophied' appearance of the left ventricle in hypohydrated horses could affect interpretation of echocardiographic variables that are applied to the prediction of athletic performance. Echocardiography may prove a noninvasive method of monitoring volume status and response to fluid therapy in hypovolemic horses. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. Objective: To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Methods: Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Results: Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Conclusions: Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. Potential relevance: This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function. [ABSTRACT FROM AUTHOR]

During hospitalization, horses typically undergo frequent blood sampling for diagnostic testing and monitoring. The need for numerous samples in hospitalized horses makes acquisition from an intravenous catheter (IVC) both convenient and less stressful to the patient. We hypothesized that there would be no significant difference in the plasma chemistry and CBC variables from blood samples obtained from a jugular catheter as compared with direct jugular venipuncture. Fifty adult hospitalized horses; 25 receiving constant rate crystalloid therapy, and 25 receiving low volume IV medication. This study was conducted using a prospective, blinded, cross-over design. Samples were obtained sequentially by direct venipuncture of the jugular vein and aspiration from an IVC in the contralateral vein after an appropriate presample of blood was obtained and discarded. Samples were submitted for blinded analysis including CBC, plasma chemistry analysis, stall side plasma glucose concentration, PCV, and total protein concentration. Data obtained were analyzed using a Student's t-test with compensation for unequal variances between the 2 groups. Analyses were Bonferroni corrected for a 5% 2-tailed hypothesis test. There were no statistically significant or clinically relevant differences associated with sampling method (venipuncture versus catheter) regardless of fluid administration status in any of the 24 analytes measured. Blood samples obtained by IVC have clinically equivalent values to those taken by direct venipuncture in commonly performed analyses. Additional investigation is warranted to establish if this technique is associated with increased complications such as phlebitis or bacteremia. [ABSTRACT FROM AUTHOR]

A dynamic mathematical model of a closed mammary system in lactating cows was developed to incorporate the setpoint concept of tissue activity, using equations where nutrient supply and absorption are locally regulated so as to maintain a given rate of milk protein yield. The model consists of 12 differential equations, 11 of which are concerned with intracellular biochemical compartments and one describes the volume of tissue actively perfused by blood (AP). The intracellular compartments are: amino acids (AAs), acetate, fatty acids (FAs), β-hydroxybutyrate, glucose-6-phosphate, fructose-6-phosphate, phospho-glyceraldehyde, pyruvate, mitochondrial acetyl-CoA, adenosine triphosphate (ATP) and adenosine diphosphate (ADP). The model simulates mechanisms which are aimed at reproducing and, thereby, explain variations in mammary plasma flow (MPF) observed experimentally. The AP changes according to variations in the metabolic status or in the metabolic requirements of the gland. Should the tissue energy charge (i.e. ATP/ADP ratio) exceed a baseline ratio, then AP decreases and consequently MPF declines. Conversely, when milk protein yield increases, AP increases and MPF rises. In the present model, AA uptake by the mammary gland is inhibited by intracellular AAs. It is also assumed that, when milk protein yield diminishes, the respiratory chain and ATP synthesis become uncoupled and consequently ATP yield is reduced. Model evaluation included behavioural analysis and sensitivity analysis. Behaviour analysis was conducted to test whether the model mechanisms reproduced the scenarios from which the model hypotheses were developed, and took into consideration: an increase in arterial glucose concentration (HIGLC), increases in arterial concentrations of non-esterified FAs, triacylglycerol and β-hydroxybutyrate (HIFAT), a 50% reduction of arterial histidine concentration (LOHIS), and a hyperinsulinaemic euglycaemic clamp (HIINS). Both HIGLC and HIFAT resulted in a decrease in MPF and in milk protein yield; moreover, the scenario HIGLC also produced a notable decrease in the extraction of glucose. The scenario LOHIS resulted in increased MPF and extraction of His from plasma. However these responses were not sufficiently large to prevent a severe reduction of milk protein yield which was accompanied by a reduction in the extraction of other essential AAs. The scenario HIINS resulted in an increase of MPF and of milk protein yield, in the extraction of His and of other essential AAs. Model sensitivity analysis focused on variation of both affinity and inhibition constants of some of the Michaelis–Menten equations. Improvements in model structure and directions for future research suggested by the modelling analysis are discussed. [ABSTRACT FROM PUBLISHER]

