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Summary: Background: Pituitary pars intermedia dysfunction (PPID) is a commonly described endocrine disorder in higher latitudes of the Northern hemisphere but the description of the disease at lower latitudes and in the Southern hemisphere is limited. Objectives: Document the clinical features of PPID at different Australian latitudes and climates, and investigate factors associated with survival, laminitis and insulin dysregulation (ID). Study design: Retrospective study of 274 equids from eight institutions across Australia. Methods: A diagnosis of PPID was based on endogenous ACTH, overnight dexamethasone suppression test, thyrotropin‐releasing hormone stimulation test or necropsy. Clinical and clinicopathologic characteristics of PPID and therapeutic responses were investigated. Laminitis was diagnosed by radiographic or histologic changes and ID was diagnosed based on endogenous insulin, an oral glucose test or a 2‐step insulin‐response test. Results: Being a pony, having a higher body condition score and pergolide administration were associated with survival. The clinical presentation of PPID changed with latitude and climate, with anhidrosis and polyuria/polydipsia more commonly recognised at lower latitudes. Laminitis was diagnosed in 89.9% of cases and ID was present in 76.5% of cases in which they were investigated. Main limitations: Despite the sample size, the lack of uniform testing at all locations (primary or referral cases) and the incompleteness of data sets limited the power of the statistical analyses. Conclusions: PPID can present with variable signs at different latitudes and climates, and ID should be investigated in equids diagnosed with PPID. Adequate body condition and administration of pergolide are fundamental in PPID management. [ABSTRACT FROM AUTHOR]

Summary: A 15‐year‐old pony mare was presented for investigation of haematuria of 2 weeks' duration. On cystoscopy, multiple small pedunculated soft tissue structures were observed on the bladder mucosa. Histopathological analysis of the masses was consistent with chronic polypoid cystitis. The polypoid lesions and associated haematuria resolved following prolonged antibiotic treatment. Polypoid cystitis has not previously been described in horses. This condition should be considered a differential for haematuria, requiring cystoscopy and biopsy to confirm a diagnosis. [ABSTRACT FROM AUTHOR]

Summary: This report describes a case of severe hypophosphataemia associated with the management of hyperlipaemia in a miniature pony following colic surgery. Clinical signs attributed to hypophosphataemia included obtundation, anorexia, tachycardia, tachypnoea and generalised muscle fasciculations. Hyperlipaemia was managed with enteral and partial parenteral nutrition; insulin was also administered to control hyperglycaemia after the initiation of caloric support. Specific therapy for hypophosphataemia consisted of parenteral potassium phosphate at 0.03 mmol/kg bwt/h (i.v.). The pony made a full recovery without further complications. Hypophosphataemia may be an under‐recognised clinical problem in certain populations of critically ill equids, such as those with hyperlipaemia and receiving insulin as part of their management. The routine measurement of phosphate concentration in these cases is recommended. [ABSTRACT FROM AUTHOR]

Summary: Background: Snake envenomation is a cause of morbidity and mortality in domestic animals worldwide. The clinical features of crotalid snake (pit viper) envenomation are widely reported and well described in horses but elapid snake envenomation is poorly characterised. Objectives: To describe the presentation, clinical and laboratory findings, treatment and outcome of horses with a diagnosis of elapid snake envenomation in Australia. Study design: Retrospective case series. Methods: Medical records of horses with a diagnosis of elapid snake envenomation (2006–2016) at several university and private veterinary practices were reviewed. Inclusion criteria comprised one or more of the following: 1) observed snakebite, 2) positive snake venom detection kit (SVDK) result, 3) appropriate clinical response to treatment with antivenom or 4) supportive post‐mortem findings. Results: Fifty‐two cases met the inclusion criteria. Most cases (94%) demonstrated clinical signs of neurotoxicity, characterised by generalised neuromuscular weakness. Associated neurologic signs included staggering gait, muscle fasciculations, recumbency, mydriasis, ptosis and tongue paresis. Concurrent clinically important conditions included rhabdomyolysis (50%) and haemolysis (19%). Of 18 urine samples evaluated with a SVDK, only three (17%) were positive. Overall survival was favourable (86%) among 49 horses who received antivenom. Eighteen surviving horses (43%) required more than one vial of antivenom. Main limitations: Possible cases within the searchable database were not included if horses died acutely or responded to symptomatic treatment without receiving antivenom. Conclusions: Elapid snake envenomation is primarily a syndrome of neuromuscular weakness. Supportive anamnesis or an obvious bite site is rarely encountered. In endemic areas, this diagnosis should be considered for horses with generalised neuromuscular weakness, altered mentation, rhabdomyolysis and/or haemolysis; especially during spring and summer months. Diagnostic suspicion is best confirmed by response to treatment with antivenom. [ABSTRACT FROM AUTHOR]

