Other Flashcards
Survey of UK veterinary students’ perceptions about a career in equine practice
20% of students reported an intention to work in equine practice, but risk of selection bias.
The results indicate a potential mismatch between the number of students interested in equine practice and the availability of equine jobs for new graduates.
Students with pre-existing equine interest/experience are more likely to want to enter equine practice.
EMS appears important for students’ training in equine medicine
Comparison of plasma l-lactate between jugular and cephalic veins in healthy and systemically ill horses using a point-of-care device
• Plasma L-lactate (LAC) values were significantly higher in cephalic vein (CV) samples compared to jugular vein (JV) samples in both healthy and systemically ill horses:
• Healthy horses: JV median 0.8 mmol/L; CV mean 1.5 ± 0.4 mmol/L.
• Systemically ill horses: JV median 1.9 mmol/L; CV median 2.9 mmol/L.
• In systemically ill horses, CV values often exceeded the normal reference range, while JV values remained within normal limits.
• LAC values were significantly higher in systemically ill horses than in healthy horses at both venipuncture sites (P < 0.001).
Noncontact infrared thermometer measurements offer a reasonable alternative to rectal temperature measurement in afebrile horses
Infrared thermometer measurements from the perineum and eye correlated significantly with rectal temperature readings:
• Perineum: R = 0.57, P < 0.001.
• Eye: R = 0.37, P < 0.001.
• Other sites (gingiva, axilla, neck) showed lower correlations or were unreliable.
Reference ranges (in climate-controlled conditions) for rectal and infrared thermometer readings:
• Rectal: 36.7–38.6 °C.
• Perineum: 36.0–37.8 °C.
• Eye: 35.7–37.1 °C.
Bias and agreement analysis supported the use of correction factors:
• Perineum: +0.77 °C.
• Eye: +1.23 °C.
Outdoor Measurements:
• Infrared measurements were less consistent in outdoor settings with cold ambient temperatures (<10 °C).
• Increased variance observed at the eye (P = 0.002), gingiva (P = 0.047), and perineum (P = 0.005).
• Infrared readings at the eye remained reliable outdoors, but perineum readings were significantly affected.
• The infrared thermometer was designed for use between 10–40 °C, limiting its effectiveness in extreme outdoor conditions.
Clinical predictive models in equine medicine: A systematic review
• 90 predictive models from 63 peer-reviewed articles, including nine external validation studies.
• Most models (41%) addressed colic, followed by neonatal illnesses (12%) and chronic pulmonary diseases (10%).
Model Development:
• Logistic regression was the most frequently used method (66% of models), followed by discriminant analysis (9%) and partial least squares regression (7%).
• Most models were developed in academic settings (80%) within North America (65%) and Europe (33%).
Model Performance:
• Calibration metrics were reported in 41% of models, primarily using Hosmer-Lemeshow tests, despite its known limitations.
• Discrimination (AUC/C-statistic) was reported in 38% of models, with 39% achieving AUC > 0.9, indicating outstanding discrimination.
Risk of Bias (ROB):
• All models exhibited a high ROB, attributed to:
-Exclusion of cases with missing data (complete case analysis).
-Univariate screening of predictors.
-Lack of correction for overfitting.
• 70% of models lacked validation, raising concerns about their applicability to new populations.
Common Applications of Predictive Models
• Colic Models:
-37 models focused on colic, with the most common outcome being survival to hospital discharge.
-Top predictors for short-term survival included: Heart rate, packed cell volume, and mucous membrane characteristics.
-Four models predicted the need for exploratory laparotomy, incorporating rectal palpation findings and peritoneal fluid analysis.
• Neonatal Illness Models:
- 11 models targeted neonatal sepsis and short-term survival.
-Common predictors for sepsis included serum IgG levels, band neutrophil count, and neutrophil toxic changes.
• Other Conditions: Models addressed chronic pulmonary diseases, infectious diseases, lameness/ataxia, and rare conditions like equine atypical myopathy.
