BackgroundDespite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown.ObjectivesTo study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome.AnimalsA total of 479 consecutive adult horse emergency admissions to a private primary referral practice.MethodsProspective observational study. All adult horses admitted for emergency treatment over the study period were included. Multivariate logistic regression and stepwise model selection were used.ResultsEach of the 4 SIRS criteria was associated with outcome in this population. Thirty‐one percent of emergency cases had 2 or more abnormal SIRS criteria on admission and were defined as SIRS cases. SIRS was associated with increased odds of death (odds ratio [OR] = 8.22; 95% CI, 4.61–15.18; P < .001), an effect mainly found for acute gastrointestinal cases. SIRS cases were assigned a SIRS score of 2, 3, or 4, according to the number of abnormal SIRS criteria fulfilled on admission, and SIRS3 and SIRS4 cases had increased odds of death compared to SIRS2 cases (OR = 4.45; 95% CI, 1.78–11.15; P = .002). A model of severe SIRS including the SIRS score, blood lactate concentration, and color of the mucous membranes best predicted outcome in this population of horses.Conclusions and Clinical ImportanceSystemic inflammatory response syndrome is associated with an increased risk of death in adult horses presenting with acute gastrointestinal illnesses. The model of severe SIRS proposed in this study could be used to assess the status and prognosis of adult equine emergency admissions.
BackgroundCardiac troponin-I assays have been validated in horses.’High-sensitivity’ cardiac troponin assays are now the standard in human cardiology. Objective: Appropriately validate the’high-sensitivity’ cardiac Troponin-T (hscTnT) assay for clinical use in horses, establish reference intervals, determine the biological variation, and demonstrate assay utility in selected clinical cases. Methods: Analytical validation of the Roche hscTnT assay included within- and between-run precision, linear dose response, limit of quantitation (LoQ), stability, and comparison with cTn-I (iSTAT). Reference intervals and biological variation were determined using adult, healthy, Non-Competition Horses (N = 125) and Racing-Thoroughbreds (N = 178). HscTnT levels were measured in two horses with cardiac pathology.ResultsThe hscTnT demonstrates acceptable within-run (L1 = 6.5 ng/L, CV 14.9 %, L2 = 10.1 ng/L, CV 8.7 %, L3 = 15.3 ng/L, CV 5.4 %) and between-run precision (L1 = 12.2 ng/L, CV 8.4 %, L2 = 57.0 ng/L, CV 8.4 %, L3 = 256.0 ng/L, CV 9.0 %). The assay was linear from 3 to 391 ng/L. The LoQ was validated at 3 ng/L. Samples demonstrated insignificant decay over freeze-thaw cycle. Comparison with cTnI assay showed excellent correlation (range: 8.0–3535.0 ng/L, R2 = 0.9996). Reference intervals: The upper 95th and 99th percentile of the hscTnT population distribution were 6.8 and 16.2 ng/L in Non-Competition Horses, and 14.0 and 23.2 ng/L in Racing-Thoroughbreds. Between-breed, diurnal effect, and between-day variation was below LoQ. Two clinical cases with presumed cardiac pathology had hscTnT levels of 220.9 ng/L and 5723.0 ng/L.ConclusionsThis benchmark study is the first to comply with CLSI guidelines, thus further establishing the performance characteristics of the hscTnT assay, and reference intervals in healthy horses. Two clinical cases demonstrated further the clinical utility of the assay.
Background: Swimming is used for rehabilitation and conditioning purposes in equine sports medicine despite the lack of understanding of equine swimming kinematics. The aim of this study was to assess forelimb joints kinematics (elbow, carpus, and fetlock) in swimming horses. The specific objectives were 1- to calculate and compare joint angles in swimming vs. passive mobilizations (PM), 2- to determine joint angular velocities during a swimming stride cycle.Methods: Eleven elite endurance horses swam in a 100-m straight pool. Underwater (swimming) and overground (PM) videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metacarpal epicondyle, ulnar carpal bone, lateral humeral epicondyle, and the greater tubercle of humerus, from which elbow, carpus and fetlock angles, and angular velocities were obtained. As a reference, maximal fetlock, carpus, and elbow flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities and range of motion (ROM) were compared.Results: Carpus and fetlock ROM were significantly smaller (p < 0.001) during swimming when compared with PM, while there was no difference in elbow ROM between both situations. The carpus had the greatest ROM of all joints during swimming. Absolute angular velocities values of all joints during swimming were greater during retraction than protraction (p < 0.001). When compared to other joints during protraction, the carpus joint reached the highest angular velocity.Conclusion: Swimming, as a rehabilitation exercise, has the potential to benefit horses where great elbow ROM with a moderate carpus and fetlock extension are wanted.
BackgroundThe Heavy Horse Pull is a competition where teams of two horses pull an increasingly heavy sled for a short distance. Similar to human wrestlers, some horses may undergo rapid weight change in order to enter a lower weight category. The objectives were to study the physiological effects of this practice as well as of the pulling competition in draft horses.ResultsFifty horses were divided into light-, middle- and heavyweight categories based on their arrival weights and competed 1–3 days after. Body weight was measured upon arrival and pre-competition. Blood was sampled for chemistry and high sensitivity cardiac troponin T (hscTnT) at arrival, pre- and post-competition in 34, 26 and 20 horses, respectively. Body weight increased significantly between arrival and pre-competition for light (7.2% (Median: 62.8Kg (41.7–77.0)) and middle (8.6% (Median: 80.5Kg (62.7–90.9)) weight categories. Change in body weight was correlated (r = 0.69, p = 0.002) with competition ranking for middleweights. The ratios of weight pulled to team body weight were 2.7 (1.9–2.8), 2.6 (2.5–2.6) and 2.4 (2.2–2.5) for the lightweights, middleweights and heavyweights, respectively. Blood chemistry indicated hemoconcentration on arrival in the middleweight and lightweight horses. Hemoconcentration was not seen on arrival in some horses with marked rapid weight change. Overall, no chemistry parameter changed between pre- and post-competition. The hscTnT stayed within normal range post-competition.ConclusionsWhile horses arrived to the event with indications of hemoconcentration, they appeared to have sufficient time to rehydrate prior to competition, and the effects of the competition were reversible within 3 h.
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