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Abstract
Objective—To determine the effect of azithromycin chemoprophylaxis on the cumulative incidence of pneumonia caused by Rhodococcus equi, age at onset of pneumonia, and minimum inhibitory concentration (MIC) of azithromycin for R equi isolates cultured from fecal and clinical samples.
Design—Controlled, randomized clinical trial.
Animals—338 foals born and raised at 10 equine breeding farms; each farm had a history of endemic R equi infections.
Procedures—Group 1 foals were control foals, and group 2 foals were treated with azithromycin (10 mg/kg [4.5 mg/lb], PO, q 48 h) during the first 2 weeks after birth. Foals were monitored for development of pneumonia attributable to R equi infection and for adverse effects of azithromycin. Isolates of R equi were tested for susceptibility to azithromycin.
Results—The proportion of R equi–affected foals was significantly higher for control foals (20.8%) than for azithromycin-treated foals (5.3%). Adverse effects of azithromycin treatment were not detected, and there were no significant differences between groups for the MICs of azithromycin for R equi isolates cultured from fecal or clinical samples.
Conclusions and Clinical Relevance—Azithromycin chemoprophylaxis effectively reduced the cumulative incidence of pneumonia attributable to R equi among foals at breeding farms with endemic R equi infections. There was no evidence of resistance to azithromycin. Nonetheless, caution must be used because it is possible that resistance could develop with widespread use of azithromycin as a preventative treatment. Further investigation is needed before azithromycin chemoprophylaxis can be recommended for control of R equi infections.
Abstract
OBJECTIVE To identify courses in which first-year veterinary students struggled academically and to survey veterinarians as to their opinions on existing prerequisite courses and proposed alternatives.
DESIGN Electronic surveys.
SAMPLE Associate deans for academic affairs at colleges of veterinary medicine and practicing veterinarians in North America and the Caribbean.
PROCEDURES Surveys were sent to associate deans of academic affairs seeking information on courses in which first-year veterinary students most commonly struggled academically. The 6 courses most commonly listed as prerequisites for admission to veterinary college were identified, and practitioners were asked to rank the relative importance of those courses for preparing students for veterinary college and to rank the importance of 7 potential alternative courses.
RESULTS Data were obtained from 21 associate deans and 771 practicing veterinarians. First-year veterinary students most commonly struggled academically in anatomy, physiology, and histology courses, but these courses were rarely included as prerequisites for admission. Practicing veterinarians agreed that anatomy and physiology should be considered as possible alternatives to 1 or more current prerequisite courses, such as organic chemistry and physics.
CONCLUSIONS AND CLINICAL RELEVANCE First-year veterinary students commonly encountered academic difficulties in anatomy, physiology, and histology. Because few surveyed veterinary colleges include these courses as prerequisites for admission, many students were exposed to this material for the first time as veterinary students, potentially adding to their academic difficulties and causing stress and anxiety. To help address this situation, veterinary colleges might consider replacing 1 or more current prerequisite courses (eg, organic chemistry and physics) with anatomy, physiology, and histology.
Abstract
Objective—To evaluate sensitivity and specificity of a multiplex polymerase chain reaction (PCR) assay for simultaneous detection of Rhodococcus equi and differentiation of strains that contain the virulence-associated gene (vapA) from strains that do not.
Sample Population—187 isolates of R equi from equine and nonequine tissue and environmental specimens and 27 isolates of bacterial species genetically or morphologically similar to R equi.
Procedure—The multiplex PCR assay included 3 gene targets: a universal 311-bp bacterial 16S ribosomal RNA amplicon (positive internal control), a 959-bp R equi-specific target in the cholesterol oxidase gene ( choE ), and a 564-bp amplicon of the vapA gene. Duplicate multiplex PCR assays for these targets and confirmatory singleplex PCR assays for vapA and choE were performed for each R equiisolate. An additional PCR assay was used to examine isolates for the vapB gene.
Results—Results of duplicate multiplex and singleplex PCR assays were correlated in all instances, revealing high specificity and reliability (reproducibility) of the vapA multiplex assay. Of the pulmonary isolates from horses with suspected R equi pneumonia, 97.4% (76/78) yielded positive results for vapA. Seven of 50 (14%) human isolates of R equi yielded positive results for vapA. Six human R equi isolates and 1 porcine isolate yielded positive results for vapB. No isolates with vapA and vapB genes were detected.
