Objectives—To measure serum polymyxin B concentration after single and repeated IV infusions in horses.
Animals—5 healthy horses.
Procedures—In study 1, 1 mg (6,000 U) of polymyxin B/kg was given IV and blood samples were collected for 24 hours. In study 2, 1 mg of polymyxin B/kg was given IV every 8 hours for 5 treatments and blood samples were collected until 24 hours after the last dose. Polymyxin B concentration was measured as the ability to suppress nitrite production by murine macrophages stimulated with lipopolysaccharide and interferon-α. Urine was collected prior to the first drug infusion and 24 hours after the fifth drug infusion for determination of urinary γ-glutamyl transferase (GGT)to-creatinine ratios.
Results—In study 1, mean ± SEM maximal serum polymyxin B concentration was 2.93 ± 0.38 μg/mL. Polymyxin B was undetectable 18 hours after infusion. In study 2, maximal polymyxin B concentrations after the first and fifth doses were 2.98 ± 0.81 μg/mL and 1.91 ± 0.50 μg/mL, respectively. Mean trough concentration for all doses was 0.22 ± 0.01 μg/mL. A significant effect of repeated administration on peak and trough serum concentration was not detected. Urine GGT-to-creatinine ratios were not affected by polymyxin B administration.
Conclusions and Clinical Relevance—Polymyxin B given as multiple infusions to healthy horses by use of this protocol did not accumulate in the vascular compartment and appeared safe. Results support repeated IV use of 1 mg of polymyxin B/kg at 8-hour intervals as treatment for endotoxemia.
Objective—To investigate the use of a specific antibody index (AI) that relates Sarcocystis neurona–specific IgG quotient (QSN) to total IgG quotient (QIgG) for the detection of the anti–S neurona antibody fraction of CNS origin in CSF samples obtained from horses after intragastric administration of S neurona sporocysts.
Animals—18 adult horses.
Procedures—14 horses underwent intragastric inoculation (day 0) with S neurona sporocysts, and 4 horses remained unchallenged; blood and CSF samples were collected on days – 1 and 84. For purposes of another study, some challenged horses received intermittent administration of ponazuril (20 mg/kg, PO). Sarcocystis neurona–specific IgG concentrations in CSF (SNCSF) and plasma (SNplasma) were measured via a direct ELISA involving merozoite lysate antigen and reported as ELISA units (EUs; arbitrary units based on a nominal titer for undiluted immune plasma of 100,000 EUs/mL). Total IgG concentrations in CSF (IgGCSF) and plasma (IgGplasma) were quantified via a sandwich ELISA and a radial immunodiffusion assay, respectively; QSN, QIgG, and AI were calculated.
Results—Following sporocyst challenge, mean ± SEM SNCSF and SNplasma increased significantly (from 8.8 ± 1.0 EUs/mL to 270.0 ± 112.7 EUs/mL and from 1,737 ± 245 EUs/mL to 43,169 ± 13,770 EUs/mL, respectively). Challenge did not affect total IgG concentration, QSN, QIgG, or AI.
Conclusions and Clinical Relevance—S neurona–specific IgG detected in CSF samples from sporocyst-challenged horses appeared to be extraneural in origin; thus, this experimental challenge may not reliably result in CNS infection. Calculation of a specific AI may have application to the diagnosis of S neurona–associated myeloencephalitis in horses.
A 12-year-old 510-kg (1,122-lb) Thoroughbred mare was evaluated because of an 8-week history of sudden-onset nonprogressive hind limb ataxia. There had been minimal to no clinical improvement following multiple treatments (administration of ponazaril, toltrazuril, decoquinate, and levamisole) for equine protozoal myeloencephalitis (EPM). Heart and respiratory rates were within reference limits, and rectal temperature was slightly high (38.7°C [101.7°F]). The remainder of the physical examination findings were unremarkable.
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Signalment: An 8-year-old female mixed-breed pony that had been shown successfully as a hunter pony.
History: The pony was referred for evaluation because of a sudden onset of head tilt and circling. One day prior to the initial evaluation, the pony's head became tilted to the left with the neck turned to the right; the pony was reluctant to move to the left, but remained alert and responsive. Flunixin meglumine (1.1 mg/kg [0.5 mg/lb], IV, once) was administered with no improvement.
Physical examination: Findings of a physical examination were unremarkable.
Objective—To estimate prevalence of and identify factors associated with anhidrosis in horses in Florida.
Design—Cross-sectional study and case-control study.
Animals—4,620 horses on 500 farms.
Procedures—A questionnaire was structured and mailed to farm owners or managers to obtain information related to diagnosis of anhidrosis in horses and exposure factors associated with this condition. The frequency of investigated farm- and animal-level factors was compared between farms and horses affected and not affected with anhidrosis, respectively.
Results—The prevalence of anhidrosis was 11% at the farm level and 2% at the animal level. The odds of anhidrosis were 2.13 and 4.40 times as high in farms located in central and southern Florida, respectively, compared with odds for farms in northern Florida. The odds of anhidrosis were 5.26 and 15.40 times as high in show and riding instruction operations, respectively, compared with odds for ranch operations. At the animal level, breed (Thoroughbreds and warmblood horses), foaling place (western or midwestern region of the United States), and family history of anhidrosis were significantly associated with anhidrosis.