• Limited focus on emerging conditions or diseases with complex pathophysiology.
Retrospective evaluation of factors associated with emergency frequency and survival in equids presenting for emergency care (2019-2020): 3071 cases
Climate Influence:
• Higher average barometric pressure and decreases in barometric pressure were associated with increased emergency admissions.
• Higher maximum daily temperatures correlated with higher emergency rates.
Temporal Patterns:
• Mondays had the highest number of daily emergencies (P < 0.001).
• Summer and fall months (June through November) showed increased emergency rates.
Overall Survival:
• Survival rate for all emergencies was 89%.
• Primary emergencies had a higher survival rate (92%) compared to referral emergencies (68%; OR = 5.2, P < 0.0001).
Critical Factors for Nonsurvival:
Primary emergencies:
• Increased age (P < 0.001).
• Higher heart rates (P < 0.001).
• Absent or decreased gastrointestinal sounds (P < 0.001).
Combined primary and referral emergencies:
• Elevated PCV l (OR = 1.079, P < 0.001).
• Absent GIT sounds
• Clinicians with 1–4 years of experience had better survival outcomes compared to less experienced (<1 year) and highly experienced (>4 years) veterinarians, likely reflecting differences in case severity handled by each group.
Precision and accuracy of a point of care glucometer for detection of hypoglycaemia in horses
The point-of-care (POC) glucometer demonstrated lower precision compared to laboratory (LAB) methods:
• Repeatability coefficient (RC):
-POC: 0.47 mmol/L.
-LAB: 0.09 mmol/L.
• Coefficient of variation (CV):
-POC: 9.95% (exceeded the acceptable threshold of ≤5%).
-LAB: 2.11%.
• POC glucometer consistently underestimated glucose concentrations compared to LAB results:
-Mean bias: -0.26 mmol/L.
-Limits of agreement (LOA): -0.88 to 0.37 mmol/L.
-Only 69% of POC measurements were within 20% of LAB results, and fewer than 14% were within 5%.
Clinical Relevance:
• Despite measurement error, the POC glucometer provided adequate repeatability for identifying hypoglycemia, defined as glucose <4 mmol/L.
• The total error (TE) for POC was 32.6%, exceeding the allowable limit of 10% for hypoglycemic samples.
• Previous research showed greater glucometer error in hyperglycemia compared to euglycemia; this study confirmed similar variability in hypoglycemia.
Evaluation of medial saphenous venous pressures as an indirect method of measuring intra-abdominal pressures in the horse
Medial saphenous venous pressure (MSVP) strongly correlated with intra-abdominal pressure (IAP) in horses during induced pneumoperitoneum with carbon dioxide:
• Intraclass correlation coefficient (ICC): 0.92 (P < 0.001).
• Repeated measures correlation: r = 0.98 (P < 0.001).
• Bland-Altman analysis showed MSVP overestimated IAP by a mean bias of 15.7 mmHg, with wide limits of agreement (7.4–24.1 mmHg).
MSVP increased stepwise with IAP:
• Significant rise in MSVP observed at 20 mmHg (P < 0.03).
• Respiratory rate increased significantly with higher IAP (P < 0.001), reflecting thoracic compliance reduction.
• Mean arterial blood pressure (MAP) also increased as IAP rose, with significant differences noted at 15 mmHg (P = 0.04).
Retrospective analysis of post-mortem findings in Thoroughbreds aged from birth to 18 months presented to a UK pathology laboratory
Mortality Patterns:
• Median age at post-mortem (PM): 21 days (IQR: 2–118 days).
• Neonatal period (0–2 days) had the highest mortality, with congenital deformities as the leading cause.
Common Pathologies:
• Congenital Defects (20.4% of cases):
-Predominantly musculoskeletal (75%), such as flexural deformities of the carpi and fetlocks.