Conclusions and Clinical Relevance—The multiplex PCR assay is a sensitive and specific method for simultaneous confirmation of species identity and detection of the vapA gene. The assay appeared to be a useful tool for microbiologic and epidemiologic diagnosis and research. (Am J Vet Res 2005;66:1380–1385)
Abstract
Objective—To ascertain the frequency of ultrasonographic identification of liver at sites recommended for blind percutaneous liver biopsy in middle-aged horses and to determine whether the liver is obscured by other organs or too thin for safe sample collection at recommended locations.
Design—Prospective case series.
Animals—36 healthy middle-aged (between 6 and 18 years old) Quarter Horses or Quarter Horse crosses.
Procedures—Blood samples were collected from each horse and submitted for evaluation of liver function. Horses with any indication of liver dysfunction on serum biochemical analysis were excluded. The region just below a line drawn between the dorsal aspect of the tuber coxae and the point of the elbow joint in the right 11th, 12th, 13th, and 14th intercostal spaces (ICSs) was imaged by ultrasonography for the presence of liver. In each ICS, liver thickness and whether there was partial obstruction in viewing the liver caused by other abdominal or thoracic organs were recorded.
Results—39% (14/36) of horses had liver imaged on ultrasonographic examination in all of the 11th to 14th ICSs. None of the 36 horses had liver of adequate thickness (ie, liver thickness ≥ 3.5 cm) for biopsy in all of the imaged ICSs. For 22 horses in which the liver was not visible on ultrasonographic examination of an ICS, lung was imaged instead in 12 (55%) horses, intestine in 8 (36%), and both intestine and lung in 2 (9%).
Conclusions and Clinical Relevance—On the basis of the results of this study, the practice of blind percutaneous liver biopsy in horses is not recommended because of the risk of serious complications.
Abstract
Objective—To describe frequency, types, and clinical outcomes of extrapulmonary disorders (EPDs) in foals in which Rhodococcus equi infection was diagnosed, and to identify factors determined at the time of admission that differentiated foals that developed EPDs from foals with R equi infection identified only in the lungs.
Design—Retrospective case series.
Animals—150 foals aged 3 weeks to 6 months with a diagnosis of R equi infection.
Procedures—Medical records were reviewed for information on date of admission, signalment, history, clinical signs, diagnostic testing, treatment, duration of hospitalization, invoice, and outcome. For each EPD identified, further information was collected on the identification, location, treatment, and outcome of the lesion.
Results—Of 150 foals with R equi infections, 111 (74%) had at least 1 of 39 EPDs. Survival was significantly higher among foals without EPDs (32/39 [82%]) than among foals with EPDs (48/111 [43%]), but many EPDs were only recognized after death. Risk factors significantly associated with EPDs included referral status, duration of clinical signs prior to admission, leukocytosis, and neutrophilia. Foals with EPDs also had a higher heart rate and BUN concentration than foals without.
Conclusions and Clinical Relevance—Practitioners should recognize that extrapulmonary manifestations of R equi occur with high prevalence affecting diverse organ systems, that multiple systems are generally affected when EPDs occur, and that suspicion of R equi infection should prompt evaluation and monitoring of extrapulmonary sites. Improved recognition of the presence of these disorders will help practitioners to better advise their clients in the treatment and outcome of foals with R equi infections.
Abstract
Objective—To assess signalment, history, results of clinical and laboratory testing, and outcome for beef cattle with a left displaced abomasum (LDA), right displaced abomasum (RDA), or abomasal volvulus (AV).
Design—Retrospective study.
Animals—19 beef cattle with an AV, LDA, or RDA.
Procedure—Signalment; history; results of physical examination, diagnostic testing, and surgical exploration; and condition of the animal at discharge were obtained from medical records.
Results—Fourteen cattle had an AV, 4 had an RDA, and 1 had an LDA. Duration of clinical signs ranged from 1 to 21 days. Eighteen cattle had an AV or RDA; 7 were Brahmans, 12 were males, and median age was 10 months. Abdominal distention was observed in 11 cattle, heart rate of ≥ 100 beats/minute was detected in 14, and the abomasum was palpable per rectum in all cattle in which per rectal examination was performed. Leukocytosis, neutrophilia, hyperglycemia, azotemia, hypochloremia, and hypokalemia were common laboratory findings. At surgery, 3 cattle with an AV or RDA had a ruptured abomasum. Of the remaining 15 cattle, 12 survived.
Conclusions—Clinical course in beef cattle with an AV or RDA was more protracted than that typically associated with these conditions in dairy cattle, but survival rate in beef cattle that did not have rupture of the abomasum was sim ilar to that of dairy cattle.
