Over a 24-month period, serum tumor necrosis factor (TNF) activity was determined in 289 horses with colic attributable to gastrointestinal tract disease. Serum TNF activity was quantitated by use of a modified in vitro cytotoxicity bioassay, using WEHI 164 clone-13 murine fibrosarcoma cells. Causes for colic, determined by clinical and laboratory evaluation, exploratory celiotomy, or necropsy included: gastrointestinal tract rupture (GTR); ileal impaction; small intestinal strangulating obstruction (SIO); proximal enteritis (PE); transient small intestinal distention; large-colon displacement; large-colon vovulus; large-colon impaction; colitis; small-colon obstruction; peritonitis; and unknown. Each diagnosis was placed into 1 of 3 lesion categories: inflammatory disorders (GTR, PE, colitis, peritonitis); strangulating intestinal obstruction (SIO, large-colon volvulus); and nonstrangulating intestinal obstruction (ileal impaction, transient small intestinal distension, large-colon displacement, large-colon impaction, small-colon obstruction, unknown). The prevalence of high serum TNF activity and/or mortality were evaluated. Differences were tested at significance level of P < 0.05. Approximately 20% of the 289 horses has serum TNF activity greater than that found in clinically normal horses (> 2.5 U/ml). Twenty-three horses (8%) had marked increase in serum TNF activity (greater than or equal to 10 U/ml) which was more prevalent among horses with SIO and PE than in horses of other diagnostic groups, except those with GTR. Mortality and marked increase in serum TNF activity were greater in horses with intestinal inflammatory disorders or strangulating intestinal obstruction than in horses with nonstrangulating intestinal obstruction. Similarly, a greater proportion of the horses that died had markedly high serum TNF activity than did horses that lived. Mortality of horses with serum TNF greater than or equal to 10 U/ml was greater than that of horses with serum TNF activity < 10 U/ml. Results indicate possible association between colic and serum TNF activity in horses and that high mortality may be associated with horses with markedly increased serum TNF activity.

peer reviewed | Myeloperoxidase (MPO) is a specific enzyme of neutrophil azurophilic granules with a strong oxidative activity. Thanks to a radioimmunoassay of equine myeloperoxidase, the authors have observed a significantly higher plasma level of MPO in horses operated for strangulation obstruction of the large intestine (n = 6) than in horses suffering from a non-strangulating displacement of the large intestine (n = 9). For the 2 groups, 3 phases were distinguished: reception (P1), intensive care (P2) and terminal phase (P3). The mean peak values of MPO for these phases were 121.6 ng/mL (P1), 168.6 ng/mL (P2), and 107.0 ng/mL (P3) for the non-strangulating group, and 242.6 ng/mL (P1); 426.0 ng/mL (P2), and 379.5 ng/mL (P3) for the strangulation group. The variations of the mean peak values of plasma MPO were significantly different between the 2 groups and between the different phases. A significant increase of the least square means of MPO was observed between P1 and P2. A significant decrease of the least square means of the number of circulating leukocytes was observed between P1 and P3. Polymorphonuclear neutrophil activation could play a major role in the pathogenesis of acute abdominal disease and endotoxic shock.

peer reviewed | Gastrointestinal disorders, especially strangulating intestinal obstructions, are still a major cause of illness and death in the horse. Circulating lipopolysaccharides may activate both neutrophils and monocytes. The activated neutrophils release myeloperoxidase (MPO), a specific enzyme with strong oxidative activity. The aim of this study was to evaluate MPO concentrations in the plasma and peritoneal fluid (PF) of horses with colic and to check the hypothesis that these concentrations would be higher in a case of strangulating obstruction than in cases of nonstrangulating disease. By using a specific enzyme-linked immunosorbent assay for equine MPO, we determined the MPO concentrations in horses admitted to a clinic for colic. Horses with nonstrangulating or strangulating obstruction of the large intestine (NSLI or SLI), strangulating obstruction of the small intestine (SSI), or inflammatory bowel disease (IBD) were compared with healthy horses. The horses with SLI, SSI, or IBD had significantly higher MPO levels in plasma and PF than did those in the other 2 groups. The mean plasma level was significantly higher in the horses with NSLI than in the healthy horses. High MPO values in PF indicated necrotic bowel. These results show that neutrophil activation occurs during nonstrangulating and strangulating intestinal obstruction in horses and that the plasma and PF MPO concentrations may be a marker of the severity of the disease.

peer reviewed | Techniques of cost-effectiveness analyses were applied to determine whether or not it is economically efficient to measure the packed cell volume (PCV) on a colic horse before deciding on abdominal surgery. The effects of this decision of uncertainty on the estimated values of the parameters (probability of survival after surgery, surgery costs, PCV positive predictive value, and length of survival after surgery) were considered along with the monetary values of collecting additional information on those parameters. The effects of uncertainty on the incremental net benefits of each alternative were depicted by tornado diagrams, cost-effectiveness acceptability curves, and posterior probability distributions. The worth of additional information was computed as the expected values of perfect and sampling information. Given previously published results, the best PCV cut-off point to distinguish between survivors and nonsurvivors was at 44%. At this threshold, the most economically effective alternative is to measure PCV before surgery providing the owner is willing to pay less than €672 for each year the horse survives. Uncertainty on probability of survival after surgery largely influenced the decision whether or not to measure the PCV, but one should spend at most €381 in research to reduce this uncertainty. A study of postoperative survival of 500 colic horses would ensure an expected gain of €370 associated with a reduction in uncertainty.