Background: Sequential lactate concentration ([LAC]) measurements have prognostic value in that hospitalized humans and neonatal foals that have a delayed return to normolactatemia have greater morbidity and case fatality rate. Hypothesis: Prognosis for survival is decreased in horses with a delayed return to normal [LAC]. Animals: Two hundred and fifty adult horses presented for emergency evaluation excepting horses evaluated because of only ophthalmologic conditions, superficial wounds, and septic synovitis without systemic involvement. Methods: Prospective observational study. [LAC] was measured at admission and then at 6, 12, 24, 48, and 72 hours after admission. The change in [LAC] over time ([LAC]Δ T) was calculated from changes in [LAC] between sampling points. Results: Median [LAC] was significantly ( P < .001) higher at admission in nonsurvivors (4.10 mmol/L [range, 0.60–18.20 mmol/L]) when compared with survivors (1.30 mmol/L [range, 0.30–13.90 mmol/L]) and this difference remained at all subsequent time points. The odds ratio for nonsurvival increased from 1.29 (95% confidence interval 1.17–1.43) at admission to 49.90 (6.47–384) at 72 hours after admission for every 1 mmol/L increase in [LAC]. [LAC]Δ T was initially positive in all horses but became negative and significantly lower in nonsurvivors for the time periods between 24–72 hours (− 0.47, P= .001) and 48–72 hours (− 0.07, P= .032) when compared with survivors (0.00 at both time periods) consistent with lactate accumulation in nonsurvivors. Conclusions and Clinical Importance: These results indicate that lactate metabolism is impaired in critically ill horses and [LAC]Δ T can be a useful prognostic indicator in horses. [ABSTRACT FROM AUTHOR]

Background: Lactate concentration in blood or plasma ([LAC]) and change in [LAC] are associated with survival in sick foals. Hypothesis: [LAC] and change in [LAC] over time are associated with survival at 96 hours and discharge in neonatal foals. Furthermore [LAC] and change in [LAC] over time correlate with blood culture results and blood pressure at admission. Animals: Two hundred and twenty-five foals consecutively admitted to a Neonatal Intensive Care Unit. Methods: Retrospective case review. Foals ≤30 days of age with [LAC] from arterial (190) or umbilical (35) blood gas analysis ([LAC]BG) at admission, 24, and 48 hours. [LAC]BG, blood pressure, blood culture status, and outcome (survival versus nonsurvival at 96 hours and discharge) were recorded. Change in [LAC]BG over time ([LAC]BGΔT) was calculated. Results: [LAC]BG was lower in survivors (96 hours and discharge) at all times. [LAC]BGΔT was larger for survivors (96 hours). Odds of survival (96 hours and discharge) decreased 18, 39, 53 and 22, 38, and 47%, respectively, at each sample time for every 1 mmol/L increment in [LAC]BG and increased 156% for each 1.0/day increment in [LAC]BGΔT from admission to 24 hours at 96 hours. Blood pressure and [LAC]BG were not correlated ( P= .196) until removal of selected foals (mean arterial pressure <60 mmHg, admission [LAC]BG <5.5 mmol/L) ( P < .001). Bacteremia was not associated with [LAC]BG. Proposed admission [LAC]BG cut-points for future studies were 6.5 mmol/L (96 hours) and 5.5 mmol/L (discharge). Conclusions and Clinical Importance: Prospective studies evaluating [LAC], [LAC]BGΔT, and cut-points in sick foals are warranted. [ABSTRACT FROM AUTHOR]

Background: Neutral Protamine Hagedorn human analogue insulin (Humulin N) is commonly used for treatment of canine diabetes mellitus (DM). However, blood glucose and serum insulin concentrations in Humulin N-treated dogs with naturally occurring DM have not been reported. Objective: To investigate blood glucose and serum insulin concentrations in the clinical setting of client-owned Humulin N-treated dogs with naturally occurring, well-regulated DM. Animals: Ten client-owned dogs with naturally occurring, well-regulated DM. Methods: In this clinical study, blood glucose and serum insulin concentrations were measured when dogs received food and insulin (T0), at approximately every half hour for the next 2 hours, and then approximately every 2 hours for an additional 8 hours. Insulin duration of action was defined as the number of hours from T0 to the lowest blood glucose concentration and until blood glucose concentration returned to an interpolated value of 70% of basal blood glucose concentration (Glucoseb). Results: Mean percent of insulin-induced blood glucose suppression was 49.9 ± 17.1% (median, 46%; range, 29–78%). Insulin duration of action ranged from 4 to 10 hours. Blood glucose concentration increased initially and returned to Glucoseb within 0.6–2.2 hours after T0 in 5 dogs. This initial blood glucose surge then was followed by blood glucose suppression in all 5 dogs. Conclusions and Clinical Importance: These results suggest that Humulin N administered SC twice daily is an effective mode of treatment for dogs with naturally occurring DM. Postprandial hyperglycemia is present in some well-regulated diabetic dogs treated with Humulin N. [ABSTRACT FROM AUTHOR]

