Objective—To develop a high-speed, continuous-flow, automated plasmapheresis procedure for the high-volume harvest of equine plasma in accordance with current good manufacturing practice.
Animals—143 horses (predominantly draft breeds) between 3 and 10 years of age at the time of purchase.
Procedures—Adaptations were made to automated plasmapheresis instruments and sterile disposable collection sets, which allowed for dual-instrument, continuous-flow operation. Donor horses were connected to the apparatus via 2 catheters (1 inserted in each jugular vein). The instruments removed whole blood from donors, fractionated the blood, diverted plasma to collection bags, and simultaneously returned concentrated cells to the donors. Plasmapheresis was performed on donor horses at 14-day intervals with a maximum of 22 mL of plasma/kg of donor body weight harvested during each plasmapheresis procedure.
Results—During a 5-year period, 3,240 plasmapheresis procedures were performed and > 50,000 L of sterile equine plasma was harvested in accordance with current good manufacturing practice. Donors typically remained calm during the plasmapheresis procedures and tolerated the procedures well. The high-volume and frequent plasma harvest did not result in sustained hypoproteinemia in donor horses. Adverse events associated with the automated plasmapheresis technique were infrequent, and the recurrence of adverse events was minimized by making minor adjustments to the procedure.
Conclusions and Clinical Relevance—The automated plasmapheresis procedure described in this report can be used to safely harvest equine plasma or to perform therapeutic plasmapheresis in horses.
Objective—To determine the effects of intensive serial plasmapheresis on total plasma protein and total IgG concentrations in donor horses involved in a plasmapheresis program.
Animals—18 horses (13 mares and 5 geldings; 13 Belgians, 3 Percherons, 1 Standardbred, and 1 warmblood) ranging from 7 to 14 years of age (mean ± SD, 10 ± 3 years) and weighing 822 ± 128 kg.
Procedures—Horses from which 22 mL of plasma/kg of donor body weight was harvested at 14-day intervals for a minimum of 8 consecutive plasmapheresis donations were retrospectively selected for use in the evaluation. Automated plasmapheresis procedures were performed by use of 2 modified plasmapheresis instruments/donor horse. Plasma samples were obtained at each donation and used for determination of total protein and total IgG concentrations. Total plasma protein concentrations were determined via refractometry. A commercially available ELISA was used to determine total equine IgG concentrations.
Results—The 18 donor horses were used in 8 to 19 serial donations (mean ± SD, 13 ± 3 donations) during the study. Donor horses had significant decreases in both plasma protein and IgG concentrations over the study period.
Conclusions and Clinical Relevance—Serial plasmapheresis procedures caused significant decreases in both plasma protein and IgG concentrations in donor horses; however, decreases were not physiologically relevant. Performing plasmapheresis in horses in accordance with the evaluated automated plasmapheresis procedures did not result in a critical decrease in total plasma protein or total IgG concentrations.
Objective—To determine between-pony and within-pony variations and interobserver and intraobserver agreements of a technique for measurement of flow-mediated vasodilation (FMD) in healthy ponies.
Animals—6 healthy pony mares (weight range, 236 to 406 kg; body condition score range, 3/9 to 7/9; age range, 14 to 25 years).
Procedures—In each pony, the left median artery was occluded with a blood pressure cuff (inflated to > 300 mm Hg for 5 minutes). Two-dimensional ultrasonographic images of the artery were recorded for 30 seconds before cuff inflation and for 2 minutes after cuff deflation. Maximum luminal diameters of arteries were compared with their baseline diameters to calculate FMD (relative percentage increase in luminal size). Images were obtained from 6 ponies 1 time and from 1 pony 6 times. Independent analysis of images was performed by 2 investigators, 1 of whom analyzed images on 2 occasions.
Results—Mean ± SD FMD in 6 ponies (1 time) was 12.57 ± 4.28% and in 1 pony (6 times) was 7.30 ± 2.11%. Between-pony and within-pony coefficients of variation were 34.09% and 28.84%, respectively. Interobserver agreement was fair (intraclass correlation coefficient, 0.47); intraobserver agreement was poor (intraclass correlation coefficient, 0.30).
Conclusions and Clinical Relevance—FMD was identified and measured in ponies. Measurement of FMD is used to assess endothelial function in humans and has been investigated in dogs. Measurement of FMD in ponies appeared to be feasible and could be used to assess endothelial function (to determine predisposition for development of laminitis or cardiovascular diseases).
Objective—To determine whether preanalytic and analytic factors affect evaluation of the urinary protein-to-creatinine (UPC) ratio in dogs.
Sample—50 canine urine samples.
Procedures—The UPC ratio was measured to assess the intra-assay imprecision (20 measurements within a single session), the influence of predilution (1:10, 1:20, and 1:100) for urine creatinine concentration measurement, and the effect of storage at room temperature (approx 20°C), 4°C, and −20°C.
