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This narrative review explores the etiopathogenesis, clinical signs, diagnosis and treatment of ESGD (equine squamous gastric disease) and discusses the impact of this commonly encountered condition on the equine industry. ESGD refers specifically to peptic injury of the squamous mucosa of the stomach. Prevalence is highest in performance horses, but the disease has been documented across many breeds and ages, including in feral horses and foals. The pathogenesis of ESGD is well understood. Intensive management and exercise are important factors that contribute to a disruption of the normal stratification of gastric pH. This results in exposure of the vulnerable squamous mucosa to acid, leading to ulceration. Clinical signs are variable and there is little evidence to support a direct association between reported signs and the presence or absence of lesions seen on gastroscopy. Management is aimed at acid suppression and mitigation of known risk factors.

This report describes bilateral mammary gland infection with a previously unidentified Cephalobus species of nematode. Only one previous case of verminous mastitis due to a Cephalobus species has been reported, pre‐dating the widespread use of molecular diagnostics. This report describes the case presentation and management, as well as the morphological and molecular methods of nematode identification.

BACKGROUND Equine glandular gastric disease (EGGD) is recognised as a separate entity to equine squamous gastric disease (ESGD) and it is recommended that lesions are graded differently. Currently, no validated scoring system exists for EGGD. OBJECTIVES To determine inter-observer reliability of two previously described grading systems for EGGD and to assess if agreement improved with gastroscopy experience, specialist training or familiarity with the descriptive system. STUDY DESIGN Cross-sectional survey. METHODS A link to an electronic questionnaire containing 20 images of glandular lesions was circulated. Respondents were asked to score lesions using descriptive terminology and a 0-2 verbal rating scale (VRS). Krippendorff's alpha reliability estimate was used to assess inter-rater agreement. A mixed effects model was used to determine which descriptive categories were associated with lesions being described as severe and decision to treat. RESULTS Eighty-two veterinarians responded, 49 diplomates and 33 non-diplomates. There was no agreement when all four descriptive variables were combined (α = 0.19). Agreement was fair to moderate for severity (α = 0.52), distribution (α = 0.44), appearance (α = 0.38) and shape (α = 0.32). Agreement for the VRS was similar to that for severity (α = 0.53). Agreement was better among diplomates across all categories. Lesion appearance and shape, but not distribution, were associated with both a decision to treat; and lesions being described as severe (P =

South Africa currently loses over 1000 white rhinoceros (Ceratotherium simum) each year to poaching incidents, and numbers of severely injured victims found alive have increased dramatically. However, little is known about the antimicrobial treatment of wounds in rhinoceros. This study explores the applicability of enrofloxacin for rhinoceros through the use of pharmacokinetic-pharmacodynamic modelling. The pharmacokinetics of enrofloxacin and its metabolite ciprofloxacin were evaluated in five white rhinoceros after intravenous (i.v.) and after successive i.v. and oral administration of 12.5 mg/kg enrofloxacin. After i.v. administration, the half-life, area under the curve (AUC

Foreword The European College of Equine Internal Medicine (ECEIM) consensus statement recently made the distinction between disease of the squamous mucosa (Equine Squamous Gastric Disease; ESGD) and of the glandular mucosa (Equine Glandular Gastric Disease; EGGD) ( Sykes et al, 2015a ). Since its publication, a number of reports have furthered understanding of the pathology and management of EGGD, such that new clinical guidelines for the management of this condition were considered necessary. The following guidelines are the consensus views of subject specialist representing authors of the ECEIM consensus statement, authors of recent clinical research, and clinical specialists active in the management of horses with this condition. The recommendations were developed using an informal two-round Delphi process, considering published and unpublished research relating to EGGD using a round table forum and online discussion. Where research evidence was conflicting or absent, collective expert opinion based on the clinical experience of the group was applied. The opinions expressed are the consensus of views expressed by the authors. The expert group was organised by UK-Vet Equine with sponsorship from Luoda Pharma.

