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Summary: Septic osteomyelitis of the temporomandibular joint (TMJ) is rarely seen in equine medicine with few reported cases, and none reported involving Fusobacterium necrophorum. This report describes the diagnosis and successful treatment of septic osteomyelitis of the temporomandibular joint (TMJ) in an 11‐year‐old Australian Stockhorse mare in Queensland, Australia. [ABSTRACT FROM AUTHOR]

Summary: This case report discusses a successful partial splenectomy for treatment of a splenic abscess in a horse. A 2‐year‐old Thoroughbred colt was hospitalised 5 weeks after an episode of severe colic that was followed by gradual weight loss and anorexia, pyrexia for 5 days and dehydration on the day of referral. A large splenic abscess was identified ultrasonographically. Following initial medical treatment, an exploratory laparotomy was performed. Multiple adhesions were released and a partial splenectomy conducted to remove the abscess. Migrant metallic wires penetrating from the small intestine into the splenic parenchyma were found to be the cause for the adhesions and the abscess. This paper summarises the potential advantages of utilising a partial vs. a total splenectomy and highlights the potential complications of these surgical procedure in equines. [ABSTRACT FROM AUTHOR]

Summary: The third metacarpal bone (McIII) is a common site of long bone fractures in racehorses. However, articular fractures of the dorsomedial aspect of McIII are a rare location of such injuries. This report describes the successful standing surgical repair of an articular fracture of the dorso‐medial proximal McIII in a 4‐year‐old Standardbred racing mare using lag screw fixation. [ABSTRACT FROM AUTHOR]

Background: Mycotic rhinitis is a rare disease in horses, with few cases reported worldwide and none reported in Australia. Fungal infection of the upper respiratory tract can occur in all species, but its prevalence in horses is considerably lower than in canines or humans. The disease is linked to a variety of pathogens and the clinical signs are associated with subsequent upper respiratory tract damage. Case report: A 6‐year‐old Quarter Horse gelding in Queensland, Australia, was presented with chronic nasal discharge and dyspnoea following previous unsuccessful medical treatment of 9 months’ duration. Culture yielded a mixed growth of Cryptococcus and Rhodotorula, as well as secondary bacterial species. The horse was anaesthetised and positioned in sternal recumbency. The nasal passages and sinuses were bathed with fluconazole and dimethylsulfoxide for 1 h on two separate occasions 4 weeks apart. Systemic antimicrobials and corticosteroids were also administered for brief courses. Endoscopic examination 4 months after treatment demonstrated clinical resolution of the rhinitis with residual scar tissue. Owners reported resolution of clinical signs and following the treatment the gelding was able to perform athletically. Clinical relevance: Mycotic rhinitis is an unusual disease that can be difficult to treat successfully. This report describes a technique for topical sinonasal bathing under general anaesthetic that was well tolerated, easy to perform and resulted in a successful clinical outcome. [ABSTRACT FROM AUTHOR]

Background: Conventional radiography is currently the most common imaging modality used by veterinarians investigating foals with suspected osteomyelitis. Emerging evidence in adult horses and humans suggests computed tomography (CT) is a superior modality for evaluation of osseous changes in general. This study aimed to evaluate the potential benefits of CT versus conventional radiography in cases of osteomyelitis in foals. Methods: Cases of osteomyelitis in foals under 6 months of age admitted over a 6‐year period at a single referral hospital that had both CT and conventional radiography images were retrieved. Case details and measurements of the largest area of bone lysis identified in two planes (lateromedial/sagittal and dorsopalmar/dorsal) were evaluated by three veterinarians with a range of experience. Results: A significant difference regarding lesion size was seen on the lateromedial (LM) radiographic projections compared with the equivalent sagittal plane CT image. The LM radiographic evaluation resulted in a 37% underestimation of the area of the lesion. Additionally, use of the LM radiographic projections were 2.5‐fold more variable in the measurement area compared with CT. In general, regardless of projection, CT produced more information regarding lesion area and, in some cases, detected osseous changes that were not evident on the radiographs. Clinical relevance: LM radiographic projections are less reliable and commonly result in an under‐appreciation of lesion size and extent. CT detected lesions that were difficult or impossible to identify on radiographs and may allow improved treatment planning. [ABSTRACT FROM AUTHOR]