Background: Coagulopathy is a potentially underrecognized complication of sepsis and septic shock in critically ill neonatal foals. Hypothesis: Critically ill neonatal foals have abnormalities in coagulation that are associated with disease severity and outcome. Animals: Foals <72 hours old admitted to a neonatal intensive care unit. Methods: Prospective, observational study. Blood was collected at admission, 24, and 48 hours for platelet count, prothrombin time, activated partial thromboplastin time, antithrombin activity and concentrations of fibrin degradation products, and fibrinogen in plasma from all foals. Results: Sixty-three foals were enrolled and classified as Septic Shock (12), Septic (28), and Other (23). At least 1 abnormal value was found in 18/28 (64%) samples from the Septic Shock group, 66/85 (78%) from the Septic group, and 30/59 (51%) from the Other group ( P= .01). Coagulopathy (3 or more abnormal values) was present in 7/28 (25%) samples in the Septic Shock group, 14/85 (16%) samples in the Septic group, and 3/59 (5%) samples in the Other group ( P= .0028). Clinically detectable bleeding occurred in 8/12 (67%) Septic Shock cases, 11/28 (39%) Septic cases, and 3/23 (13%) Other cases ( P= .009). Foals in Septic Shock were 12.7 times more likely to have clinical evidence of bleeding than those in the Other group (95% CI 2.3–70, P= .004). Treatment with fluids or plasma did not have a detectable effect on coagulation values. Conclusions and Clinical Importance: Coagulopathy commonly occurs in critically ill neonatal foals, especially those with sepsis and septic shock. [ABSTRACT FROM AUTHOR]