Reasons for performing study: The relative influences of obesity and adaptation to high glycaemic diets on the development of insulin dysregulation in equids are unclear. Objectives: To determine whether increased adiposity per se is responsible for the decreased insulin sensitivity often observed in obese horses or whether a dietary glycaemic response is critically important. Study design: Randomised controlled trial. Methods: Eighteen horses and ponies were studied over a 20-week period. They received ad libitum hay plus either a high fat (low glycaemic) diet (FAT; n = 6) or a similar (isocaloric) diet containing 1.5 g/kg bwt once daily glucose (GLU; n = 6) to induce obesity. A third group received a control ration (CON; n = 6). Adiposity was monitored using body condition score (BCS) and total body fat mass percentage (TBFM) determined using a deuterium oxide dilution technique. Insulin sensitivity was assessed using a frequently sampled i.v. glucose tolerance test. Plasma concentrations of glucose, insulin, leptin, adiponectin, tumour necrosis factor-α (TNF-α) and serum amyloid A (SAA) were measured. Results: The FAT and GLU groups became obese (BCS ≥7) whereas the CON group maintained moderate condition (BCS ≤6). Total body fat mass and leptin concentrations were increased in the FAT and GLU groups than in the CON group (P<0.001 and P = 0.003, respectively). Values for both insulindependent (SI) and insulin-independent (Sg) glucose disposal were higher in the GLU group compared with the FAT and CON groups (P = 0.006 and P = 0.03, respectively). There were no differences in adiponectin, TNF-α or SAA between groups (all P≥0.4). Conclusions: Increased adiposity did not reduce insulin sensitivity in either the FAT or the GLU diet groups, suggesting that obesity per se might not be responsible for the lower SI values reported in previous studies. Contrary to expectations, once daily glucose appeared to increase insulin sensitivity. Further work is required into the dietary causes of insulin resistance in equids. [ABSTRACT FROM AUTHOR]

Previous liquid chromatography/mass spectrometry (LC/MS) methods for the detection of insulin and other similar peptide hormones in equine plasma relied on the use of antibody affinity extraction. As a result, these methods were not suitable for routine high-throughput analysis. A solid-phase extraction (SPE) method incorporating size exclusion as well as reversed-phase interactions allows the selective extraction of peptide hormones such as adrenocorticotropic hormone (ACTH), insulin and their synthetic analogues from equine plasma with approximately 80% extraction efficiencies. This extraction was combined with on-column derivatisation with acetic anhydride, followed by tryptic digestion and analysis by micro-LC/MSMS for high-sensitivity peptide hormone detection. The analysis of tryptic peptides provides greater sensitivity and more robust chromatography compared with the analysis of intact insulin and ACTH. For quantitative analysis, isotopically labelled internal standards of target peptides can be prepared in the laboratory through the use of deuterated acetic anhydride. The utility of the method was assessed for the analysis of ACTH and insulin in samples from horses suffering from pituitary pars intermedia dysfunction (PPID)., (© 2024 John Wiley & Sons Ltd.)

