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Background Objectives Animals Methods Results Conclusions and Clinical Importance Noninvasive ventilation (NIV) provides effective respiratory support in foals, but face masks are poorly tolerated and associated with hypercapnia. Bi‐nasal prongs might be a more effective device interface in foals.To compare bi‐nasal prongs and masks for NIV in foals with pharmacologically induced respiratory insufficiency.Six healthy foals.In a randomized cross‐over study, sedated foals received NIV delivered by mask or bi‐nasal prongs, with the treatment repeated using the alternative device interface after a 3‐day rest period. After periods of spontaneous ventilation through the allocated interface, with and without supplementary O2 (T2‐T3), foals were subject to 10‐minute treatment periods of NIV at different pressure support (5 or 10 cmH2O) and end‐expiratory pressure settings (5 or 10 cmH2O), with and without supplementary O2 (T4‐T7). Vital signs, arterial blood gases, spirometry, and gas exchange data were measured in the final 2 minutes of each treatment window.Bi‐nasal prongs were well tolerated and required less manual positioning or monitoring compared to the mask. Partial pressure of carbon dioxide did not increase during NIV with bi‐nasal prongs and was lower than observed with masks (mean difference, 8.2 mmHg [95% confidence interval, 4.1‐12.2 mmHg] at T6). Oxygenation and respiratory mechanics were improved in all foals and not different between device interfaces.Nasal prongs were well tolerated, had similar effects on respiratory function, and appeared to ameliorate hypercapnia observed previously during NIV in foals. [ABSTRACT FROM AUTHOR]

Background: Grading of equine gastric ulcer syndrome (EGUS) is undertaken in clinical and research settings, but the reliability of EGUS grading systems is poorly understood. Hypothesis/Objectives: Investigate interobserver and intraobserver reliability of an established ordinal grading system and a novel visual analog scale (VAS), and assess the influence of observer experience. Animals Sixty deidentified gastroscopy videos. Methods: Six observers (3 specialists and 3 residents) graded videos using the EGUS Council (EGUC) system and VAS. Observers graded the videos three 3 for each system, using a cross‐over design with at least 1 week between each phase. The order of videos was randomized for each phase. Methods: Interobserver and intraobserver reliability were estimated using Gwet's agreement coefficient with ordinal weights applied (AC2) for the EGUC system and the intraclass correlation coefficient (ICC) for the VAS. Results: Using the EGUC system, interobserver reliability was substantial for squamous (AC2 = 0.69; 95% confidence interval [CI], 0.57‐0.80) and glandular mucosa (AC2 = 0.72; 95% CI, 0.70‐0.75), and intraobserver reliability was substantial for squamous (AC2 = 0.80; 95% CI, 0.71‐0.90) and glandular mucosa (AC2 = 0.80; 95% CI, 0.74‐0.86). Interobserver reliability using the VAS was moderate for squamous (ICC = 0.64; 95% CI, 0.31‐0.96) and poor for glandular mucosa (ICC = 0.35; 95% CI, 0.06‐0.64), and intraobserver reliability was moderate for squamous (ICC = 0.74; 95% CI, 0.62‐0.86) and glandular mucosa (ICC = 0.56; 95% CI, 0.39‐0.72). Conclusions and Clinical Importance: The EGUC system had acceptable intraobserver and interobserver reliability and performed well regardless of observer experience. Familiarity and observer experience improved reliability of the VAS. [ABSTRACT FROM AUTHOR]

Background: Omeprazole preparations vary in bioavailability in horses. Hypothesis/Objectives: To characterize the pharmacokinetics and pharmacodynamics of an existing enteric‐coated oral omeprazole paste (REF) and a novel, in‐feed, enteric‐coated dry granule preparation (NOV). Animals Twelve Standardbred/Thoroughbred mares free from clinical disease. Methods: A prospective, blinded randomized interventional study was trial, conducted in 3 parts: (a) bioavailability study, (b) dose titration study, and (c) comparative clinical pharmacodynamic study, each using a blocked crossover design. Results: Consistent with the larger dose administered, Cmax (median, 1032 ng/mL; range, 576‐1766) and AUC0‐24 (median, 63.9 μg/mL*min; range, 42.4‐152.4) were greater after single oral administration of NOV than REF (282.7 ng/mL; range, 94.8‐390.2, and 319 23.8 μg/mL*min; range, 8.2‐42.3, respectively; both P =.004). No differences were observed between products for absolute oral bioavailability (NOV 55% range, 15‐88; REF 17% range, 10‐77; P =.25). Treatment with both preparations was associated with reduced gastric squamous ulcer scores and increased pH of gastric fluid. Bioequivalence was demonstrated for pharmacodynamic measures with the exception of % time pH <4, despite differences in dose rate and subsequent plasma omeprazole concentrations. Conclusions and Clinical Importance: The findings of this study indicate that the NOV product would be a suitable alternative to the reference product, and confirm that plasma concentrations of omeprazole and omeprazole dose do not predict drug pharmacodynamics in horses. [ABSTRACT FROM AUTHOR]