BACKGROUND: Blood pressure variability (BPV) is one putative risk factor for cardiovascular disease and mortality in hemodialysis patients. The purposes of this study are to identify a suitable metric of long-term BPV in this population and determine whether an association between BPV and all-cause mortality exists. STUDY DESIGN: Retrospective cohort study. SETTINGS & PARTICIPANTS: Patients from the Accelerated Mortality on Renal Replacement (ArMORR) cohort who were adult, incident to hemodialysis at any Fresenius Medical Care unit between June 2004 and August 2005, and had suitable blood pressure data were studied (n = 6,961). PREDICTOR: Predialysis blood pressures measured between dialysis days 91 and 180 were used to determine each patient's absolute level of, trend in (slope over time), and variability in blood pressure. OUTCOME: All-cause mortality beginning immediately after day 180 and continuing through day 365 or until censoring (median follow-up, 185 days). RESULTS: Of the 4 candidate BPV metrics, only average residual-intercept ratio adequately distinguished BPV from absolute blood pressure level and temporal blood pressure trend. In the primary analysis, each SD increase in systolic and diastolic BPV was associated with adjusted hazard ratios for all-cause mortality of 1.13 (95% confidence interval, 1.03 to 1.23) and 1.15 (95% confidence interval, 1.06 to 1.26), respectively. Results were consistent across multiple sensitivity analyses in which inclusion and exclusion criteria and timing of blood pressure measurements were varied. LIMITATIONS: Contingency of results on the validity of mathematic description of BPV; potential for misclassification bias and residual confounding. CONCLUSIONS: Provided the mathematical descriptions of BPV are valid, the data suggest that systolic and diastolic BPV is associated with all-cause mortality in incident hemodialysis patients. Additional study is necessary to confirm and generalize findings, assess the interplay between systolic and diastolic BPV, and assess causality. Copyright © 2008 National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Background: Norepinephrine increases arterial blood pressure but may have adverse effects on renal blood flow. Fenoldopam, a dopamine-1 receptor agonist, increases urine output in normotensive foals. The combination of norepinephrine and fenoldopam may lead to improved renal perfusion compared with an infusion of norepinephrine alone. The combined effects of these drugs have not been reported in the horse. Hypothesis: Norepinephrine will alter the hemodynamic profile of foals without affecting renal function. Addition of fenoldopam will change the renal profile during the infusions without changing the hemodynamic profile. Animals: Five conscious pony foals. Methods: Each foal received norepinephrine (0.3 μg/kg/min), combined norepinephrine (0.3 μg/kg/min) and fenoldopam (0.04 μg/kg/min), and a control dose of saline in a masked, placebo-controlled study. Heart rate (HR), arterial blood pressure (direct), and cardiac output (lithium dilution) were measured, and systemic vascular resistance (SVR), stroke volume, cardiac index (CI), and stroke volume index were calculated. Urine output, creatinine clearance, and fractional excretion of electrolytes were measured. Results: Norepinephrine and a combined norepinephrine and fenoldopam infusion increased arterial blood pressure, SVR, urine output, and creatinine clearance and decreased HR and CI compared with saline. The combination resulted in higher HR and lower arterial blood pressure than norepinephrine alone. Conclusions and Clinical Importance: Norepinephrine might be useful for hypotensive foals, because in normal foals, this infusion rate increases SVR without negatively affecting renal function (creatinine clearance increased). Fenoldopam does not provide additional benefit to renal function. These findings warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: More information is needed regarding accuracy of commonly used methods of glucose measurement in the critically ill horse. Hypothesis: Glucometry will have good agreement with a laboratory standard. Glucometry with plasma will have better agreement than when performed with whole blood. Animals: Fifty sequentially admitted equine emergency patients, aged >1year. Methods: Venous blood was collected at admission and immediately analyzed by point-of-care glucometry on both whole blood (POC/WB) and plasma (POC/PL), a multielectrode blood gas analyzer with whole blood (BLG), and a standard laboratory method with plasma (CHEM). Paired data were compared using Lin's concordance correlation, Pearson's correlation, and robust regression. Bias and limits of agreement were tested by the Bland-Altman technique. Bivariate regression analysis was used to explore confounding factors. Results: Concordance was significant for all comparisons, and was strongest for CHEM-POC/PL (0.977) and weakest for POC/WB-POC/PL (0.668). Pearson's correlation was excellent for all comparisons except those with POC/WB. All comparisons had excellent robust regression coefficients except those with POC/WB. Conclusions and Clinical Importance: POC glucometry with plasma had excellent agreement with a laboratory standard, as did blood gas analysis. POC glucometry with whole blood correlated poorly with a laboratory standard. These differences may be clinically important, and could affect decisions based on glucose concentrations. [ABSTRACT FROM AUTHOR]

Background: Bacteremia in sick foals is associated with survival, but the association of bacteremia and diarrhea is not reported. Hypothesis: Neonatal foals with diarrhea will commonly be bacteremic. Animals: One hundred and thirty-three neonatal foals. Methods: Records of all foals <30 days of age presenting with diarrhea between January 1990 and September 2007 were reviewed. Results: Sixty-six of 133 foals (50%) were bacteremic at admission, with 75 isolates from the 66 samples. The blood culture from a further 18 foals (13.5%) grew coryneform bacteria. Nine foals (6.8%) had 2 or more organisms grown on blood culture. One foal had 5 different organisms, interpreted as contamination. Forty-eight foals (36%) had no growth on admission blood cultures. No cultures isolated fungal organisms. Excluding coryneform bacteria, 43 isolates (57%) were Gram-negative organisms and 32 isolates (43%) were Gram-positive organisms. The most common isolate was Enterococcus spp. (22 isolates, 29%), followed by Pantoea agglomerans (13 isolates, 17%). IgG concentration at admission was not associated with blood culture status. Blood culture status was not associated with survival to hospital discharge. Conclusions and Clinical Importance: Bacteremia is common in neonatal foals with diarrhea. Decisions regarding antimicrobial selection should be made with these differences in mind. [ABSTRACT FROM AUTHOR]