-Often resulted in euthanasia within the first 2 days of life.
• Pneumonia (14.6%):
-Median age at PM: 53 days.
-Rhodococcus equi identified in 50% of cases, followed by Streptococcus spp. (20%).
• Neonatal Sepsis/Maladjustment Syndrome (NSM) (12.4%):
-Median age at PM: 3 days.
-Hypoxia and Streptococcus spp. were common contributing factors.
• Enteritis/Colitis (10.9%):
-Median age at PM: 91 days.
-Infectious agents included Clostridium perfringens and E. coli.
• Gastrointestinal Rupture/Obstruction (8.8%):
-Parasites (e.g., ascarids, tapeworms) were implicated in 25% of cases.
• Fractures (6.7%):
-Rib fractures (44%) often caused secondary injuries (e.g., lung or heart lacerations).
Infectious Pathogens:
• Identified in 33% of cases, with R. equi being the most prevalent pathogen.
Efficacy of treatment of equine anhidrosis with acupuncture and Chinese herbs is low but higher in treated horses compared with placebo
Immediate response (2 days post-treatment):
• Treated horses showed significantly higher sweat response ratios at certain terbutaline concentrations (1.0, 100, and 1,000 µg/mL) compared to the placebo group.
• 26% (5/19) of treated horses exhibited a ≥2-fold increase in sweat response compared to 4% (1/25) in the placebo group.
Sustained response (4 weeks post-treatment):
• Differences in sweat responses between groups were not statistically significant.
• One treated horse maintained an increased sweat response at 0.1 µg/mL terbutaline, but this was not significant (P = 0.07).
Efficacy:
• While treatment demonstrated some short-term benefits, the overall efficacy was low and results were not sustained beyond 4 weeks.
Clinical and biochemical factors associated with survival in equids attacked by dogs: 28 cases (2008-2016)
• The overall survival rate was 79%, comparable to other species subjected to similar trauma.
Key Predictors of Nonsurvival:
• Body Temperature: Lower body temperature was strongly associated with nonsurvival (P < 0.005). Survivors: Mean temperature 37.9°C vs. nonsurvivors: 36.1°C.
• Blood Lactate: Increased admission lactate levels were linked to worse outcomes (P < 0.005). Survivors: Mean lactate 3.1 mmol/L vs. nonsurvivors: 13.1 mmol/L.
• Total Protein: Lower serum total protein levels correlated with higher mortality (P = 0.006). Survivors: Mean 6.4 g/dL vs. nonsurvivors: 5.1 g/dL.
• Smaller equids (e.g., ponies, miniature horses) had significantly lower survival rates than full-sized horses: OR 0.02
Injury Patterns:
• Most common sites of injury were: Limbs: 79%. Face/Neck: 50%. Trunk: 29%.
Trauma Dynamics:
• Injuries involved complex trauma including puncture, crushing, and tearing, leading to tissue contamination and systemic complications such as:
- Hypoperfusion: Contributing to hypothermia and hyperlactatemia.
- Rhabdomyolysis: Suggested by elevated creatine kinase (CK) levels in nonsurvivors.
- SIRS
Survey of the knowledge and perceptions of horse owners in Ireland of common clinical conditions and their impact
Self-rated knowledge varied significantly among the eight conditions:
• Highest knowledge: Mud rash (84.1% rated as “very good”).
• Lowest knowledge: Equine Metabolic Syndrome (EMS, 42% rated as “very good”).
• EMS was the least known condition, with 18% of respondents having never heard of it.
Strong correlation between perceived impact on horses and emotional impact on owners:
• Strongest correlation: EMS (r = 0.62, P < 0.001).
• Weakest correlation: Arthritis (r = 0.36, P < 0.001).
• Owners believed EMS and equine asthma had the most severe impacts on horse activity and comfort.
• Mud rash was perceived to have the least impact.
Conditions causing the greatest emotional concern:
• EMS and equine asthma.