Conclusions and Clinical Relevance—This study provides new information on the prevalence of and factors for anhidrosis in horses in Florida. Horses with a family history of anhidrosis should be examined by a veterinarian for diagnosis of this condition before they are exposed to exercise in a hot and humid climate.
Case Description—A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye.
Clinical Findings—Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulcer-ation of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic examination revealed right-sided otitis media. Temporohyoid osteoarthropathy in the right guttural pouch and mycosis in the left guttural pouch were diagnosed.
Treatment and Outcome—Ceratohyoidectomy of the right stylohyoid bone was performed, and the left internal carotid artery was occluded via placement of stainless steel spring embolization coils. The mare regained the ability to eat without difficulty and improved clinically for approximately 4 weeks. However, the mare returned to the medical center 53 days after surgery with left-sided Horner syndrome, atrophy of the right side of the tongue, and a 3-week history of dysphagia and weight loss. Endoscopic evaluation revealed progression of mycotic growth in the left guttural pouch. The mare was euthanatized.
Clinical Relevance—Although the mycotic lesion in the left guttural pouch was an incidental finding at the time of initial examination, the lesion progressed to cause dysphagia and Horner syndrome after occlusion of the left internal carotid artery, a treatment that is typically associated with resolution of guttural pouch mycosis. Arterial occlusion is not necessarily a reliable method of resolving guttural pouch mycosis.
A 2-year-old Thoroughbred filly in race training was found in its stall with signs of lethargy and periorbital swelling and a corneal ulcer in the left eye; there appeared to be no vision in that eye. These signs were attributed to unobserved head trauma. Over a 3-day period, medical management of the ulcer with topical administration of antimicrobials and atropine was unsuccessful, and the horse was referred for further evaluation. The horse had been treated with acupuncture 2 months earlier for suspected pelvic limb weakness. At the referral examination, the upper eyelid of the left eye was swollen with chemosis
Objective—To evaluate the effect of intermittent oral administration of ponazuril on immunoconversion against Sarcocystis neurona in horses inoculated intragastrically with S neurona sporocysts.
Animals—20 healthy horses that were seronegative for S neurona–specific IgG.
Procedures—5 control horses were neither inoculated with sporocysts nor treated. Other horses (5 horses/group) each received 612,500 S neurona sporocysts via nasogastric tube (day 0) and were not treated or were administered ponazuril (20 mg/kg, PO) every 7 days (beginning on day 5) or every 14 days (beginning on day 12) for 12 weeks. Blood and CSF samples were collected on day – 1 and then every 14 days after challenge for western blot assessment of immunoconversion. Clinical signs of equine protozoal myeloencephalitis (EPM) were monitored, and tissues were examined histologically after euthanasia.
Results—Sera from all challenged horses yielded positive western blot results within 56 days. Immunoconversion in CSF was detected in only 2 of 5 horses that were treated weekly; all other challenged horses immunoconverted within 84 days. Weekly administration of ponazuril significantly reduced the antibody response against the S neurona 17-kd antigen in CSF. Neurologic signs consistent with EPM did not develop in any group; likewise, histologic examination of CNS tissue did not reveal protozoa or consistent degenerative or inflammatory changes.
Conclusions and Clinical Relevance—Administration of ponazuril every 7 days, but not every 14 days, significantly decreased intrathecal anti–S neurona antibody responses in horses inoculated with S neurona sporocysts. Protocols involving intermittent administration of ponazuril may have application in prevention of EPM.
Case Description—Two geldings, aged 11 and 17 years, were examined for treatment of ureteroliths located approximately 10 cm proximal to the bladder.
Clinical Findings—Ureteral obstruction was an incidental finding in 1 horse that was referred because of urinary tract obstruction and a cystic calculus. This horse did not have clinical or laboratory evidence of renal failure, although severe hydronephrosis was evident on transabdominal ultrasonography. The second patient had a serum creatinine concentration of 6.3 mg/dL (reference range, 0.8 to 2.2 mg/dL) and mild hydronephrosis of the affected left kidney.
Treatment and Outcome—In both patients, the obstructed ureter was exteriorized through a flank incision as a standing procedure, and the calculus was crushed and removed with a uterine biopsy forceps introduced through a ureterotomy approximately 25 cm proximal to the calculus. The cystic calculus was removed through a perineal urethrostomy by lithotripsy, piecemeal extraction, and lavage. The horse without azotemia developed pyelonephritis in the affected kidney and was euthanatized because of complications of a nephrectomy 13 months later. In the horse with azotemia, the serum creatinine concentration decreased after surgery, and the horse returned to its intended use. However, it was euthanatized approximately 2 years after surgery because of progressive renal failure, and a large nephrolith was found in the previously unobstructed right kidney.
Clinical Relevance—The technique used for ureterolith removal was successful in both horses in this report, did not require sophisticated equipment, and could be effective in the early stages of ureteral obstruction as a means of restoring urine flow and renal function. The outcome in the horse with advanced unilateral renal disease without azotemia would suggest that nephrectomy should be considered as a treatment in such patients.