Objective To identify prognostic variables for adult equids and foals with tetanus. Design Multicenter retrospective study (2000–2014). Setting Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. Animals One hundred fifty-five adult equids and 21 foals with tetanus. Interventions None. Measurements and Main Results Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates in adults and foals were 68.4% and 66.7%, respectively. Variables associated with survival in adults included: standing, normal intestinal sounds and defecation, voluntarily drinking, eating soft or normal food, lower heart and respiratory rates, high base excess on admission, longer diagnosis time, treatment and hospitalization delay, and mild severity grade. Variables associated with death included: anorexia, dysphagia, dyspnea, low blood potassium concentration on admission, moderate and severe disease grading, development of dysphagia, dyspnea, recumbency and seizures during hospitalization, treatment with glycerol guaiacolate, intravenous fluids, and intravenous glucose solutions. Variables associated with survival in foals included standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay. Outcome was not different between different tetanus antitoxin (TAT) dosages, although there was a trend of increasing survival rate with increasing TAT dosages. Cases with appropriate vaccination prior to development of tetanus were rare, but had improved outcome and shorter hospitalization. Conclusions Prognosis for equine tetanus is poor with similar outcome and prognostic factors in foals and adults. The prognostic assessment of cases with tetanus provides clinicians with new evidence-based information related to patient management. Several prognostic indicators relate to the ability to eat or drink, and more severe clinical signs relate to poor outcome. Increasing intravenous dosages of TAT has no significant effect on outcome, but the positive trend identified may support a recommendation for high intravenous TAT dosages. Further evaluation is warranted.

OBJECTIVE: To describe clinical data of hospitalized adult equids and foals with tetanus. DESIGN: Multicenter retrospective study (2000-2014). SETTING: Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. ANIMALS: One hundred fifty-five adult equids (>6 months) and 21 foals (

A two-year-ten-month colt was referred for investigation and surgical treatment of cryptorchidism. Preanaesthetic clinical examination revealed no abnormalities and no relevant history was reported. The patient was anaesthetised with a total intravenous anaesthesia technique, both testicles were identified after induction, and a bilateral open castration was performed in the recovery box. Surgery, anaesthesia and recovery were uneventful. However, in the first hour postrecovery, clinical signs compatible with pulmonary oedema developed. Following arterial blood sampling and airway endoscopy, a low-grade pulmonary oedema was suspected and alleged to have occurred following transient laryngeal spasm. The patient was treated symptomatically and received supportive care. Two days after the surgery, the clinical signs were resolved, and the patient was discharged.

The alleviation of pain and prevention of suffering are key aspects of animal welfare. Unfortunately, analgesic drugs are not available for all species. White rhinoceros (Ceratotherium simum), representing one of such species, which survive poaching attempts inflicted with severe facial injuries and gunshot wounds, nonetheless require analgesic support. To improve treatment conditions, this study explored the use of carprofen for the treatment of pain and inflammation in white rhinoceros. The pharmacokinetics of 1 mg/kg intramuscular carprofen was evaluated in six healthy white rhinoceros. The half‐life of λz and mean residence time was 105.71 ± 15.67 and 155.01 ± 22.46 hr, respectively. The area under the curve and the maximum carprofen concentration were 904.61 ± 110.78 μg ml−1 hr−1 and 5.77 ± 0.63 μg/ml, respectively. Plasma TXB2 inhibition demonstrated anti‐inflammatory properties and indicated that carprofen may be effective for a minimum of 48 hr in most animals. With its long half‐life further indicating that a single dose could be effective for several days, we suggest that carprofen may be a useful drug for the treatment of white rhinoceros.