Case report: This report details a case of recurrent nasal discharge in a 3-year-old Quarter Horse filly. Endoscopic examination found an incomplete guttural pouch median septum presumed to be congenital in origin. The filly suffered recurrent bacterial infections despite multiple courses of systemic antimicrobial therapy and ultimately underwent transendoscopic laser salphingopharyngostomy to establish effective guttural pouch drainage. At six months after surgery, there was no recurrence of nasal discharge or guttural pouch empyema. Conclusion and clinical relevance: There is a wider variation in embryologic developmental anomalies in the guttural pouch than currently recorded in the literature. While the congenital defect in this case was identified due to the recurrent bacterial infections, it is unlikely that incomplete guttural pouch median septum was the inciting factor. A fistula was created to bypass the guttural pouch ostia, which were assumed to be functionally abnormal. [ABSTRACT FROM AUTHOR]

Surgical treatment is almost always combined with medical therapy to treat fungal infections of the upper airway. Overall, equine veterinary medicine is lacking of extensive and large studies in sinonasal mycosis to further understand the pathophysiology, early recognition and treatment of this disease in horses. Fungal rhinitis is uncommon in horses, and its prevalence varies geographically (Stewart and Cuming 2015). However, the number of therapeutic options for the treatment of fungal infections is still quite limited when compared with those available for bacterial infections. [Extracted from the article]

Summary A case of paranasal sinus fibromatosis in an 11-year-old Thoroughbred gelding is reported. At admission the gelding underwent a unilateral frontal sinusotomy and a paranasal sinus mass was extensively debulked. The mass was diagnosed via histopathology as a desmoid fibromatosis with bone invasion, reactive osteoclastic osteolysis and osteoproliferation. The gelding had radiographic evidence of slow recurrence of the mass 8 months post operatively. The histopathological appearance and short-term outcome are presented for this previously undiagnosed condition of the horse. Recognition of paranasal fibromatosis and the resultant differentiation from other types of paranasal sinus neoplasia may allow for improved prognostication of equine sinus lesions. [ABSTRACT FROM AUTHOR]

Objective: To identify thoroughbred industry stakeholders' views on the yearling sales endoscopy in Australia., Design: Semi-structured qualitative group interviews with equine veterinarians, thoroughbred breeders and yearling purchasers., Methods: Twenty-nine experienced thoroughbred industry stakeholders participated in online focus groups: (1) equine veterinarians involved in yearling endoscopy; (2) thoroughbred breeders; and (3) yearling buyers. The focus groups were audio and video recorded and digital whiteboards were available. Data was transcribed, live-coded and analysed thematically., Results: The main themes identified included the uncertainty surrounding the relationship between yearling laryngeal function and future performance, especially the significance of yearlings with grade 3 out of 5 laryngeal function; interobserver variability in the laryngeal function grade assigned by veterinarians to the same endoscopic exam; and the presence of intra-horse variability in laryngeal function over different time points., Discussion: Stakeholders raised multiple concerns about the current yearling sales endoscopy process in Australia. Recommendations to address these concerns include further investigation into the race performance of yearlings identified with grade 3 laryngeal function; training of veterinarians to reduce inter-observer variability; and the need to determine the most appropriate grading system to use in yearlings. Future research should evaluate the significance of intra-horse variability in a yearling population., (© 2024 The Authors. Australian Veterinary Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Veterinary Association.)

This study examines and describes circumstances involving non-fatal firearm injuries in a pediatric population from a Level I Pediatric Trauma Center in the southeastern U.S. Researchers analyzed Firearm Injury Questionnaire (FIQ) data collected from 144 children and adolescents, aged 2-17 years, who were treated in the emergency department and/or admitted to the hospital for non-fatal firearm injuries. Descriptive statistics are presented regarding participant demographics and FIQ responses, such as caregiver information, mental health history, adverse childhood experience (ACE) exposure, firearm access, injury intent, relationship to shooter, type of firearm used, and context of injury. Most patients identified as Black (82%) and male (75%), with most injuries categorized as intentional (72%) versus unintentional (24%) assaults. The average ACEs score was .60, with only 37% of patients' reporting any ACE experience; however, nearly half (47%) of patients reported experiencing a traumatic event beyond an identified ACE. Community violence was the most common context that attributed to patients' assaults (56%). As U.S. pediatric gun injury and fatality trends are increasing, this study provides timely data regarding pediatric firearm injuries and exposure to community violence. These findings highlight the need to provide integrated health services to pediatric patients experiencing non-fatal firearm injuries. Researchers discuss public health implications for integrated mental health care services, hospital- and school-based violence intervention programs, policy recommendations, and directions for future research., Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00568-4., Competing Interests: Conflict of InterestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023.)

