Veterinary Clinical Sciences - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 12
-
ItemElapid snake envenomation in horses: 52 cases (2006-2016)(WILEY, 2018-03)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.
-
ItemPolypoid cystitis as a cause of haematuria in a pony mare(Wiley, 2019-05-01)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.
-
ItemEffects of polymyxin-B on TNF-α production in equine whole blood stimulated with three different bacterial toxins(WILEY, 2018-02)Polymyxin-B is used to treat equine systemic inflammation. Bacterial toxins other than lipopolysaccharide (LPS) contribute to systemic inflammation but the effects of polymyxin-B on these are poorly defined. Whole blood aliquots from six healthy horses diluted 1:1 with RPMI were incubated for 21 hr with 1 μg/ml of LPS, lipoteichoic acid (LTA) or peptidoglycan (PGN) in the presence of increasing concentrations of polymyxin-B (10-3000 μg/ml). A murine L929 fibroblast bioassay was used to measure TNF-α activity. Polymyxin-B significantly inhibited the effects of all three bacterial toxins. Analysis of variance showed the IC50 value for polymyxin-B for TNF-α inhibition caused by LTA (11.19 ± 2.89 μg/ml polymyxin-B) was significantly lower (p = .009) than the values for LPS (46.48 ± 9.93 μg/ml) and PGN (54.44 ± 8.97 μg/ml). There was no significant difference in IC50 values between LPS and PGN (p > .05). Maximum inhibition of TNF-α was 77.4%, 73.0% and 82.7% for LPS, PGN and LTA, respectively and was not significantly different between toxins. At the two highest concentrations of polymyxin-B, TNF-α began to increase. These data suggest that polymyxin-B may inhibit the effects of bacterial toxins other than LPS and might be a more potent inhibitor of LTA than LPS or PGN.
-
ItemPasture-associated stringhalt: Contemporary appraisal of an enigmatic syndrome(WILEY, 2019-03)Summary Although described clinically for several centuries, stringhalt remains an intriguing and enigmatic condition. In pasture‐associated stringhalt (PSH), the clinical sign of exaggerated, prolonged hindlimb flexion is associated with a peripheral neuropathy affecting the larger myelinated axons that is thought to be the result of exposure to a plant‐derived neurotoxin. It is likely that multiple host and environmental risk factors interact to produce PSH and the precise aetiology has not yet been elucidated. Drought‐affected, poor‐quality pasture and the presence of Hypochoeris radicata (commonly referred to as Catsear, Flatweed and False Dandelion) are recognised risk factors. Affected horses are typically mature and taller animals are considered more susceptible. Most horses with PSH recover spontaneously if removed from the presumptive source of toxin; however, recovery can be prolonged, taking several years for some horses, and might be incomplete in occasional cases. A wide range of therapies have been attempted in horses with PSH including phenytoin, thiamine, taurine, infiltration of digital extensors with botulinum toxin and lateral digital extensor myotenectomy procedure. The efficacy of these treatments is uncertain since controlled trials have not been performed and the spontaneous recovery of most horses makes any response to treatment difficult to interpret.
-
ItemTreatment of supraventricular tachycardia in a horse(WILEY, 2017-05)OBJECTIVE: To describe the treatment of persistent supraventricular tachycardia (SVT) in a young horse in endurance training. CASE SUMMARY: A 6-year-old Arab gelding in endurance training presented for a dysrhythmia and decreased performance. SVT was diagnosed and conversion to a normal sinus rhythm was achieved following administration of a constant rate infusion of amiodarone. However, reversion to SVT occurred shortly after initiation of ridden exercise. A second attempt to convert the dysrhythmia with amiodarone failed, but normal sinus rhythm was achieved with transvenous electrical cardioversion (TVEC). Postmortem examination of the heart revealed extensive fibrous replacement of most of the left atrial myocardium; these changes likely provided the structural substrate for the dysrhythmia. The underlying cause of the fibrosis was not identified. NEW OR UNIQUE INFORMATION PROVIDED: SVT is a form of supraventricular tachyarrhythmia rarely diagnosed in the horse. A recent report has described sudden death of a horse following attempted conversion of SVT with oral flecainide acetate. In the present report, we describe short-term conversion of SVT in a horse using intravenous amiodarone with no significant adverse effects. When the dysrhythmia recurred, the animal was donated for teaching purposes and conversion was achieved with TVEC. Normal sinus rhythm persisted for 2 weeks until the horse was euthanized for postmortem evaluation of the heart. Intravenous amiodarone or TVEC could be considered as treatments for supraventricular tachyarrhyhmias other than atrial fibrillation in the horse.
-
ItemSevere hypophosphataemia associated with the management of hyperlipaemia in a miniature pony(WILEY, 2018-07)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.