Summary Equine laryngeal dysplasia (ELD) is a congenital disorder caused by hypoplasia or aplasia of the structures derived from the fourth and possibly sixth branchial arches. The severity of the clinical signs varies widely, and depends on which structures are involved and the extent of the defect. In most cases, affected horses present with abnormal respiratory noise during exercise and poor performance. Manifestation of the disease in foals is very rare. This case report describes an unusual presentation of ELD in a neonatal foal. The foal presented with severe respiratory distress and weakness. Equine laryngeal dysplasia was suspected on endoscopy and later confirmed on post mortem examination of the larynx. To the best of our knowledge, this is the first report describing ELD as a cause of respiratory distress in a neonatal foal.

Summary This paper summarises the clinical findings of 9 cases of disseminated alimentary mycobacteriosis in horses presented at a Finnish referral equine hospital 2009–2014. Four of 9 horses were Standardbreds and 8/9 horses were male. The median age was 2 years, ranging from 6 months to 15 years. The duration of clinical signs before admission ranged from 2 weeks to 6 months. All horses demonstrated deterioration of the clinical signs after a protracted period of the disease and were finally subjected to euthanasia after poor response to multiple medical therapies. The most common complaints on admission were weight loss and diarrhoea (9/9), pyrexia (7/9), ventral oedema (7/9), lethargy (7/9) and inappetance (6/9). The most common clinicopathological abnormalities were hypoalbuminaemia and hyperfibrinogenaemia, which were present in all horses. Rectal biopsy specimens were examined from 5/9 horses and specimens were stained with Ziehl-Nielsen (ZN). At rectal biopsy, mild multifocal neutrophilic or mild granulomatous proctitis was recognised in all 5 horses, but the ZN stain for mycobacteria was positive in only one biopsy. A liver biopsy was taken from one horse in which hepatomegaly was observed clinically and revealed marked granulomatous hepatitis with the presence of mycobacteria. The rectal biopsy from this horse was ZN negative. At post mortem examination, chronic, multifocal to coalescing granulomatous typhlocolitis and lymphadenitis were found in all horses with the small intestine less frequently involved. At histopathological examination of post mortem samples, a ZN stain was performed and intracellular acid-fast bacilli were identified in macrophages and multinucleated giant cells in the large intestine, liver and lymph nodes in 9/9 horses and in the small intestine in 5/9 horses. Mycobacterium avium ssp. hominissuis was isolated in 5/9 horses from post mortem samples.

No abstract available.

A 4-year-old Thoroughbred gelding underwent an explorative celiotomy for a suspected small intestinal obstruction. During surgery, an impacted diverticulum of the ileum was suspected, necessitating a jejunocaecostomy. The owner opted for euthanasia. On post-mortem examination and histopathology, a true diverticulum on the mesenteric side of the ileum, with ileal hypertrophy, was diagnosed.

Background Equine gastric ulcer syndrome (EGUS) is common in adult horses, particularly those involved in performance disciplines. Currently, detection of EGUS by gastroscopy is the only reliable ante mortem method for definitive diagnosis; however it is unsuitable as a screening test because it is expensive, time consuming, and is not readily available to most veterinarians. Sucrose permeability testing represents a simple, economical alternative to gastroscopy for screening purposes, and the feasibility of this approach in the horse has been previously reported. The aim of this study was to determine the diagnostic accuracy of blood sucrose as a screening test for EGUS in a large group of adult horses with and without naturally occurring gastric disease. Results One hundred and one adult horses with or without naturally occurring gastric ulceration were studied. The diagnostic accuracy of blood sucrose for diagnosis of gastric lesions (GL), glandular lesions (GDL), squamous lesions (SQL), and clinically significant lesions (CSL) at 45 and 90 min after administration of 1 g/kg of sucrose via nasogastric intubation was assessed using receiver operator characteristics (ROC) curves and calculating the area under the curve (AUC). For each lesion type, sucrose concentration in blood was compared to gastroscopy, as the gold standard, and sensitivities (Se) and specificities (Sp) were calculated across a range of sucrose concentrations. Ulcer grading was performed blindly by one observer; and the results were validated by comparing them with that of two other observers, and calculating the level of agreement. Cut-off values were selected manually to optimize Se. The prevalence of GL, GDL, SQL, and CSL was 83, 70, 53 and 58% respectively. At the selected cut-offs, Se ranged from 51 to 79% and Sp ranged from 43 to 72%, depending upon the lesion type and time of sampling. Conclusions Blood sucrose is neither a sensitive or specific test for detecting EGUS in this population of adult horses with naturally occurring gastric ulceration. Further studies aimed at evaluating the performance characteristics of the test in different study populations are warranted. Given the limitations of endoscopy, due consideration should also be given to alternative methods for comparison of blood sucrose with a gold standard. Electronic supplementary material The online version of this article (doi:10.1186/s13028-017-0284-1) contains supplementary material, which is available to authorized users.