One of the most common diseases in horse breeding is colic. Colic cases are the leading cause of horse loss and economic loss in Turkey as well as the whole world. Failure to the effective management of colic is a major obstacle in obtaining the desired yield of sport horses in Turkey and it is thought that most people are away from horse breeding and equestrian sports due to this reason. The objectives of this study are to set forth the prevalence and cost of colic cases in sport horses for two years and, present the rate of recurrent colic cases in the same period respectively. Throughout the study, economical and some technical parameters related to the course of the disease were obtained between January 2017 and December 2018. Interviews and data collection were conducted from 984 sport horses in all ages and gender for 24 months. The collected data were recorded and processed in the database created via MS Excel 2010 and IBM SPSS 22 for Windows. The average cost of colic management for a 4-day treatment in 2018 was $215.60. The rate of recurrent colic cases was 48,2% and the development of laminitis was 11,9% in a year following the treatment. As a result, it was estimated that the average annual economic loss of colic in 984 horses was $36.806 in addition to horse losses. Horses that survived spontaneously, without any invasive treatment, and suffering from different disorders other than colic, were removed from the study. It is concluded that reduction of cost in colic cases and prevention of recurrent colic cases and post-colic diseases, such as laminitis, would increase horse welfare and yield from horses in Turkey.

OBJECTIVE To characterize epithelial cells of the small intestine and colon in horses without clinical gastrointestinal abnormalities with an emphasis on the stem cell niche constituents. SAMPLE Mucosal biopsy specimens from small and large intestines obtained from 12 horses euthanized for reasons unrelated to gastrointestinal disease or systemic disease. PROCEDURES Intestinal biopsy specimens were collected by sharp dissection immediately following euthanasia. Specimens were prepared for immunohistochemical, immunofluorescence, and transmission electron microscopic imaging to detect and characterize each epithelial cell type. Antibodies against protein biomarkers for cellular identification were selected on the basis of expression in other mammalian species. RESULTS Intestinal epithelial cell types were identified by means of immunostaining and morphological characterization with transmission electron microscopy. Some differences in biomarker expression and antibody cross-reactivity were identified in equine tissue, compared with other species. However, each known type of mucosal epithelial cell was identified in equine tissue. CONCLUSIONS AND CLINICAL RELEVANCE The methodology used can enhance detection of stem cells and progenitor cells as well as postmitotic cell lineages in equine intestinal tissues. Results may have relevance to regenerative potential of intestinal mucosa and survival in horses with colic.

Objective-To compare effects of 2 acetylcholinesterase inhibitors on recovery quality of horses anesthetized with isoflurane. Animals-6 horses in phase 1, 7 horses in phase 2A, and 14 horses in phase 2B. Procedures-The study comprised 3 phases (2 randomized, blinded crossover phases in horses undergoing orthopedic procedures and 1 prospective dose-determining phase). In phase 1, horses were anesthetized with isoflurane and received neostigmine or saline (0.9% NaCl) solution prior to anesthetic recovery. Phase 2A was a physostigmine dose-determining phase. In phase 2B, horses were anesthetized with isoflurane and received neostigmine or physostigmine prior to recovery. Objective recovery events were recorded and subjective visual analogue scale scores of recovery quality were assigned from video recordings. Results-Recovery measures in phase 1 were not different between horses receiving neostigmine or saline solution. In phase 2A, 0.04 mg of physostigmine/kg was the highest cumulative dose that did not cause clinically relevant adverse behavioral or gastrointestinal effects. Horses receiving physostigmine had higher mean +/- SD visual analogue scale recovery scores (70.8 +/- 13.3 mm) than did horses receiving neostigmine (62.4 +/- 12.8 mm) in phase 2B, with fewer attempts until sternal and standing recovery. Incidence of colic behavior did not differ among groups. Conclusions and Clinical Relevance-Inhibition with physostigmine improved anesthetic recovery quality in horses anesthetized with isoflurane, compared with recovery quality for horses receiving neostigmine. Inhibition of central muscarinic receptors by inhalation anesthetics may underlie emergence delirium in horses recovering from anesthesia.

