Objectives: To investigate the acid-base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution of sSID variables to changes in blood pH and HCO 3 − and to determine whether clinical, acid-base, and biochemical variables on admission are associated with the mortality of sick goats. Animals: One hundred forty-three sick goats. Methods: Retrospective study. Calculated sSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (A tot). The relationship between measured blood pH and HCO 3 − , and the sSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization. Results: Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and A tot acidosis were acid-base disorders frequently encountered in sick goats. In sick goats, the sSID variables explained 97% and 100% of the changes in blood pH and HCO 3 − , respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats. Conclusions and Clinical Importance: The sSID approach is a useful methodology to quantify acid-base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.

Summary A retrospective study was made of the course and outcome of labour in 226 patients in whom a singleton fetus presented by the breech. Patients with macerated stillbirths or who were delivered before the 28th week of gestation had been excluded. Of the 226 patients, 101 received extradural analgesia, 79 received parenteral analgesia and 46 underwent elective Caesarean section. There was no difference in the incidence of breech extraction or emergency Caesarean section in the first two groups of patients. The length of both first and second stages of labour in multiparae was prolonged in the extradural group, but not markedly so. The Apgar scores of the infants delivered vaginally were not significantly different at one minute in both groups but the five minute Apgar score in the infants of primiparae was significantly higher in the extradural group. The Apgar score at one minute in the group delivered by emergency Caesarean section was significantly lower after extradural block but the difference was not significant at five minutes. This study suggests that the management and outcome of labour when the breech presents is not adversely affected by the provision of extradural analgesia.

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Background: Use of different analyzers to measure electrolytes in the same horse can lead to different interpretation of acid-base balance when using the simplified strong ion difference (sSID) approach. Objective: Investigate the level of agreement between 2 analyzers in determining electrolytes concentrations, sSID variables, and acid-base disorders in sick horses. Animals: One hundred twenty-four hospitalized horses. Methods: Retrospective study using paired samples. Electrolytes were measured using a Beckman Coulter AU480 Chemistry analyzer (PBMA) and a Nova Biomedical Stat Profile (WBGA), respectively. Calculated sSID variables included strong ion difference, SID 4 ; unmeasured strong ions, USI; and total nonvolatile buffer ion concentration in plasma (A tot). Agreement between analyzers was explored using Passing-Bablok regression and Bland-Altman analysis. Kappa (κ) test evaluated the level of agreement between analyzers in detecting acid-base disorders. Results: Methodologic differences were identified in measured Na + and Cl − and calculated values of SID 4 and USI. Mean bias (95% limits of agreement) for Na + , Cl − , SID 4 , and USI were: −1.2 mmol/L (−9.2 to 6.8), 4.4 mmol/L (−4.4 to 13), −5.4 mmol/L (−13 to 2), and −6.2 mmol/L (−14 to 1.7), respectively. The intraclass correlation coefficient for SID 4 and USI was .55 (95%CI: −0.2 to 0.8) and .2 (95%CI: −0.15 to 0.48), respectively. There was a poor agreement between analyzers for detection of SID 4 (κ = 0.20, 95%CI, 0.1 to 0.31) or USI abnormalities (κ = −0.04, 95% CI, −0.11 to 0.02). Abbreviations: A − , total net negative charge of plasma proteins; AG, anion gap; Atot, total plasma concentration of nonvolatile weak acids; HCO3 − , bicarbonate; ICC, intraclass correlation coefficient; L-lac − , L-lactate; P v CO 2 , venous partial carbon dioxide pressure; SID, strong ion difference; SIDm, measured strong ion difference; SIG, strong ion gap; sSID, simplified strong ion difference approach; TP, total protein; TS, total solids; USI, unmeasured strong ions.