Prospective studies documenting the efficacy and side effects of medical treatment for colonic sand accumulation in horses are limited. The purpose of the study was to compare the effect of enteral administration of magnesium sulphate (MgSO 4 ), psyllium mucilloid (psyllium), and a combination of MgSO 4 and psyllium on the evacuation of large accumulations of sand in the large colon of adult horses. Thirty-four horses with naturally acquired, large sand accumulations (>5 cm × 15 cm) identified on abdominal radiography were randomly allocated to one of three treatment groups: (1) 1 g/kg psyllium ( n = 12); (2) 1 g/kg MgSO 4 ( n = 10), or (3) their combination ( n = 12). Treatments were administered once a day via nasogastric intubation and continued for a total of 4 days. Lateral radiographs of the ventral abdomen were repeated on day 4 of treatment. If the area of sand in the radiographic image was 2 on day 4, the sand accumulation was considered resolved. Of 12 horses treated with a combination of psyllium and MgSO 4 , nine evacuated the sand from the ventral colon within 4 days. In comparison, only 3/12 horses treated with psyllium and 2/10 horses treated with MgSO 4 resolved (both significantly different from the combination; P 0.05). Large accumulations of sand in the large colon of horses can be treated medically. Administering a combination of psyllium and MgSO 4 via nasogastric intubation once daily for a total of 4 days was a more effective treatment than either constituent alone.

Summary Congenital hypothyroidism and dysmaturity syndrome (CHD) in neonatal foals was first described in western Canada in 1981 and remains an important problem for the western Canadian horse industry. This syndrome is characterised by hyperplasia of the thyroid gland, increased gestational length and multiple congenital musculoskeletal abnormalities. This case series describes the first confirmed cases of CHD in Europe and challenges contemporary opinion which suggests that this syndrome is distinct from congenital hypothyroidism associated with visible goitre.

A simple and accurate method for quantifying sucrose in equine serum that can be applied to sucrose permeability testing in the horse was developed and validated using gas chromatography with flame ionization detection. The assay provided an acceptable degree of linearity, accuracy, and precision at concentrations of sucrose as low as 2.34 μmol/l and as high as 20.45 μmol/l. Percentage recovery of sucrose from serum ranged from 89% to 102%; repeatability and intermediate precision (relative standard deviation) ranged from 3.6% to 6.7% and 4.1% to 9.3%, respectively. The limit of detection was 0.73 μmol/l. No interfering peaks were observed except lactose, which gave 2 peaks, one of which overlapped partially with sucrose. To evaluate the suitability of the method for quantifying sucrose in serum samples from horses with naturally occurring gastric ulceration, 10 horses with and without naturally occurring gastric ulceration were subjected to sucrose permeability testing. All horses demonstrated an increase in serum sucrose concentration over time following oral administration of sucrose; however, the increase from baseline was significant for horses with gastric ulceration at 45 min ( P = 0.0082) and 90 min ( P = 0.0082) when compared with healthy horses. It was concluded that gas chromatography with flame ionization detection is a valid method for quantifying sucrose in equine serum and can be applied directly to the analysis of sucrose in equine serum as part of a larger validation study aimed at developing a blood test for the diagnosis of gastric ulcers in horses.