Objective-To assess pharmacokinetics of pregabalin in horses after a single intragastric or IV dose. Animals-5 healthy adult mares. Procedures-Horses received 1 dose of pregabalin (approx 4 mg/kg) via nasogastric tube in a crossover-design study; after a 3-week washout period, the same dose was administered IV. Food was not withheld. Plasma pregabalin concentrations in samples obtained 0 to 36 hours after administration were measured by use of ultra-performance liquid chromatography with triple quadrupole tandem mass spectrometry. Pharmacokinetic variables were estimated by means of noncompartmental analysis. Results-Mild sedation was observed in 2 horses following intragastric and IV pregabalin administration. Signs of mild, transient colic or behavioral abnormalities were observed in all horses following IV administration. After intragastric administration, median (range) maximal plasma concentration was 5.0 μg/mL (4.4 to 6.7 μg/mL), time to maximal plasma concentration was 1. 0 hour (0.5 to 2.0 hours), elimination half-life was 8.0 hours (6.2 to 9.4 hours), and area under the curve from time 0 to infinity (AUC(0-∞)) was 47.2 μg·h/mL (36.4 to 58.4 μg·h/mL). After IV administration, initial concentration was 22.2 μg/mL (19.8 to 27.7 μg/mL), elimination half-life was 7.74 hours (6.94 to 8.17 hours), and AUC0-∞ was 48.3 μg·h/mL (44.8 to 57.2 μg·h/mL). Bioavailability was 97.7% (80.7% to 109.8%). Median predicted values for minimal, mean, and maximal steady-state plasma concentrations after intragastric administration assuming an 8-hour dosing interval were 3.9, 5.3, and 6.3 μg/mL, respectively. Conclusions and Clinical Relevance-At a simulated intragastric dosage of approximately 4 mg/kg every 8 hours, median pregabalin steady-state plasma concentration in healthy horses was within the therapeutic range reported for humans. Therapeutic concentrations and safety of this dosage have not been established in horses.

Objective: To determine whether the method of lipopolysaccharide (LPS) administration (intermittent vs continuous) affects the magnitude and duration of the systemic inflammatory response in horses and whether prolonged (48 hours) endotoxemia induces laminitis. Animals: 12 healthy adult horses (10 mares and 2 geldings). Procedures: Horses were randomly assigned to receive LPS (total dose, 80 μg; n = 4) or saline (0.9% NaCl) solution (80 mL/h; 4) via constant rate infusion or 8 bolus IV injections of LPS (10 μg, q 6 h;4) during a 48-hour period. Physical examinations were performed every 4 hours, inflammatory cytokine gene expression was determined for blood samples obtained every 8 hours, and IV glucose tolerance tests were performed. Results: All LPS-treated horses had signs of depression and mild colic; those signs abated as the study progressed. Administration of LPS increased expression of interleukin-1β, interleukin-6, and interleukin-8, but results were not significantly different between LPS treatment groups. Cytokine expression was significantly higher on the first day versus the second day of LPS treatment. Interleukin-1β expression was positively correlated with rectal temperature and expression of other cytokines. Glucose and insulin dynamics for both LPS groups combined did not differ significantly from those of the saline solution group. Signs of laminitis were not detected in any of the horses. Conclusions and Clinical Relevance: Horses developed LPS tolerance within approximately 24 hours after administration was started, and the method of LPS administration did not affect the magnitude or duration of systemic inflammation. Laminitis was not induced in horses.

Objective—To determine whether administration of lidocaine during ischemia and reperfusion in horses results in concentrations in smooth muscle sufficient to protect against the negative consequences of ischemia-reperfusion injury on smooth muscle motility. Animals—12 horses. Procedures—Artificial ischemia and reperfusion injury of jejunal segments was induced in vivo in conjunction with lidocaine treatment during ischemia (IRL) or without lidocaine treatment (IR). Isometric force performance was measured in vitro in IRL and IR smooth muscle preparations with and without additional in vitro application of lidocaine. Lidocaine concentrations in smooth muscle were determined by means of high-performance liquid chromatography. To assess the influence of lidocaine on membrane permeability, activity of creatine kinase and lactate dehydrogenase released by in vitro incubated tissues was determined biochemically. Results—In vivo administration of lidocaine allowed maintenance of contractile performance after an ischemia and reperfusion injury. Basic contractility and frequency of contractions were significantly increased in IRL smooth muscle tissues in vitro. Additionally, in vitro application of lidocaine achieved further improvement of contractility of IR and IRL preparations. Only in vitro application of lidocaine was able to ameliorate membrane permeability in smooth muscle of IR and IRL preparations. Lidocaine accumulation could be measured in in vivo treated samples and serum. Conclusions and Clinical Relevance—In vivo lidocaine administration during ischemia and reperfusion had beneficial effects on smooth muscle motility. Initiating lidocaine treatment during surgery to treat colic in horses may improve lidocaine's prokinetic features by protecting smooth muscle from effects of ischemia and reperfusion injury.