Reasons for Performing Study: Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with nonsurvival. Hypoglycemia is also seen in critically ill humans, and is associated with nonsurvival. This might also be true in the critically ill foal. Objectives: To investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS). Methods: Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95), 48 hours (82), and 60 hours (45) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS. Results: 29.1% of foals had blood glucose concentrations within the reference range (76–131 mg/dL) at admission, 36.5% were hyperglycemic, and 34.4% were hypoglycaemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the 1st 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations <2.8 mmol/L (50 mg/dL) or >10 mmol/L (180 mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS. Conclusions and Potential Relevance: Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation. [ABSTRACT FROM AUTHOR]

The Cornell-Penn-Miner (CPM) Dairy is an applied mathematical nutrition model that computes dairy cattle requirements and the supply of energy and nutrients based on characteristics of the animal, the environment and the physicochemical composition of the feeds under diverse production scenarios. The CPM Dairy was designed as a steady-state model to use rates of degradation of feed carbohydrate and protein and the rate of passage to estimate the extent of ruminal fermentation, microbial growth, and intestinal digestibility of carbohydrate and protein fractions in computing energy and protein post-rumen absorption, and the supply of metabolizable energy and protein to the animal. The CPM Dairy version 3.0 (CPM Dairy 3.0) includes an expanded carbohydrate fractionation scheme to facilitate the characterization of individual feeds and a sub-model to predict ruminal metabolism and intestinal absorption of long chain fatty acids. The CPM Dairy includes a non-linear optimization algorithm that allows for least-cost formulation of diets while meeting animal performance, feed availability and environmental restrictions of modern dairy cattle production. When the CPM Dairy 3.0 was evaluated with data of 228 individual lactating dairy cows containing appropriate information including observed dry matter intake, the linear regression between observed and model-predicted milk production values indicated the model was able to account for 79·8% of the variation. The concordance correlation coefficient (CCC) was high (rc=0·89) without a significant mean bias (0·52 kg/d; P=0·12). The accuracy estimated by the CCC was 0·997. The root of mean square error of prediction (MSEP) was 5·14 kg/d (0·16 of the observed mean) and 87·3% of the MSEP was due to random errors, suggesting little systematic bias in predicting milk production of high-producing dairy cattle. Based upon these evaluations, it was concluded the CPM Dairy 3.0 model adequately predicts milk production at the farm level when appropriate animal characterization, feed composition and feed intake are provided; however, further improvements are needed to account for individual animal variation. [ABSTRACT FROM PUBLISHER]

Previous investigations into ruminal lipolysis of triacylglycerol and ruminal biohydrogenation (BH) of unsaturated long-chain fatty acids have generally quantified these processes with either zero-order or first-order kinetics. This investigation examined if Michaelis-Menten and other nonlinear kinetics might be useful for quantifying these processes. Data from 2 previously published in vitro experiments employing rumen fluid from sheep to investigate the lipolysis of trilinolein, the BH of cis-9, cis-12 linoleic acid (LA), and the BH of fatty acids derived from the lipolysis of trilinolein were used for the development of a multi-compartmental model. The model described the lipolysis of triacylglycerol well. The model also provided a good mathematical description of the resulting production of nonesterified fatty acids, the isomerization of nonesterified LA, and subsequent production of rumenic acid (RA), vaccenic acid (VA), and stearic acid (SA). However, the model described poorly the patterns of the concentrations of LA, RA, VA, and SA after incubation of trilinolein in rumen fluid. The model is consistent with known stoichiometry and biochemistry and is parsimonious in that it employs a minimal number of parameters to describe all of the major aspects of lipolysis and BH. The first step in the lipolysis of trilinolein was described by Michaelis-Menten kinetics (Vmax = 529 ± 16 mg/L per h; Km= 698 ± 41 mg/L). Both subsequent lipolysis steps were approximated by a first-order (linear kinetics) rate constant (k = 2.64 ± 0.041/h). Isomerization of LA to RA was modeled by simple Michaelis-Menten kinetics (Vmax = 2,421 ± 83 mg/L per h; Km = 440 ± 22 mg/L). The kinetics of the BH of RA to VA was described by a Michaelis-Menten-type process involving competitive inhibition by VA (Vmax = 492 ± 6.5 mg/L per h; Km = 1 mg/L). The final step, the BH of VA to SA, was modeled by a quasi-first-order process (k = 0.533 ± 0.021/h), but as the concentration of VA increased, its BH appeared to be self-inhibited such that when the concentration of VA acid exceeded 517 ± 10.4 mg/L, BH was completely inhibited. The major new insights and benefits afforded by this model are 1) lipolysis and BH are described by nonlinear kinetics; 2) high concentrations of VA appear to inhibit its own BH; and 3) BH of RA appears to proceed at a much greater rate when triglyceride is present in the incubation medium. This model provides a conceptual framework for researching ruminal lipolysis and BH. [ABSTRACT FROM AUTHOR]