Summary Gastroscopy is the most common technique used in veterinary medicine to evaluate the stomach in horses and to date, no complications have been described associated with the procedure. This paper reports 4 cases developing a nonstrangulating segmental volvulus of the small intestine after gastroscopy at 3 referral institutions over a 2 year period. After performing diagnostic gastroscopy, all horses developed acute and severe clinical signs of colic unresponsive to medical management. Time range between gastroscopy and onset of colic signs varied from 10 min to 3 h. An exploratory laparotomy revealed a nonstrangulating segmental volvulus of the small intestine that was manually corrected without need for resection in all horses. In all cases, affected small intestine was severely gas distended. Three of those horses survived to discharge and were alive at follow-up. One horse was subjected to euthanasia 2 days after surgery due to diffuse intestinal lymphoma.

Summary A 3-year-old pregnant Standardbred mare was treated at the University of Helsinki Equine Teaching Hospital for severe idiopathic immune-mediated thrombocytopenia and haemolytic anaemia (Evan's syndrome). Despite initial improvement with supportive care and immunosuppressive doses of corticosteroids and azathioprine, the mare died from a fatal cerebral haemorrhage on Day 21 of treatment.

The use of MRI has been recently increasing in veterinary patients, and this modality has been adapted for use in large animals with the concurrent use of gadolinium-based contrast media. Possible adverse reactions to its administration have been described in human and veterinary medicine, but there are no reports in foals. This case report describes the occurrence of seizure-like activity following administration of gadolinium to a 1.5-month old Finnish warmblood foal that was admitted for an MRI scan and cerebral spinal fluid collection. After the administration of contrast media, severe muscle twitching was observed. Prompt intervention, facilitated by constant patient monitoring and administration of propofol and diazepam, resulted in the control of the seizure and a favourable outcome. Since no alterations were found during the diagnostic investigation, it was suspected that the seizure-like activity might have been an adverse reaction to the contrast medium.

A veterinary degree can provide an ideal opportunity to broaden your horizons and travel the world, working in a variety of roles. Here, six veterinary surgeons who have spent varying amounts of time working overseas outline their very different experiences.

Background Equine gastric glandular disease (EGGD) is a term used to classify erosive and ulcerative diseases of the glandular mucosa of the equine stomach. Epidemiologic studies of risk factors for EGGD have not been reported. Objective To determine risk factors for EGGD. Animals Cases (n = 83) had endoscopic evidence of EGGD; controls (n = 34) included healthy horses and horses with equine squamous gastric disease (ESGD) without EGGD. Methods Retrospective case-control study. The data were analyzed by multivariable logistic regression modeling. Analysis was performed on the full dataset. An additional analysis compared horses with glandular lesions (n = 43) against healthy horses (n = 22). Results On first analysis, Warmblood breed (OR = 13.9, 95% CI 2.2–90.9, P = .005) and an increasing number of caretakers (OR = 7.3, 95% CI 0.98–55.6, P = .053) were associated with an increased risk of EGGD. On analysis of the subset of data, Warmblood breed (OR = 28.6, 95% CI 2.96–250.0, P = .004) and increasing number of riders (OR = 12.99, 95% CI 0.94–166.7, P = .056) were risk factors. The presence of sand in the colon appeared to have a protective effect against EGGD (OR = 0.195, 95% CI 0.04–1.0, P = .051 for sand versus not having sand). Conclusions and clinical importance This study suggests that Warmbloods are predisposed to EGGD and multiple handlers/riders might increase the risk of EGGD. Identification of risk factors allows speculation on potential pathophysiological mechanisms of EGGD.