Radiographs underestimate the extent of bone injury in horses with third carpal bone (C3) fractures (Fx). We aimed to describe bone pathologies identified using computed tomography (CT) and compare the diagnostic value of digital radiography (DR) and CT in horses with C3 Fx. CT images of 15 racehorses with C3 Fx and 10 controls were reviewed (Part 1) then DR and CT images of 26 racehorses (24 Thoroughbred, 2 Standardbred) with C3 Fx (Part 2) were evaluated. Agreement on fracture geometry and concomitant bone lesions was tested between DR and CT using the kappa statistic (Part 2). For agreement analysis, 38 limbs were used (27 Fx carpi from 26 horses and 11 contralateral carpi). Intermodality agreement was good for recognition of displacement, fair for comminution, articular surface bone loss and osseous fragmentation, and poor-slight for recognition of whether the Fx was complete, additional fissures and lucencies. CT provides more detailed information than DR regarding bone pathology and fracture configuration in horses with C3 fracture. Correlation of CT findings with clinical information and outcome needs to be explored; however, the more accurate diagnosis possible with CT is likely valuable when deciding on the most appropriate management and for surgical planning.

Introduction: Upper airway endoscopy of thoroughbred (TB) yearlings is commonly used in an attempt to predict laryngeal function (LF) and its impact on future race performance. The aim of this study was to determine if different grading systems and laryngeal grades were correlated with future performance., Materials and Methods: Postsale endoscopic recordings were obtained from an Australian TB yearling sale during a four-year period from 2008 to 2011. Horses were included if they had a diagnostic postsale video endoscopic recording and raced within Australia. Recordings were graded using the Havemeyer system and subsequently recategorised according to the Lane scale and two condensed scales. Performance data were sourced from Racing Australia and comparisons were made between groups., Results: A total of 1244 horses met the inclusion criteria. There were no significant differences in sex or sales price between groups. There were no significant differences in the number of starts or wins between groups for any grading system. For the condensed Havemeyer scale, horses with intermediate LF were separated into two groups. Significant differences in earnings were found between 'normal' and 'abnormal' (P = 0.02) and 'intermediate-low' and 'abnormal' grades (P = 0.03). There were no significant differences between horses with 'intermediate-high' and 'abnormal' grades (P = 0.40). No significant differences were found between the two intermediate grades (P = 0.60) or between horses with normal LF and either 'intermediate-low' or 'intermediate-high' grades (P = 0.99)., Discussion: Resting LF in Australian yearling TBs assessed using a condensed Havemeyer grading scale had some predictive value for future racing performance. This information should be considered when performing yearling endoscopic examinations., (© 2022 The Authors. Australian Veterinary Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Veterinary Association.)

Background: As myosin heavy chain (MyHC) profile of muscle fibres is heavily influenced by neural input, changes in MyHC expression are expected in horses clinically affected with recurrent laryngeal neuropathy (RLN) yet, this has not been thoroughly investigated., Objectives: To describe the changes in MyHC and fibre diameter in left cricoarytenoideus dorsalis (L-CAD) muscle of horses with clinical signs of RLN., Study Design: Observational cohort study., Methods: Immunohistochemistry was used to assess the MyHC-based fibre-type proportion, size and grouping in the L-CAD of 10 Thoroughbred horses, five clinically affected with RLN and five unaffected controls based on resting endoscopic examination. The Mann-Whitney U test was used to compare the two groups., Results: Compared to controls (of mean age 3.0 ± 1.7 years) which only expressed type I, IIA and IIX MyHC, the L-CAD of affected horses (of mean age 2.8 ± 0.8 years) had obvious fibre-type grouping, and despite apparent compensatory hypertrophy of a small number of fibres, a decrease in overall fibre diameter (median difference -35.2 µm, 95% CI -47.4 to -7.9, P = .02) and diameter of type IIA fibres (median difference -46.8 µm, 95% CI -52.1 to -5.0, P = .03) was observed. Anti-fast MyHC (MY32) cross-immunoreacted with embryonic-MyHC. Whereas MY32-positive fibres were identified as type IIX in controls, in affected horses these fibres were less than 50 µm diameter with internal nuclei and were MYH3-positive for embryonic myosin indicating depletion of type IIX fibres, yet active regeneration and fibre renewal., Main Limitations: Small sample size that did not include subclinical cases. Fibre size and appearance rather than staining colour were relied upon to differentiate embryonic from type IIX MyHC., Conclusions: Horses clinically affected with RLN have overall atrophy of fibres, loss of IIX fibres and expression of embryonic myosin indicating regenerative capacity. Despite hypertrophy of some remaining fibres, the overall decline in the bulk of fibres, including those most fatigue-resistant, may be the critical change that results in failure to maintain arytenoid abduction during exercise although direct comparison to subclinical cases is needed to confirm this., (© 2020 EVJ Ltd.)

