Highlights of recent clinically relevant papers

In this study, Josephine Faulkner and co-workers in Belgium described the range of abnormalities present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field magnetic resonance imaging (MRI). MRI images of horses diagnosed with SGD were identified from medical records. These were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting potential pathways of pathological progression and severity of stress injury. A total of 132 limbs from 111 horses were included: predominantly Warmbloods competing in showjumping (n = 83) and dressage (n = 18). SGD MRI classifications were: 0 (normal, n = 0), 1 (small subchondral defect, n = 2), 2 (osseous densification, n = 28), 3 (subchondral microfissure with osseous densification, n = 7), 4 (bone oedema-like signal within the subchondral ± trabecular bone and ± subchondral microfissure or demineralisation, n = 72), 5 (incomplete macrofissure/fracture, n = 23) and 6 (complete fracture, n = 0). Classification 4c (bone oedema-like signal with demineralisation) and 5 had higher proportions in the plantar third of hindlimbs (3% and 10%, respectively) compared with forelimbs (0% and 0%, respectively). The SGD classification and extent of bone oedema-like signal were not significantly different between lame (n = 116) and nonlame limbs (n = 16). Periosteal new bone and oedema-like signal were identified (either confidently or suspected) at the dorsoproximal aspect of the proximal phalanx (P1) in 25% and 39% of limbs, respectively. The SGD MRI classification system is a useful means to describe the severity of SGD. The presence or absence of lameness is not a dependable measure of the severity of SGD. This study by Myra Barrett and co-workers in the USA compared ultrasound to magnetic resonance imaging (MRI) for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL) and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between the heel bulbs, and results of the two modalities were compared. A total of 70 ultrasound and MRI examinations of 45 horses were included. Ultrasound had good sensitivity (85%), moderate specificity (60%) and accuracy of 70% for evaluating the dorsal tearing of the DDFT. Accuracy was lower for navicular bursa effusion (67%), navicular bursa proliferation (61%) and CSL enlargement (61%). Tearing of the DDFT distal to the navicular bone was identified with MRI in 27 limbs, 20 of which also had dorsal damage proximal to the navicular bone identified with ultrasound. Ultrasound evaluation remains a useful screening tool, particularly for the assessment of DDFT tearing proximal to the navicular bone but risks underdiagnosing pathology to the navicular bursa and CSL. Clinically significant concurrent damage to the distal DDFT and other osseous and soft tissues in the hoof capsule is unlikely to be identified without MRI. In this study, Christiana Bromberger and co-workers in Brazil and the USA evaluated the presence of Equus caballus papillomaviruses (EcPVs) in equine aural plaque samples. Aural plaques have been linked to Equus caballus papillomavirus. Although 10 types of EcPVs have been described, only EcPVs 1, 3, 4, 5 and 6 have been observed in association with aural plaques. A total of 29 aural plaque samples (from 15 horses) were collected and assessed for the presence of the DNA of these EcPVs by PCR. Additionally, 108 aural plaque samples used in previous research were evaluated for the presence of EcPVs 8 and 9. Previously described primers were used for PCR to detect EcPVs 1 to 8, and specific primers were designed for EcPV 9. Minigenes were synthesised and used as a positive control in the PCRs for the undetected EcPVs. EcPVs 2, 7, 8 and 9 were not detected in any of the evaluated samples, suggesting that these viral types are not involved in the aetiology of the equine aural plaque in Brazil. EcPV 6 was the most prevalent (81%), followed by EcPVs 3 (72%), 4 (63%) and 5 (47%), which reinforces the idea that these viruses play an important role in the aetiology of the equine aural plaque in Brazil. This study by Cynthia Xue and co-workers in St Kitts compared postoperative outcomes in a group of jennies treated with intravenous flunixin meglumine (FM) or