Reports of newly discovered equine hepatotropic flavi- and parvoviruses have emerged throughout the last decade in many countries, the discovery of which has stimulated a great deal of interest and clinical research. Although commonly detected in horses without signs of disease, equine parvovirus hepatitis (EqPV-H) and equine hepacivirus (EqHV) have been associated with liver disease, including following the administration of contaminated anti-toxin. Our aim was to determine whether EqPV-H and EqHV are present in Australian horses and whether EqPV-H was present in French horses and to examine sequence diversity between strains of both viruses amongst infected horses on either side of the globe. Sera from 188 Australian horses and 256 French horses from horses with and without clinical signs of disease were collected. Twelve out of 256 (4.7%) and 6 out of 188 (3.2%) French and Australian horses, respectively, were positive for the molecular detection of EqPV-H. Five out of 256 (1.9%) and 21 out of 188 (11.2%) French and Australian horses, respectively, were positive for the molecular detection of EqHV. Australian strains for both viruses were genomically clustered, in contrast to strains from French horses, which were more broadly distributed. The findings of this preliminary survey, with the molecular detection of EqHV and EqPV-H in Australia and the latter in France, adds to the growing body of awareness regarding these recently discovered hepatotropic viruses. It has provided valuable information not just in terms of geographic endemicity but will guide equine clinicians, carers, and authorities regarding infectious agents and potential impacts of allogenic tissue contamination. Although we have filled many gaps in the world map regarding equine hepatotropic viruses, further prospective studies in this emerging field may be useful in terms of elucidating risk factors and pathogenesis of these pathogens and management of cases in terms of prevention and diagnosis.

Field tests and their association with laminitis have not been evaluated in large cohorts. The objectives of this study were to evaluate the performance of basal insulin (BI), the oral sugar test (OST) and the insulin tolerance test (ITT) to diagnose ID and investigate their association with laminitis. Insulin dysregulation status was determined in 146 ponies using BI (insulin concentration >20 µIU/mL), an OST (insulin concentration >65 µIU/mL at 60 or 90 min after oral administration of 0.45 mL/kg corn syrup) and an ITT (< 50% reduction in glucose concentration 30 min after intravenous administration of 0.1 IU/kg insulin). Laminitis was identified using modified-Obel scores. A Bayesian approach was used to define the characteristics of the tests and receiver operating characteristic curves were used to assess their association with laminitis. All tests were well tolerated and laminitis was diagnosed in 9% of ponies. Insulin dysregulation was diagnosed in 15% of ponies using BI, 38% using the OST and 54% using the ITT with 11% of ponies positive for all three tests. The sensitivities and specificities of BI, the OST and the ITT to diagnose ID were 0.52 (95% confidence interval [CI], 0.35-0.79) and 0.97 (95% CI, 0.91 - 1.00), 0.84 (95% CI, 0.70 - 0.94) and 0.60 (95% CI, 0.49 - 0.71), and 0.85 (95% CI, 0.68-0.96) and 0.88 (95% CI, 0.75 - 0.97), respectively. Only BI and the OST were associated with laminitis (P = 0.003 and 0.015, respectively)., Competing Interests: Declaration of Competing Interest None of the authors has any other financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Plasma adrenocorticotropic hormone (ACTH) concentration is commonly measured to diagnose pituitary pars intermedia dysfunction (PPID). Several intrinsic and extrinsic factors affect ACTH concentrations, including breed. The objective of this study was to prospectively compare plasma ACTH concentrations among different breeds of mature horses and ponies. Three breed groups comprised Thoroughbred horses (n = 127), Shetland ponies (n = 131) and ponies of non-Shetland breeds (n = 141). Enrolled animals did not show any signs of illness, lameness or clinical signs consistent with PPID. Blood samples were collected 6 months apart, around the autumn equinox and spring equinox, and plasma concentrations of ACTH were measured by chemiluminescent immunoassay. Pairwise breed comparisons within each season were performed on log transformed data using the Tukey test. Estimated mean differences in ACTH concentrations were expressed as fold difference with 95 % confidence intervals (CI). Reference intervals for each breed group per season were calculated using non-parametric methods. In autumn, higher ACTH concentrations were found among non-Shetland pony breeds compared with Thoroughbreds (1.55 fold higher; 95 % CI, 1.35-1.77; P < 0.001), and in Shetland ponies compared with Thoroughbreds (2.67 fold higher; 95 % CI, 2.33-3.08; P < 0.001) and non-Shetland pony breeds (1.73 fold higher; 95 % CI, 1.51-1.98; P < 0.001). In spring, no differences were identified among breed groups (all P > 0.05). Reference intervals were similar among breed groups in spring, but upper limits for ACTH concentrations were markedly different between Thoroughbred horses and pony breeds in autumn. These findings emphasise that breed should be accounted for when determining and interpreting reference intervals for ACTH concentrations among healthy horses and ponies in autumn., Competing Interests: Conflict of Interest Statement None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: To compare circannual plasma concentrations of adrenocorticotropic hormone (ACTH) and seasonal dexamethasone suppression test (DST) results between three different equine breed groups., Methods: Six Standardbred horses, six Andalusian horses and six mixed-breed ponies were followed over a 1-year period, during which time groups were managed identically. Blood samples were collected monthly (around the autumn equinox) or in every second month (other times of the year) for the determination of plasma ACTH concentrations using a chemiluminescent immunoassay. Overnight DSTs were performed quarterly, with suppression of plasma cortisol to below 27 nmol/L at 19 h considered a normal result., Results: Seasonal variation in plasma ACTH concentrations was present among all breed groups with, as expected, higher levels detected around the autumn equinox, from February to April (P < 0.001). Plasma ACTH concentrations were different between breed groups in March, with higher levels in Andalusians compared with Standardbreds (P = 0.048) and in ponies compared with Standardbreds (P = 0.010). Suppression of cortisol during the DST was normal for all animals in winter, spring and summer, but five Andalusians and three ponies returned abnormally high results in autumn, compared with zero Standardbreds., Conclusion: Higher plasma ACTH concentrations and more false-positive DST results were obtained during autumn in ponies and Andalusian horses when compared with Standardbred horses. Potential differences between breeds should be considered when interpreting test results for horses and ponies that are evaluated for pituitary pars intermedia dysfunction. Further work is recommended to establish population-based reference intervals and clinical cut-off values for ACTH in different equine breeds., (© 2020 Australian Veterinary Association.)