Background: Ventilator-associated pneumonia is common and is treated using nebulized antibiotics. Although adequate pulmonary biodistribution is important for antibiotic effect, there is a lack of data for both intravenous (IV) and nebulized antibiotic administration during mechanical ventilation., Objective: To describe the comparative pulmonary regional distribution of IV and nebulized technetium-99m-labeled tobramycin ( 99m Tc-tobramycin) 400 mg in a mechanically-ventilated ovine model., Methods: The study was performed in a mechanically-ventilated ovine model. 99m Tc-tobramycin 400 mg was obtained using a radiolabeling process. Computed tomography (CT) was performed. Ten sheep were given 99m Tc-tobramycin 400 mg via either an IV (five sheep) or nebulized (five sheep) route. Planar images (dorsal, ventral, left lateral and right lateral) were obtained using a gamma camera. Blood samples were obtained every 15 min for 1 h (4 time points) and lung, liver, both kidney, and urine samples were obtained post-mortem., Results: Ten sheep were anesthetized and mechanically ventilated. Whole-lung deposition of nebulized 99m Tc-tobramycin 400 mg was significantly lower than with IV (8.8% vs. 57.1%, P<0.001). For both administration routes, there was significantly lower deposition in upper lung zones compared with the rest of the lungs. Dorsal deposition was significantly higher with nebulized 99m Tc-tobramycin 400 mg compared with IV (68.9% vs. 58.9%, P=0.003). Lung concentrations of 99m Tc-tobramycin were higher with IV compared with nebulized administration. There were significantly higher concentrations of 99m Tc-tobramycin in blood, liver and urine with IV administration compared with nebulized., Conclusions: Nebulization resulted in lower whole and regional lung deposition of 99m Tc-tobramycin compared with IV administration and appeared to be associated with low blood and extra-pulmonary organ concentrations., (Copyright © 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)

Objective: The advent of new technologies has made it possible to explore alternative ventilator manufacturing to meet the worldwide shortfall for mechanical ventilators especially in pandemics. We describe a method using rapid prototyping technologies to create an electro-mechanical ventilator in a cost effective, timely manner and provide results of testing using an in vitro-in vivo testing model., Results: Rapid prototyping technologies (3D printing and 2D cutting) were used to create a modular ventilator. The artificial manual breathing unit (AMBU) bag connected to wall oxygen source using a flow meter was used as air reservoir. Controlled variables include respiratory rate, tidal volume and inspiratory: expiratory (I:E) ratio. In vitro testing and In vivo testing in the pig model demonstrated comparable mechanical efficiency of the test ventilator to that of standard ventilator but showed the material limits of 3D printed gears. Improved gear design resulted in better ventilator durability whilst reducing manufacturing time (< 2-h). The entire cost of manufacture of ventilator was estimated at 300 Australian dollars. A cost-effective novel rapid prototyped ventilator for use in patients with respiratory failure was developed in < 2-h and was effective in anesthetized, healthy pig model.

Optimal concentrations of unbound antimicrobials are essential for a maximum microbiological effect. Although hypoalbuminemia and albumin fluid resuscitation are common in critical care, the effects of different albumin concentrations on the unbound concentrations of highly protein-bound antimicrobials are not known. The aim of this study was to compare the effects of different albumin states on total and unbound concentrations of ertapenem and ceftriaxone using an ovine model. The study design was a prospective, three-phase intervention observational study. The subjects were healthy Merino sheep. Eight sheep were subjected to three experimental phases: normoalbuminemia, hypoalbuminemia using plasmapheresis, and albumin replacement using a 25% albumin solution. In each phase, ceftriaxone at 40 mg/kg of body weight and ertapenem at 15 mg/kg were given intravenously. Blood samples were collected at predefined intervals and analyzed using an ultrahigh-performance liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters such as the area under the curve from 0 to 24 h (AUC 0-24 ), plasma clearance (CL), and apparent volume of distribution in the terminal phase ( V ) were estimated and compared between the phases. The protein and albumin concentrations were significantly different between phases. Hypoalbuminemia resulted in a significantly lower AUC 0-24 and higher CL of total and unbound concentrations of ceftriaxone than in the other phases, whereas albumin replacement led to higher AUC 0-24 and lower CL than in the other phases for both drugs. The V values for total drug concentrations for both drugs were significantly lower with albumin replacement. For highly protein-bound drugs such as ceftriaxone and ertapenem, both hypoalbuminemia and albumin replacement may affect unbound drug exposure., (Copyright © 2020 American Society for Microbiology.)