Results—The coefficient of variation at room temperature determined with the 1:20 predilution was < 10.0%, with the highest coefficients of variation found in samples with a low protein concentration or low urine specific gravity. This variability could result in misclassification of samples with UPC ratios close to the thresholds defined by the International Renal Interest Society to classify dogs as nonproteinuric (0.2), borderline proteinuric (0.21 to 0.50), or proteinuric (> 0.51). A proportional bias was found in samples prediluted 1:10, compared with samples prediluted 1:20 or 1:100. At room temperature, the UPC ratio did not significantly increase after 2 and 4 hours. After 12 hours at room temperature and at 4°C, the UPC ratio significantly increased. The UPC ratio did not significantly change during 3 months of storage at −20°C.
Conclusions and Clinical Relevance—The intra-assay precision of the UPC ratio was sufficiently low to avoid misclassification of samples, except for values close to 0.2 or 0.5. The optimal predilution ratio for urine creatinine concentration measurement was 1:20. A 1:100 predilution is recommended in samples with a urine specific gravity > 1.030. The UPC ratio must be measured as soon as samples are collected. Alternatively, samples should be immediately frozen to increase their stability and minimize the risk of misclassification of proteinuria.
Objective—To determine reference values for kaolin-activated thromboelastography in echocardiographically normal cats.
Animals—30 healthy cats without evidence of cardiomyopathy on echocardiographic examination.
Procedures—All cats underwent echocardiographic examination, the findings of which were reviewed by a board-certified cardiologist. Cats that struggled (n = 10) received mild sedation with butorphanol and midazolam IM to permit phlebotomy without interruption in jugular venous blood flow. Blood samples were collected for analysis of thromboelastography variables, PCV, total solids concentration, platelet count, activated partial thromboplastin time, prothrombin time, fibrinogen concentration, and antithrombin concentration.
Results—All 4 thromboelastography variables had < 5% mean intra-assay variability. Mean values were as follows: reaction time, 4.3 minutes; clotting time, 1.6 minutes; α angle, 66.5°; and maximum amplitude, 56.4 mm. Compared with nonsedated cats, cats that required sedation had a significantly shorter clotting time and greater α angle, whereas reaction time and maximum amplitude were not significantly different.
Conclusions and Clinical Relevance—Kaolin-activated thromboelastography was a reliable test with unremarkable intra-assay variability in echocardiographically normal cats. Sedation may affect certain thromboelastography variables, but the effect is unlikely to be clinically important. It remains unknown whether subclinical cardiomyopathy has a significant effect on thromboelastography variables in cats.
Objective—To compare estimation of glomerular filtration rate determined via conventional methods (ie, scintigraphy and plasma clearance of technetium Tc 99m pentetate) and dynamic single-slice computed tomography (CT).
Animals—8 healthy adult cats.
Procedures—Scintigraphy, plasma clearance testing, and dynamic CT were performed on each cat on the same day; order of examinations was randomized. Separate observers performed GFR calculations for scintigraphy, plasma clearance testing, or dynamic CT. Methods were compared via Bland-Altman plots and considered interchangeable and acceptable when the 95% limits of agreement (mean difference between methods ± 1.96 SD of the differences) were ≤ 0.7 mL/min/kg.
Results—Global GFR differed < 0.7 mL/min/kg in 5 of 8 cats when comparing plasma clearance testing and dynamic CT; the limits of agreement were 1.4 and −1.7 mL/min/kg. The mean ± SD difference was −0.2 ± 0.8 mL/min/kg, and the maximum difference was 1.6 mL/min/kg. The mean ± SD difference (absolute value) for percentage filtration by individual kidneys was 2.4 ± 10.5% when comparing scintigraphy and dynamic CT; the maximum difference was 20%, and the limits of agreement were 18% and 23% (absolute value).
Conclusions and Clinical Relevance—GFR estimation via dynamic CT exceeded the definition for acceptable clinical use, compared with results for conventional methods, which was likely attributable to sample size and preventable technical complications. Because 5 of 8 cats had comparable values between methods, further investigation of dynamic CT in a larger sample population with a wide range of GFR values should be performed.
Objective—To test the ability of a nested PCR assay to detect Eimeria macusaniensis at various stages of infection in alpacas.
Animals—4 healthy adult alpacas with no detectable E macusaniensis.
Procedures—Alpacas were inoculated with 2 × 104 sporulated oocysts. Serial fecal samples collected during the next 38 days were tested via sucrose flotation and PCR assay.