To describe clinical data of hospitalized adult equids and foals with tetanus.Multicenter retrospective study (2000-2014).Twenty Western, Northern, and Central European university teaching hospitals and private referral centers.One hundred fifty-five adult equids (6 months) and 21 foals (6 months) with tetanus.None.Information on geographic, annual and seasonal data, demographic- and management-related data, clinical history, clinical examination and blood analysis on admission, complications, treatments, and outcomes were described and statistically compared between adults and foals. The described cases were often young horses. In 4 adult horses, tetanus developed despite appropriate vaccination and in 2 foals despite preventive tetanus antitoxin administration at birth. Castration, hoof abscesses, and wounds were the most common entry sites for adults; umbilical cord infections and wounds for foals. Stiffness was the commonest observed initial clinical sign. Blood analyses frequently revealed an inflammatory response, hemoconcentration, muscle damage, azotemia, negative energy balance, liver damage, and electrolyte and acid base disturbances. Common complications or clinical signs developing during hospitalization included dysphagia, dyspnea, recumbency, hyperthermia, seizures, hyperlipemia, gastrointestinal impactions, dysuria, and laryngeal spasms. Cases were supported with wound debridement, antimicrobial treatment, tetanus antitoxin, muscle spasm and seizure control, analgesia, anti-inflammatory drugs, fluid therapy, and nutritional support. Mortality rates were 68.4% in adult horses and 66.7% in foals. Foals differed from adult horses with respect to months of occurrence, signalment, management-related data, potential causative events, clinical signs on admission, blood analysis, complications, and severity grades.This is the first study that rigorously describes a large population of equids affected by tetanus. The information provided is potentially useful to clinicians for early recognition and case management of tetanus in adult horses and foals. Tetanus affects multiple organ systems, requiring broad supportive and intensive care. Neonatal and adult tetanus in the horse should be considered as distinct syndromes, as in human medicine.

To identify prognostic variables for adult equids and foals with tetanus.Multicenter retrospective study (2000-2014).Twenty Western, Northern, and Central European university teaching hospitals and private referral centers.One hundred fifty-five adult equids and 21 foals with tetanus.None.Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates in adults and foals were 68.4% and 66.7%, respectively. Variables associated with survival in adults included: standing, normal intestinal sounds and defecation, voluntarily drinking, eating soft or normal food, lower heart and respiratory rates, high base excess on admission, longer diagnosis time, treatment and hospitalization delay, and mild severity grade. Variables associated with death included: anorexia, dysphagia, dyspnea, low blood potassium concentration on admission, moderate and severe disease grading, development of dysphagia, dyspnea, recumbency and seizures during hospitalization, treatment with glycerol guaiacolate, intravenous fluids, and intravenous glucose solutions. Variables associated with survival in foals included standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay. Outcome was not different between different tetanus antitoxin (TAT) dosages, although there was a trend of increasing survival rate with increasing TAT dosages. Cases with appropriate vaccination prior to development of tetanus were rare, but had improved outcome and shorter hospitalization.Prognosis for equine tetanus is poor with similar outcome and prognostic factors in foals and adults. The prognostic assessment of cases with tetanus provides clinicians with new evidence-based information related to patient management. Several prognostic indicators relate to the ability to eat or drink, and more severe clinical signs relate to poor outcome. Increasing intravenous dosages of TAT has no significant effect on outcome, but the positive trend identified may support a recommendation for high intravenous TAT dosages. Further evaluation is warranted.

COLIC refers to a syndrome of abdominal pain that encompasses a wide range of disorders, which can be gastrointestinal or non-gastrointestinal in nature. The clinical manifestations of the latter are often referred to as ‘false colic’ and can pose a considerable diagnostic challenge for the veterinary surgeon. Of particular relevance are non-gastrointestinal causes of colic that present with clinical signs suggestive of a strangulating obstruction of the intestine. An accurate diagnosis in such cases is essential and hinges on the objective assessment of historical information and on the results of a systematic physical examination, clinical laboratory tests and appropriate diagnostic imaging. This article reviews the diagnosis of disorders in the horse that do not originate from the gastrointestinal tract, but which elicit real or apparent abdominal pain.

A 12-year-old hunter gelding became severely lame as a result of a laceration to the sheath of the digital flexor tendons of its left hindlimb, but there was no apparent damage to the tendons. The injury became chronically infected with Pseudomonas and Streptococcus species and Escherichia coli which did not respond to antibiotic treatment, and the horse remained lame. A postmortem examination revealed that the tendons had ruptured.