Objective: To review a large number of equine overground endoscopy (OGE) examinations to determine the incidence of dynamic upper airway obstructions (DUAO); correlations were explored with laryngeal endoscopy findings at rest and abnormal exercising respiratory noise., Methods: Retrospective analysis of horses presenting for OGE because of perceived poor performance and/or history of abnormal exercising respiratory noise between 2010 and 2014. Signalment, history and examination findings during resting laryngeal endoscopy and OGE were reviewed., Results: Of the total examinations, 311 were reviewed. One or more DUAO were found in 249/311 horses. From 210 males (colts and geldings), 121 had arytenoid cartilage collapse (ACC) and 111 had vocal fold collapse (VFC). From 101 females, 25 had intermittent dorsal displacement of the soft palate (DDSP). Resting laryngeal function grade 4 was found in 121/311 of the study population and 92/210 of males. An association was found between horses with lower resting arytenoid abduction ability to dynamic ACC and higher resting arytenoid abduction ability with DDSP. Abnormal exercising respiratory noise was positively associated with the presence of DUAO., Conclusions: Multiple DUAO in association with abnormal exercising respiratory noise was a common finding in horses examined for poor performance. This study highlights the importance of OGE in accurately diagnosing the nature of DUAO associated with poor performance., (© 2017 Australian Veterinary Association.)

Objectives: To determine the variation of tracheal mucus scores, tracheal blood scores and transendoscopic tracheal wash (TW) cytology in a population of Thoroughbred (TB) racehorses and assess their association with racing performance., Methods: A total of 220 endoscopic examinations were performed and TWs obtained from 155 TB racehorses. Samples were collected 60-120 min following gallop work. Tracheal mucus score, tracheal blood score and TW cytology were analysed and their association with racing performance assessed., Results: Of the total examinations and samples, 194 from 135 horses fitted the criteria for inclusion. The overall prevalence of visible tracheal mucus was 2.5% (5/194) and of increased tracheal mucus was 0%. The prevalence of visible tracheal blood was 8.8% (17/194) and of increased tracheal blood was 4.6% (9/194). A total of 36% (70/194) of TWs contained elevated percentages of neutrophils and of these, 96% (67/70) occurred in the absence of any visible tracheal mucus. There was no significant association between tracheal mucus score or TW cytology and subsequent racing performance. There was a statistically significant association (P = 0.004) between increased tracheal blood scores and poor racing performance., Conclusions: Visible tracheal blood seen after strenuous exercise in clinically normal TB racehorses was a risk factor for poor racing performance, but the presence of airway neutrophilia was not. No horses in this study were found to have increased tracheal mucus, so the association of increased tracheal mucus with racing performance could not be assessed., (© 2016 Australian Veterinary Association.)

Objective: Review the literature for single site cartilage defect research and evaluate the respective strengths and weaknesses of different preclinical animal models., Method: A literature search for animal models evaluating single site cartilage defects was performed. Variables tabulated and analyzed included animal species, age and number, defect depth and diameter and study duration. Cluster analyses were then used to separate animals with only distal femoral defects into similar groups based on defect dimensions. Representative human studies were included allowing comparison of common clinical lesions to animal models. The suitability of each species for single site cartilage defect research and its relevance to clinical human practice is then discussed., Results: One hundred thirteen studies relating to single site cartilage defects were reviewed. Cluster analysis included 101 studies and placed the murine, laprine, ovine, canine, porcine and caprine models in group 1. Group 2 contained ovine, canine, porcine, caprine and equine models. Group 3 contained only equine models and humans. Species in each group are similar with regard to defect dimensions. Some species occur in multiple groups reflecting utilization of a variety defect sizes. We report and discuss factors to be considered when selecting a preclinical animal model for single site cartilage defect research., Discussion: Standardization of study design and outcome parameters would help to compare different studies evaluating various novel therapeutic concepts. Comparison to the human clinical counterpart during study design may help increase the predictive value of preclinical research using animal models and improve the process of developing efficacious therapies.