-
ItemEvidence for marsh mallow (Malva parviflora) toxicosis causing myocardial disease and myopathy in four horses(Wiley, 2017-05-01)REASON FOR PERFORMING THE STUDY: Investigation of toxicosis caused by Malva parviflora was required after 4 horses from the same farm developed severe muscle fasciculations, tachycardia, sweating and periods of recumbency leading to death or euthanasia after ingesting the plant. OBJECTIVES: To describe historical, clinical, clinicopathological and pathological findings of 4 horses with suspected M. parviflora toxicosis. The role of cyclopropene fatty acids (found in M. parviflora) and mechanism for toxicosis are proposed. STUDY DESIGN: Case series. METHODS: Historical, physical examination, clinicopathological and pathological findings are reported. Due to similarities with atypical myopathy or seasonal pasture myopathy acyl carnitine profiles were performed on sera from 2 cases and equine controls. Presence of cyclopropene fatty acids was also examined in sera of 2 cases. RESULTS: M. parviflora had been heavily grazed by the horses with little other feed available. Horse 1 deteriorated rapidly and was subjected to euthanasia. Horse 2 was referred to hospital where severe myocardial disease and generalised myopathy was determined; this horse was subjected to euthanasia 36 h after admission. Horse 3 died rapidly and Horse 4 was subjected to euthanasia at onset of clinical signs. Post-mortem examinations performed on 3 horses revealed acute, multifocal cardiac and skeletal myonecrosis. Myocyte glycogen accumulation was absent when examined in Horse 2. Acyl carnitine profiles revealed increased C14-C18 acyl carnitine concentrations in cases relative to controls. Cyclopropene fatty acids were detected in sera of cases but not controls. CONCLUSION: These findings suggest aetiology different to that of atypical myopathy or seasonal pasture myopathy. We hypothesise that cyclopropene fatty acids in M. parviflora interfere with fatty acid β-oxidation in horses in negative energy balance, causing the clinical signs and abnormal acyl carnitine profiles. These equine cases suggest a pathophysiological course that closely mimics the human genetic condition very long chain acyl CoA dehydrogenase deficiency.
-
ItemEstablishment of reference intervals for serum symmetric dimethylarginine in adult nonracing Greyhounds(WILEY, 2018-09)BACKGROUND: The reference intervals (RIs) for the renal biomarkers urea and creatinine, in Greyhounds, are higher than those for non-sighthound breeds. A recent study has demonstrated a higher concentration of another biomarker of renal function, symmetric dimethylarginine (SDMA), in Greyhounds compared with other dog breeds, and thus a breed-specific RI for serum SDMA may be appropriate for Greyhounds. Greyhounds appear to be predisposed to renal disease, and the establishment of an appropriate RI for SDMA may improve the ability to identify early renal dysfunction in this breed. OBJECTIVES: The aim of this study was to establish an RI for serum SDMA in nonracing Greyhounds and to determine whether the RI for Greyhounds is different from that of non-sighthound breeds. METHODS: Blood samples were collected from 101 clinically healthy, nonracing Greyhounds for serum SDMA measurements. Results from Greyhounds were compared with serum SDMA concentrations measured in a group of non-sighthound dogs (n = 24) of similar weight, age, and sex, and with a previously established canine serum SDMA RI. RESULTS: The serum SDMA RI for Greyhounds was 6.3-19.9 μg/dL (0.31-0.99 μmol/L). Greyhounds had a significantly higher mean value (13.1 μg/dL) than that of the non-sighthound dogs (10.2 μg/dL) (P < .001), and the RI of Greyhounds was different from previously established canine RIs for SDMA. CONCLUSION: This study supports the use of a Greyhound-specific RI for SDMA. Using previously established canine RIs for this breed could result in the overdiagnosis of renal disease.
-
ItemClinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement(WILEY, 2018-03)OBJECTIVE: To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES: Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS: Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION: The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
-
ItemClinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia(WILEY, 2018-03)OBJECTIVE: To review the current literature pertaining to the use of lactate as a prognostic indicator and therapeutic guide, the utility of measuring lactate concentrations in body fluids other than blood or plasma, and the clinical management of hyperlactatemia in dogs, cats, and horses. DATA SOURCES: Articles were retrieved without date restrictions primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS: Increased plasma lactate concentrations are associated with increased morbidity and mortality. In populations with high mortality, hyperlactatemia is moderately predictive in identifying nonsurvivors. Importantly, eulactatemia predicts survival better than hyperlactatemia predicts death. Consecutive lactate measurements and calculated relative measures appear to outperform single measurements. The use of lactate as a therapeutic guide has shown promising results in people but is relatively uninvestigated in veterinary species. Increased lactate concentrations in body fluids other than blood should raise the index of suspicion for septic or malignant processes. Management of hyperlactatemia should target the underlying cause. CONCLUSION: Lactate is a valuable triage and risk stratification tool that can be used to separate patients into higher and lower risk categories. The utility of lactate concentration as a therapeutic target and the measurement of lactate in body fluids shows promise but requires further research.