Clinical Relevance—Abomasal displacement should be considered for beef cattle with abdominal distention. Prognostic indicators recommended for use in dairy cattle may not be useful for beef cattle. (J Am Vet Med Assoc 2000;216:730–733)
Abstract
Objective—To identify risk factors for enterolithiasis in horses.
Design—Matched case-control study.
Animals—26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group).
Procedure—Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis.
Results—Horses that were fed alfalfa hay, spent ≤ 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission.
Conclusions and Clinical Relevance—Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic. (J Am Vet Med Assoc 2000;216:1787–1794)
Abstract
Objective—To identify farm characteristics as risk factors for the development of Rhodococcus equi pneumonia in foals.
Design—Prospective matched case-control study.
Animals—2,764 foals on 64 equine breeding farms with 9,991 horses.
Procedure—During 1997, participating veterinarians completed paired data collection forms, 1 for a farm with ≥ 1 foal with R equi pneumonia and 1 for an unaffected control farm. Matched data were compared by use of conditional logistic regression analysis.
Results—Farm characteristics found in bivariate analyses to be associated with increased risk for pneumonia caused by R equi in foals included > 200 farm acres, ≥ 60 acres used in the husbandry of horses, > 160 horses, ≥ 10 mares housed permanently on the farm (resident mares), > 17 foals, > 0.25 foals/acre, and the presence of transient mares (mares brought temporarily to the farm for breeding or foaling) and their foals. Affected farms were significantly more likely to be > 200 acres in size and have ≥ 10 resident dam-foal pairs, whereas control farms were significantly more likely to have ≥ 75% of their dam-foal pairs housed permanently on the farm.
Conclusions and Clinical Relevance—Breeding farms with large acreage, a large number of mares and foals, high foal density, and a population of transient mares and foals are at high risk for foals developing pneumonia caused by R equi. (J Am Vet Med Assoc 2003;222:467–475)
Abstract
Objective—To determine whether foal management practices, environmental management, and preventative health practices are risk factors for development of Rhodococcus equi pneumonia in foals.
Design—Prospective matched case-control study.
Animals—2,764 foals on 64 equine breeding farms with 9,991 horses.
Procedure—During 1997, participating veterinarians completed paired data collection forms for comparison; 1 for an affected farm (containing ≥ 1 foal with pneumonia caused by R equi)and 1 for a control farm. Information collected pertained to stabling facilities, environmental management, foal husbandry, and preventative equine health practices.
Results—Matched farm data compared by use of conditional logistic regression indicated that personnel on affected farms were more likely to attend foal births, test foals for adequacy of passive immunity, administer plasma or other treatments to foals to supplement serum immunoglobulin concentrations, administer hyperimmune plasma prophylactically to foals, vaccinate mares and foals against Streptococcus equi infection, and use multiple anthelmintics in deworming programs. Affected farms were also more likely to have foals that developed other respiratory tract disorders and were approximately 4 times as likely to have dirt floors in stalls used for housing foals as were control farms.
Conclusions and Clinical Relevance—Rhodococcus equi pneumonia does not appear to be associated with poor farm management or a lack of attention to preventative health practices. Housing foals in stalls with dirt floors may increase the risk for development of R equi pneumonia. (J Am Vet Med Assoc 2003; 222:476–485)
Abstract
Objective—To evaluate the correlation between the half-time of liquid-phase gastric emptying (T50) determined by use of nuclear scintigraphy, using technetium Tc 99m pentetate, and absorption variables of orally administered acetaminophen in horses with experimentally delayed gastric emptying.
Animals—6 mature horses.
Procedure—Delayed gastric emptying was induced by IV injection of atropine sulfate. Twenty minutes later, acetaminophen and technetium Tc 99m pentetate were administered simultaneously via nasogastric tube. Serial lateral images of the stomach region were obtained, using a gamma camera. Power exponential curves were used for estimation of T50 and modified R2 values for estimation of goodness-of-fit of the data. Serial serum samples were obtained, and acetaminophen concentration was determined, using fluorescence polarization immunoassay. Maximum serum concentration (Cmax), time to reach maximum serum concentration (Tmax), area under the curve for 480 minutes, and the appearance rate constant were determined, using a parameter estimation program. Correlations were calculated, using a Spearman rank correlation coefficient.
Results—A significant correlation was detected between T50 determined by use of scintigraphy and Tmax determined by use of acetaminophen absorption. Correlation between T50 and other absorption variables of acetaminophen was not significant.
Conclusions and Clinical Relevance—The acetaminophen absorption method was a valid technique in this model of delayed gastric emptying in horses. The method may be a valuable tool for use in research as well as in clinical evaluation of gastric emptying in horses. (Am J Vet Res 2002;63:170–174)