Intestinal mycobacteriosis is a chronic, progressive disease which can affect horses of all ages, and has been identified in weanlings as young as six months of age. The disease causes a granulomatous enteritis/enterocolitis. Clinical signs are non-specific, and include weight loss, diarrhoea, intermittent fever and dependent edema secondary to protein losing enteropathy (PLE). Intestinal mycobacteriosis should be considered as a differential diagnosis in any horse with chronic diarrhea, weight loss and/or a protein losing enteropathy. The condition appears to be rare in Europe and in other parts of the world; however the authors have personally diagnosed seven cases of intestinal mycobacteriosis in Finland between 2009 and 2013, suggesting an apparent increase in the incidence of the disease in recent years.

Reasons for performing study Gastric ulceration is an important cause of morbidity in horses. Currently, gastroscopy is the only reliable antemortem method for definitive diagnosis; however, it is unsuitable as a screening test because it is expensive, invasive and time-consuming. Sucrose permeability testing represents a simple, economical, non-invasive alternative to gastroscopy for screening purposes, and the feasibility of this approach in the horse has been reported [1]. Objectives To determine the diagnostic accuracy of blood sucrose as a screening test for gastric ulceration. Study design Cross-sectional design. Methods One hundred and one adult horses with and without naturally occurring gastric ulcers were studied. The diagnostic accuracy of blood sucrose for detection of gastric ulcers at 45 and 90 min after administration of 1 g/kg bwt of sucrose via nasogastric intubation was assessed with ROC curves and calculating the area under the curve (AUC). Sucrose concentration in blood was compared with gastroscopy as the gold standard; and sensitivities (Se) and specificities (Sp) were calculated across a range of sucrose concentrations. Cut-off values were selected manually to optimise sensitivity. Results The prevalence of gastric ulcers was 83%. The AUC ± 95% CI for blood sucrose concentration when used to distinguish between horses with and without gastric ulcers at 45 and 90 min was 0.592 (0.441–0.744) and 0.615 (0.469–0.761) respectively. Sucrose concentrations of 4.70 μmol/l at 45 min; and 4.57 μmol/l at 90 min were selected as optimal cut-offs. Using these cut-offs, Se ranged from 64.4% to 77%; and Sp ranged from 42.9% to 50%. Conclusions Blood sucrose is neither a sensitive nor specific test for detecting gastric ulcers in adult horses with naturally occurring ulcers. Acknowledgements We thank Sandy Love, Satu Sankari, Anna-Maija Virtala, Noah Cohen, Allen Rousell, Kaisa Aaltonen, Anne Sjoholm and Jouni Junnila. Ethical animal research: The study protocol was approved by the National Animal Experiment Board of Finland (Elainkoelautakunta ELLA). For client-owned animals, the informed consent of the owner was obtained. Source of funding: This study was funded by the Faculty of Veterinary Medicine, University of Helsinki, Finland. Competing interests: None declared.

The objectives of this study were to assess the reliability of a numerical rating scale (NRS) and a verbal rating scale (VRS) for the assessment of lameness in horses and to determine whether they can be used interchangeably. Sixteen independent observers graded the severity of lameness in 20 videotaped horses, and the agreement between and within observers, correlation and bias were determined for each scale. The observers agreed with each other in 56 per cent of the observations with the NRS and in 60 per cent of the observations with the VRS, and the associated Kendall coefficient of concordance was high. Similar trends were evident in the agreement between two observations by each observer. The correlation between and within observers was high for both scales. There were no significant differences (bias) among the observers' mean scores when using either scale. There was a significant correlation between the lameness scores attributed when using the two scales, but the differences between the scores when plotted against their overall mean were unacceptable for clinical purposes. The results indicate that the NRS and VRS are only moderately reliable when used to assess lameness severity in the horse, and that they should not be used interchangeably.