Objectives: The aims of this study were to (1) report the incidence of laminitis among a population of horses and ponies attending Pony Clubs in Victoria, Australia, and (2) describe the dietary and management practices of the sample population., Methods: Researchers visited 10 Pony Clubs over a 10-month period. Horse and pony owners completed a questionnaire to provide information on management relating to diet and exercise. Owners were also asked to report their animal's history of laminitis, if any., Results: From a survey population of 233 horses and ponies, 15.0% of animals (35 individuals) were reported to have suffered from at least one episode of laminitis. Of the animals that had suffered from laminitis, more than half had experienced multiple episodes. The majority of previously laminitic horses and ponies (71.4%) had not experienced an episode of laminitis within the past 12 months; however, 14.2% had experienced an incident within the past month. The proportion of ponies affected by laminitis (31/142; 21.8%) was significantly higher (P < 0.001) than the proportion of horses affected by laminitis (4/91; 4.4%). The incidence of laminitis within the pony group sampled was 6.5 cases per 100 pony years, while the incidence in horses was 0.55 cases per 100 horse years., Conclusion: This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis., (© 2017 Australian Veterinary Association.)

Objective: To determine the prevalence of obesity within a population of pleasure horses and ponies in Victoria, Australia, and to compare owners' perceptions of their animals' body condition with researchers' assessments., Design: An observational study plus owner questionnaire., Methods: Ten Pony Club rallies in different regions of Victoria were attended. Information regarding 229 horses and ponies were obtained from owner questionnaires, and owners' perceptions of the current body condition of their animals were assessed using a visual analogue scale. Body condition score (BCS) was assessed by the researchers using the modified Henneke method., Results: The prevalence of researcher-assessed obesity (BCS ≥7/9) in the total surveyed population was 23.1%. A higher prevalence of obesity was identified in Shetland ponies (71.5%) and other pony types (32.0%) compared with horse breeds (9.3%). Owners perceived their animals to be in significantly lower body condition compared with the researchers' assessments (P < 0.001)., Conclusion: Although the overall prevalence of obesity within Australian pleasure horses and ponies was 24.5%, a considerably higher proportion of pony breeds fell into this category. Owners frequently underestimated their own animal's body condition. Knowing the prevalence of obesity in this population and understanding how owners perceive the body condition of their animals may help with targeting education around preventative health care, with the aim of reducing the risk of conditions such as insulin dysregulation and laminitis., (© 2016 Australian Veterinary Association.)

