Background Globally, working equines have a continued and growing socioeconomic role in supporting the livelihoods of between 300–600 million people in low income countries which is rarely recognised at a national or international level. Infectious diseases have significant impact on welfare and productivity in this population and equine trypanosomiasis is a priority disease due to its severity and prevalence. Strategies are required to improve the prevention, diagnosis, management and treatment of trypanosomiasis in equines and more data are required on the efficacy and safety of current trypanocidal drugs. Methods A prospective randomised, open-label non-inferiority trial was performed in The Gambia on horses and donkeys that fulfilled 2/5 clinical inclusion criteria (anaemia, poor body condition, pyrexia, history of abortion, oedema). Following randomised trypanocidal treatment (diminazene diaceturate, melarsomine dihydrochloride or isometamidium chloride), animals were observed for immediate adverse drug reactions and follow-up assessment was performed at 1 and 2 weeks. Blood samples underwent PCR analysis with specific Trypanosoma sp. primers. Treatment efficacy was assessed by measuring changes in clinical parameters, clinicopathological results and PCR-status post-treatment after evaluating for bias. Using PCR status as the outcome variable, non-inferiority of isometamidium treatment was determined if the upper bound limit of a 2-sided 95% CI was less than 10%. Results There was a significant beneficial effect upon the Trypanosoma sp. PCR positive population following trypanocidal treatment for all groups. The findings of clinical evaluation and PCR status supported a superior treatment effect for isometamidium. Melarsomine dihydrochloride efficacy was inferior to isometamidium. There were immediate, self-limiting side effects to isometamidium in donkeys (26%). Diminazene had the longest duration of action as judged by PCR status. Conclusions The data support the continued use of isometamidium following careful dose titration in donkeys and diminazene for trypanosomiasis in equines using the doses and routes of administration reported.
Theileria equi, one of the primary pathogens causing equine piroplasmosis, has previously been sub‐classified into a number of clades on the basis of 18S SSU rRNA gene sequence diversity. This partitioning of the parasite population has potential implications for host immunity, treatment and vaccine development. To detect and identify different clade genotypes among and within individual equine blood samples, a novel PCR‐based technique was designed and optimized. Theileria equi has only recently been described in The Gambia, and the developed genotyping technique was used to analyse blood samples taken from 42 piroplasmosis‐positive horses and donkeys within the country. Three different T. equi genotypes were detected within the population, including the same genotype as the recently described Theileria haneyi, with 61.9% of individuals found to be infected with more than one genotype. Overall, there was a trend that males were more likely to have a multiple genotype infection. Thus, the novel genotyping technique has been shown to be effective in analysis of field populations and offers researchers a rapid method of identifying multiple T. equi genotypes both within individuals and equine populations in epidemiological studies.
Summary Fasciola hepatica infestation is reported as a cause of severe eosinophilic cholangiohepatitis in a 28‐year‐old Warmblood cross pony gelding. The gelding presented initially for investigation of acute laminitis found to be secondary to pars pituitary intermedia dysfunction (PPID). Six weeks of treatment including administration of pergolide achieved good control of the laminitis but there was a marked general clinical deterioration over this period with notable weight loss, tachycardia, anorexia and ventral oedema. Hepatobiliary enzymes were increased significantly and there was mild elevation of plasma bile acid concentration. An eosinophilia in both blood and peritoneal fluid specimens and histopathological confirmation of an eosinophilic cholangiohepatitis on examination of liver biopsies supported a primary parasitic aetiology. The pony was treated for Fasciola hepatica with triclabendazole 12 mg/kg bwt but clinical signs continued to progress. Due to poor clinical response the pony was subjected to euthanasia and post mortem examination revealed an overwhelming infestation of the biliary tracts with Fasciola hepatica and a secondary chronic and severe cholangiohepatitis with marked fibrosis. To the authors' knowledge this is the first equine report demonstrating the relationship between the clinical disease syndrome, eosinophilic cholangiohepatitis and hepatic fluke infestation. Depending on geographical location, fasciolosis should be considered as a differential diagnosis for equine hepatopathies and can result in severe disease.
BackgroundThe prevalence and nature of arrhythmias in horses following general anaesthesia and surgery is poorly documented. It has been proposed that horses undergoing emergency surgery for gastrointestinal disorders may be at particular risk of developing arrhythmias. Our primary objective was to determine the prevalence and nature of arrhythmias in horses following anaesthesia in a clinical setting and to establish if there was a difference in the prevalence of arrhythmias between horses with and without gastrointestinal disease undergoing surgery. Our secondary objective was to assess selected available risk factors for association with the development of arrhythmias following anaesthesia and surgery.MethodsHorses with evidence of gastrointestinal disease undergoing an exploratory laparotomy and horses with no evidence of gastrointestinal disease undergoing orthopaedic surgery between September 2009 and January 2011 were recruited prospectively. A telemetric electrocardiogram (ECG) was fitted to each horse following recovery from anaesthesia and left in place for 24 hours. Selected electrolytes were measured before, during and after surgery and data was extracted from clinical records for analysis. Recorded ECGs were analysed and the arrhythmias characterised. Multivariable logistic regression was used to identify risk factors associated with the development of arrhythmias.ResultsSixty-seven horses with gastrointestinal disease and 37 without gastrointestinal disease were recruited. Arrhythmias were very common during the post-operative period in both groups of horses. Supra-ventricular and bradyarrhythmias predominated in both groups. There were no significant differences in prevalence of any type of arrhythmias between the horses with or without gastrointestinal disease. Post-operative tachycardia and sodium derangements were associated with the development of any type of arrhythmia.ConclusionsThis is the first study to report the prevalence of arrhythmias in horses during the post-operative period in a clinical setting. This study shows that arrhythmias are very common in horses following surgery. It showed no differences between those horses with or without gastrointestinal disease. Arrhythmias occurring in horses during the post-anaesthetic period require further investigation.
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