Background: Creeping indigo (Indigofera spicata) toxicosis is an emerging problem among horses in Florida and bordering states. Objectives: To quantify the putative toxins l-indospicine (IND) and 3-nitropropionic acid (NPA) in creeping indigo collected from multiple sites and to measure plasma toxin concentrations in ponies fed creeping indigo and horses with presumptive creeping indigo toxicosis. Study design: Experimental descriptive study with descriptive observational field investigation. Methods: Air-dried creeping indigo was assayed for IND and NPA content. Five ponies were fed chopped creeping indigo containing 1 mg/kg/day of IND and trace amounts of NPA for 5 days, then observed for 28 days. Blood samples from these ponies and from horses involved in a presumptive creeping indigo toxicosis were assayed for IND and NPA.Results: IND in creeping indigo plants was 0.4-3.5 mg/g dry matter whereas NPA was <0.01 to 0.03 mg/g. During creeping indigo feeding, clinical and laboratory signs were unchanged except for significant weight loss (median 6%, range 2%-9%; p = .04) and significant increase from baseline plasma protein concentration (median 16 g/L, range 8-25 g/L; p < .001). These changes could not definitively be ascribed to creeping indigo ingestion. Plasma IND rose to 3.9 ± 0.52 mg/L on day 6. Pharmacokinetic modelling indicated an elimination half-life of 25 days and a steady state plasma concentration of 22 mg/L. Plasma IND concentration in sick horses during an incident of creeping indigo toxicosis was approximately twice that of clinically normal pasture mates. Plasma NPA was <0.05 mg/L in all samples.Main limitations: Creeping indigo used in the feeding trial may not be representative of plants involved in creeping indigo toxicosis. There was no control group without creeping indigo in the feeding trial.

This article investigates the cultural impacts of a community orchestra in a rural setting through the examination of ‘Borderland Community Orchestra’, a crossborder ensemble operating in northern Ontario, Canada and northern Minnesota, United States. In May 2013, two surveys were conducted to understand how members of the orchestra and other community residents perceived the ensemble’s role in the rural arts culture of the area. The themes that emerged include the enrichment of local arts, importance of word-of-mouth communication and sense of community. Throughout the article, survey findings are reinforced by modern literature to demonstrate the necessity of community ensembles in the development of rural arts and the challenges of achieving sustainability. Survey responses are collected into three recommendations, which will assist Borderland Community Orchestra and other ensembles to more effectively connect with their communities: (1) Better marketing and increased awareness; (2) Perform more concerts; (3) Youth outreach and involvement. The conclusions illustrate the power of community musicmaking and deepen the understanding of community orchestras operating in rural areas around the world.

The anaesthetic management of patients with phaeochromocytoma is often difficult even when a clear-cut pre-operative diagnosis has been made. This report concerns a patient with a history of high output left ventricular failure, who presented for exploratory laparotomy and removal of a highly vascular tumour, and who intra-operatively was discovered to have a phaeochromocytoma. Case reportA 54-year-old insulin dependent diabetic of 22 years' standing first presented in June 1974, with an 8-week history of increasing exertional dyspnoea, orthopnoea, and paroxysmal nocturnal dyspnoea. Relevant clinical findings showed an obese male whose arterial pressure varied between lSO/lOO and 180/ 105 mmHg,* with peripheral oedema, elevated jugular venous pressure, and bilateral basal crepitations. Abdominal examination showed hepatomegaly and, below this, a rather ill-defined mass. Plain abdominal X-rays showed calcification within the liver, believed to be associated with this mass.The heart failure and hypertension were readily controlled with digoxin and diuretic therapy and the patient was discharged home on a weight-reducing diet and increased insulin dosage. On direct questioning he gave a past history of trauma to the liver area, and so it was felt that the calcified mass was probably an old haematoma.Eight months later he was re-admitted for investigation, because of rapidly increasing insulin requirements, a 19 kg weight loss, nocturnal bowel frequency, increased sweating, and hypertension. On this occasion abdominal examination showed a large liver and, below it, a cyst-like rounded mass over which could be heard a loud bruit. A liver scan confirmed a filling defect in the right lobe of the liver, compatible with the calcified mass previously seen on plain X-ray. Haematological investigations showed a haemoglobin of 10.9 g/dl, an ESR of 125 mm per hour, and grossly elevated values