The relationships between diet, obesity and insulin dysregulation in equids require further investigation due to their association with laminitis. This study examined the effect of dietary glycaemic load and increased adiposity on insulin sensitivity and adipokine concentrations in different equine breeds. Equal numbers of Standardbred horses, mixed-breed ponies and Andalusian horses were provided with ad libitum hay plus either cereal-rich (CHO; n = 12), fat-rich (FAT; n = 12) or control (CON; n = 9) meals over 20 weeks. The isocaloric CHO and FAT diets were fed to induce obesity by gradually increasing the supplementary feeds to provide 200% of daily digestible energy requirements by Week 20. The CON group were fed a basal ration only and maintained moderate body condition. At Week 20, the CHO and FAT groups demonstrated significantly increased body condition score, bodyweight, total body fat mass and plasma leptin concentrations compared with the CON group (P <0.001). The CHO group had lower insulin sensitivity (SI; P <0.001) and higher acute insulin response to glucose (P = 0.002) than the CON group. In contrast, the FAT group was no different to the control group. Ponies and Andalusians had lower SI values compared with Standardbreds, regardless of diet group (P = 0.001). Adiponectin concentrations were similar between the FAT and CON groups, but were significantly lower in the CHO group (P = 0.010). The provision of cereal-rich meals appeared to be a more important determinant of insulin sensitivity than the induction of obesity per se. Whether hypoadiponectinaemia is a cause or consequence of insulin dysregulation warrants further investigation., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Modulation of corticostriatal synaptic activity by dopamine is required for normal sensorimotor behaviors. After loss of nigrostriatal dopamine axons in Parkinson's disease, l-3,4-dihydroxyphenlalanine (l-DOPA) and dopamine D2-like receptor agonists are used as replacement therapy, although these drugs also trigger sensitized sensorimotor responses including dyskinesias and impulse control disorders. In mice, we lesioned dopamine projections to the left dorsal striatum and assayed unilateral sensorimotor deficits with the corridor test as well as presynaptic corticostriatal activity with the synaptic vesicle probe, FM1-43. Sham-lesioned mice acquired food equivalently on both sides, while D2 receptor activation filtered the less active corticostriatal terminals, a response that required coincident co-activation of mGlu-R5 metabotropic glutamate and CB1 endocannabinoid receptors. Lesioned mice did not acquire food from their right, but overused that side following treatment with l-DOPA. Synaptic filtering on the lesioned side was abolished by either l-DOPA or a D2 receptor agonist, but when combined with a CB1 receptor antagonist, l-DOPA or D2 agonists normalized both synaptic filtering and behavior. Thus, high-pass filtering of corticostriatal synapses by the coordinated activation of D2, mGlu-R5, and CB1 receptors is required for normal sensorimotor response to environmental cues., (Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.)