Results—Oocyst passage was detected via fecal flotation in all 4 alpacas 31 to 35 days after inoculation. Three had positive results for PCR assays on samples obtained 7 to 14 days after inoculation. One alpaca subsequently was removed from the study because of weight loss and inappetence. Two remaining alpacas had positive PCR reactions 28 and 31 days after inoculation, up to 7 days before oocysts appeared in the feces. All fecal samples with positive results for flotation also had positive results for PCR assay.
Conclusions and Clinical Relevance—The PCR assay was able to detect early (7 to 14 days) and late (28 to 31 days) prepatent infection. These positive results suggested that the assay could have been detecting DNA unassociated with oocysts or detecting shedding earlier than has been previously recognized. The gap between the early and late detection periods may not be evident in alpacas receiving a larger or continuous inoculum, as might occur with natural infection. Use of a PCR assay for analysis of fecal samples may be valuable for detection of E macusaniensis during the prepatent period, thus aiding in the identification and control of infected animals.
Objective—To determine accuracy of the use of triaxial accelerometry for measuring daily activity as a predictor of maintenance energy requirement (MER) in healthy adult Labrador Retrievers.
Animals—10 healthy adult Labrador Retrievers.
Procedures—Dogs wore an accelerometer for two 2-week periods, with data on daily activity successfully collected for 24 to 26 days. These data, along with body weight, were used as independent variables in a multiple linear regression model to predict the dependent variable of daily MER. The predictive accuracy of the model was compared with that of a model that excluded activity. Dietary energy intake at a stated amount of body weight stability was used as an equivalent measure of MER in these analyses.
Results—The multiple linear regression model that included body weight and daily activity as independent variables could be used to predict observed MER with a mean absolute error of 63.5 kcal and an SE of estimation of 94.3 kcal. Removing activity from the model reduced the predictive accuracy to a mean absolute error of 129.8 kcal and an SE of estimation of 165.4 kcal.
Conclusions and Clinical Relevance—Use of triaxial accelerometers to provide an independent variable of daily activity yielded a marked improvement in predictive accuracy of the regression model, compared with that for a model that used only body weight. Improved accuracy in estimations of MER could be made for each dog if an accelerometer was used to record its daily activity.
Objective—To determine repeatability of a wireless, inertial sensor–based lameness evaluation system in horses.
Procedures—Horses were from 2 to 29 years of age and of various breeds and lameness disposition. All horses were instrumented with a wireless, inertial sensor-based motion analysis system on the head (accelerometer), pelvis (midline croup region [accelerometer]), and right forelimb (gyroscope) before evaluation in 2 consecutive trials, approximately 5 minutes apart, as the horse was trotted in a straight line. Signal-processing algorithms generated overall trial asymmetry measures for vertical head and pelvic movement and stride-by-stride differences in head and pelvic maximum and minimum positions between right and left sides of each stride. Repeatability was determined, and trial difference was determined for groups of horses with various numbers of strides for which data were collected per trial.
Results—Inertial sensor–based measures of torso movement asymmetry were repeatable. Repeatability for measures of torso asymmetry for determination of hind limb lameness was slightly greater than that for forelimb lameness. Collecting large numbers of strides degraded stride-to-stride repeatability but did not degrade intertrial repeatability.
Conclusions and Clinical Relevance—The inertial sensor system used to measure asymmetry of head and pelvic movement as an aid in the detection and evaluation of lameness in horses trotting in a straight line was sufficiently repeatable to investigate for clinical use.
Objective—To develop an antibody-based flow cytometric assay to detect coated platelets in dogs and to characterize the interaction of recombinant human coagulation factor VIIa with activated platelets from dogs with hemophilia A.
Sample—Platelets from 4 dogs with hemophilia A, 4 dogs with hemophilia B, 4 dogs with von Willebrand disease, and 6 hemostatically normal dogs.
Procedures—Freshly isolated platelets were activated with thrombin, convulxin, or a thrombin-convulxin combination. Resulting platelet phenotypes were resolved on the basis of P-selectin and fibrinogen expression, and binding of recombinant human coagulation factor VIIa to these distinct platelet subpopulations was measured by use of a flow cytometric assay.
Results—Coated platelets were identified on the basis of expression of α-granule fibrinogen and were generated in response to stimulation with the thrombin-convulxin combination but not to stimulation with either agonist alone. Approximately 70% of the platelets from dogs with hemophilia A, hemophilia B, and von Willebrand disease and from the control dogs had the coated platelet phenotype. Recombinant human coagulation factor VIIa bound preferentially to coated platelets with a mean ± SD binding equilibrium constant of 2.6 ± 0.5μM.
Conclusions and Clinical Relevance—Formation of coated platelets in dogs was similar to that in humans. Recombinant human coagulation factor VIIa bound preferentially to coated platelets from dogs.
Impact for Human Medicine—A similar mechanism of action for recombinant human coagulation factor VIIa may exist in dogs and humans. The potential for use of dogs in the study of bleeding disorders in humans was strengthened.