Recently, a fat sub-model was introduced into the Cornell-Penn-Miner Dairy model (CPM-Dairy; Moate et al., 2004). The principal aim of the work reported here was to validate this fat sub-model in terms of its accuracy in predicting the apparent absorption (intake -- feces) of total long-chain fatty acids (LCFA) in lactating dairy cows. The fat sub-model in CPM-Dairy was used to predict the amounts (g/d) of total LCFA apparently absorbed from 63 diets described in 14 published experiments. These predicted amounts (PLCFA) were regressed against the amounts reported to be apparently absorbed (RLCFA). The regression equation was: PLCFA = -24.8 ± 25.2 + 1.011 x 0.029 x RLCFA; R² = 0.95, RMSE = 55.2 g/d. The results show that for a diverse range of diets, the fat model in CPM-Dairy can accurately predict apparent absorption of dietary total LCFA. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Few reports exist in the veterinary medical literature describing clinical and pathological findings resembling conditions described as (ALI) and acute respiratory distress syndrome (ARDS) in man. Objectives: To document history, clinical, laboratory and diagnostic findings, treatment and outcome of foals age 1-12 months diagnosed with ALI/ARDS at a referral hospital. Methods: Medical records, including radiographic, cytological, microbiological, serological and post mortem findings, were reviewed in a retrospective manner to identify foals with acute onset of respiratory distress, a partial pressure of arterial oxygen (PaO [ABSTRACT FROM AUTHOR]

Objective: To determine whether insulin resistance and secretion differ in obese premenopausal African-American women with and without glucose intolerance.Research Design and Methods: A total of 63 women underwent oral glucose tolerance tests (OGTTs). A total of 48 women underwent frequently sampled intravenous glucose tolerance tests (FSIGTs). Insulin resistance was determined from the insulin sensitivity index (S(I)) from the FSIGT. Insulin secretion during the OGTT was determined by (I(30 min) - I(0 min))/(G(30 min) - G(0 min)) and during the FSIGT by the acute insulin response to glucose (AIRg). The disposition index, the product of AIRg and S(I), was used to determine whether AIRg was adequate to compensate for insulin resistance. Statistical analyses included one-way analysis of variance with Bonferroni corrections for multiple comparisons and regression analyses.Results: The women were divided into three groups: nonobese glucose tolerant (n = 32), obese glucose tolerant (n = 17), and obese glucose intolerant (n = 14). The BMI of the three groups were 24.8 +/- 2.3, 37.8 +/- 5.5, and 42.0 +/- 7.6 kg/m(2) (mean +/- SD), respectively (P < 0.0001). The ages of the three groups were 34.9 +/- 8.4, 32.1 +/- 5.0, and 41.1 +/- 6.3 years (P = 0.011). S(I) was higher in the nonobese women than in the obese glucose-tolerant women (3.99 +/- 1.44 vs. 2.66 +/- 2.14 l x mU(-1) x min(-1), P = 0.03). S(I) was similar in the obese glucose-intolerant and obese glucose-tolerant women (2.12 +/- 1.27 vs. 2.66 +/- 2.14 l x mU(-1) x min(-1), P = 0.9). OGTT showed that insulin secretion was lower in the glucose-intolerant than the obese glucose-tolerant women (1.73 +/- 1.38 vs. 3.62 +/- 2.11, P = 0.005). FSIGT showed that AIRg was not significantly lower in glucose-intolerant than in obese glucose-tolerant women (807 +/- 665 vs. 1,253 +/- 655 mU x l(-1) x min, P = 0.078). The disposition index was lower in glucose-intolerant than in obese glucose-tolerant women (1,324 +/- 1,061 vs. 2,656 +/- 1,415, P = 0.014).Conclusions: Obese premenopausal African-American women with and without glucose intolerance have a similar degree of insulin resistance but differ in insulin secretion. [ABSTRACT FROM AUTHOR]