Breed-related differences may occur in the innate insulin sensitivity (SI) of horses and ponies, an important factor believed to be associated with the risk of laminitis. The aim of this study was to measure the glucose and insulin responses of different breeds of horses and ponies in moderate body condition to a glucose-containing meal and to compare these responses with the indices of SI as determined by a frequently sampled intravenous glucose tolerance test (FSIGT). Eight Standardbred horses, 8 mixed-breed ponies, and 7 Andalusian-cross horses with a mean ± SEM BCS 5.0 ± 0.3 of 9 were used in this study. Each animal underwent an oral glucose tolerance test (OGTT) in which they were fed a fiber-based ration (2.0 g/kg BW) containing 1.5 g/kg BW added glucose, as well as a standard FSIGT with minimal model analysis. The glucose response variables from the OGTT were similar between groups; however, the peak insulin concentration was higher in ponies (94.1 ± 29.1 μIU/mL; P = 0.003) and Andalusians (85.3 ± 18.6; P = 0.004) than in Standardbreds (21.2 ± 3.5). The insulin area under the curve was also higher in ponies (13.5 ± 3.6 IU · min · L(-1); P = 0.009) and Andalusians (15.0 ± 2.7; P = 0.004) than in Standardbreds (3.1 ± 0.6). Insulin sensitivity, as determined by the FSIGT, was lower in Andalusians (0.99 ± 0.18 × 10(-4)/[mIU · min]) than in Standardbreds (5.43 ± 0.94; P < 0.001) and in ponies (2.12 ± 0.44; P = 0.003) than in Standardbreds. Peak insulin concentrations from the OGTT were negatively correlated with SI (P < 0.001; rs = -0.75). These results indicate that there are clear breed-related differences in the insulin responses of horses and ponies to oral and intravenous glucose. All animals were in moderate body condition, indicating that breed-related differences in insulin dynamics occurred independent of obesity., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Introduction: the active engagement of fathers in maternity care is associated with long-term health and social benefits for the mother, baby and family. The maternity care expectations and experiences of expectant and new fathers have received little attention to date., Aim: to identify and synthesise good quality qualitative research that explores the views and experiences of fathers who have encountered maternity care in high resource settings., Methods: based on a pre-determined search strategy, relevant databases were searched for papers published between January 1999 and January 2010. Backchaining of the reference lists in included papers was undertaken., Inclusion Criteria: good quality qualitative research studies exploring fathers' involvement in maternity care through pregnancy, birth, and up to 6 months postnatally, that were undertaken in high resource countries. No language restrictions were imposed. ANALYTIC STRATEGY: the analysis was based on the metaethnographic techniques of Noblit and Hare (1988) as amended by Downe et al. (2007)., Findings: from 856 hits 23 papers were included. The emerging themes were as follows: risk and uncertainty, exclusion, fear and frustration, the ideal and the reality, issues of support and experiencing transition., Synthesis: fathers feel themselves to be 'partner and parent' but their experience of maternity care services is as 'not-patient and not-visitor'. This situates them in an interstitial and undefined space (both emotionally and physically) with the consequence that many feel excluded and fearful., Conclusions: fathers cannot support their partner effectively in achieving the ideal of transition to a successful pregnancy, joyful birth and positive parenthood experience unless they are themselves supported, included, and prepared for the reality of risk and uncertainty in pregnancy, labour and parenthood and for their role in this context., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: This paper aims to investigate the implications and impact from the implementation of European Working Time Directive (EWTD) compliant working patterns (the introduction of shifts) on doctors., Design/methodology/approach: A qualitative, case study based research method was used. Data collection involved: the application of semi-structured, open-ended interviewing to elicit information based upon categories defined from the literature survey; follow-up conversations with many interviewees; participant observation; thematic coding and analysis of the results., Findings: Shifts are here to stay. All doctors interviewed acknowledged that, but there was a general feeling of minimal flexibility in the system. A recurrent theme when asked how things could be improved was to split-up the week of night shifts into two shorter periods. Some doctors, particularly those working full-time with small children, already split their weekends in order to spend time with their family., Research Limitations/implications: The methodology applied was appropriate, generating ample data to facilitate discussion and from which to draw specific conclusions. A perceived limitation is the single case approach; however Remenyi argues this can be enough to add to the body of knowledge. Practical implications - The research generated suggestions for how shifts could be scheduled to make them more palatable for those who work them. Specific recommendations for future research are made., Originality/value: The research questions of the paper draw out the personal implications for doctors of their employers' adherence to the implementation of EWTD.

Purpose: To determine the cause of bilateral retrobulbar optic neuritis followed by progressive outer retinal necrosis in a patient with human immunodeficiency virus (HIV)., Methods: Extensive ophthalmologic, neurologic, infectious disease, rheumatologic, and radiologic examinations were performed., Results: Cerebrospinal fluid samples taken after the onset of bilateral retrobulbar optic neuritis and before the development of clinical progressive outer retinal necrosis disclosed varicella-zoster virus from polymerase chain reaction and viral culture., Conclusion: Ophthalmologists and neurologists should consider varicella-zoster virus optic neuritis as a potential precursor of progressive outer retinal necrosis and as a cause of retrobulbar optic neuritis in patients infected with HIV.