oral phenylbutazone (PBZ) following unilateral ovariectomies by standing left flank laparotomy. Data from medical records of 14 ovariectomised jennies (case details, weight, nonsteroidal anti-inflammatory drug [NSAID] protocol, surgery duration, operative sequence, anaesthesia protocol, physical examination findings and outcomes) were collected. From collated data, postoperative adverse events were defined as fever, tachycardia, tachypnoea, inappetence, altered mentation, abnormal oral mucous membranes, bruxism, colic, incisional complications (i.e. drainage, oedema, peri-incisional emphysema and pain) and nonsurvival, then further divided into occurrence during the early (≤24 h) or late (>24 h) postoperative period for data analysis using R software. Individual adverse events were compared between groups (PBZ vs. FM) and moments (early vs. late). PBZ treatment (2.2 mg/kg bwt IV pre-op, then 2.2 mg/kg bwt PO BID for 3 days post-op) (8/14) was associated with significantly (odds ratio, 95% confidence interval) more total (2.93, 1.97–4.36), early (3.01, 1.87–4.84) and late (2.69, 1.28–5.63) adverse events than FM treatment (1.1 mg/kg bwt IV pre-op and 1.1 mg/kg bwt IV BID for 3 days post-op) (6/14). Tachycardia (37.83, 2.21–646.66), tachypnoea (0.29, 0.13–0.66), altered mentation (2.78, 1.01–7.67), altered mucous membranes (18.38, 1.04–325.23), incisional oedema (44.33, 2.60–754.5) and incisional pain (47.78, 2.81–811.61) were significantly different between groups. Early adverse events significantly different between groups included tachycardia (50.2, 2.9–877.0), altered mentation (3.33, 1.08–10.29) and incisional pain (21.0, 1.2–374.5), with late adverse events being tachypnoea (0.07, 0.01–0.62), incisional oedema (32.92, 1.85–584.28) and incisional pain (28.92, 1.62–515.68). Colic (2/8) and nonsurvival (1/8) were rare events that only occurred in the PBZ cohort and could not be further evaluated for differences. When surgery length, operative sequence and anaesthetic protocol were controlled for, PBZ-treated donkeys were more likely to show abnormal physiologic parameters, changes in behaviour and incisional discomfort compared with FM-treated jennies. Therefore, IV FM may be the more appropriate NSAID for abdominal surgery in donkeys. This study by Maria Papapetrou and co-workers in Canada and Germany investigated the prevalence of equine parvovirus-hepatitis (EqPV-H) DNA in 170 healthy broodmares of various breeds located on 37 farms in southern Ontario, Canada. The occurrence of EqPV-H infection was determined by quantitative PCR for EqPV-H DNA in serum samples. The effects of age, breed, season, pregnancy status and equine herpesvirus-1 (EHV-1) vaccination history on EqPV-H status were also investigated. There was a prevalence of 15.9% (27/170) with viral loads of EqPV-H ranging from detectable to 2900 copies/mL. Statistical analysis showed that increasing age was a significant factor in the detection of EqPV-H DNA. Neither breed, season, pregnancy status, nor EHV-1 vaccination history was significant in predicting EqPV-H infection status. This review article by Courtney Higgins and Laura Huber discussed the emergence of multidrug resistant (MDR)-R. equi in the United States and the challenges faced to guide antimicrobial use practices. Rhodococcus equi, a gram-positive facultative intracellular pathogen and a soil saprophyte, is one of the most common causes of pneumonia in young foals. Many farms use thoracic ultrasonographic screening and antimicrobial treatment of subclinically affected foals as a preventive measure against severe R. equi infections. The wide use antimicrobials to treat subclinically affected foals has contributed to the emergence of multidrug resistant (MDR)-R. equi in both clinical isolates from sick foals and in the environment of horse-breeding farms. Alternatives to treat foals infected with MDR-R. equi are scarce and the impact of the emergence of MDR-R. equi in the environment of farms is still unknown. Reduction of antimicrobial use at horse-breeding farms is essential for the preservation of antimicrobial efficacy and, ultimately, human, animal and environmental health.

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