Background: The relationship between Thoroughbred yearling laryngeal function (YLF) grade and race performance is unclear. Objectives: To determine the effect of YLF on future race performance. Study design: Retrospective cohort study. Methods: Post-sale endoscopic recordings were reviewed from Australian yearling sales in 2018-2019. Race performance was evaluated for career and as 2-, 3- and >= 4-year-olds. Multivariable generalised linear modelling examined the association between YLF and performance, with risk estimates presented as coefficients (95% CI). Results: The YLF in 5175 examinations was graded I in 29.8% (n = 1542); II.1 in 49.0% (n = 2537), II.2 in 16.5% (n = 855), III.1 in 3.9% (n = 200), III.2 in 0.8% (n = 39) and III.3 in <0.04% (n = 2). Additional endoscopic abnormalities included ventroaxial luxation of the corniculate process (VLAC, n = 77, 1.5%); arytenoid mucosal lesions (n = 392, 7.6%) and intermittent dorsal displacement of the soft palate (iDDSP, n = 1264, 24.4%). Median (IQR) career earnings were: grade I $45 095 ($15 565, $113 220); grade II.1 $45 315 ($15 915, $107 490), grade II.2 $38 610 ($14 326, $95 218), grade III.1 $32 765 ($8565, $86 030) and grade III.2 $35 810 ($3700, $65 770). There was no difference in career earnings for YLF grades II.2 and III.1, compared with referent grade I/II.1, whereas grade III.2 earned less overall (-$46 015 (95% CI: -$89 994, -$2036), p = 0.04). Earnings in >= 4-year-olds were less for grades III.1 (-$35 076 (-$56 129, -$14 024), p = 0.001) and III.2 (-$53 219, (-$76 062, -$30 375) p < 0.001). Main limitations: Lack of follow-up data due to retrospective nature of study. Exclusion of unraced horses and those with no prize money from analysis. Conclusions: Ninety-five percent of the yearling population had grades I, II.1 or II.2 YLF and minimal difference in race performance was identified between them. Horses with grade III.1 YLF performed similarly to grades I/II.1 in their early careers but had reduced race performance at >= 4-year-old.
Back pain and diseases of the spine are prevalent issues in sport horses, with diagnosis of the underlying pathology proving a challenge for the clinician. Historically, veterinary medicine, like human medicine, has concentrated on identifying the pain generator linked to specific anatomical lesions. However, significant work in human back pain patients has revealed that many cases exhibit no identifiable lesion on imaging, or that changes to images may not correlate with the patient’s pain. This has resulted in physiotherapy-led research focusing on effects of acute, sub-acute and chronic pain on spinal muscles, as well as the implications for rehabilitation. This review aims to summarize existing literature on muscular changes due to back pain in both human and equine patients, while exploring the physiotherapy-led rehabilitation principles tailored to the various stages of back pain.
Fibrosis of muscle spindles (sensory organs) in back muscles induced by intervertebral disc (IVD) degeneration could limit transmission of muscle stretch to the sensory receptor and explain the proprioceptive deficits common in back pain. Exercise reduces back muscles fibrosis. This study investigated whether targeted muscle activation via neurostimulation reverses or resolves muscle spindle fibrosis in a model of IVD injury. In eighteen sheep, lumbar (L)1–2 and L3-4 IVD degeneration was induced by partial thickness anulus fibrosis incision and a neurostimulator was implanted. After IVD-degeneration developed for 3 months, neurostimulation of the L2 nerve root activated multifidus in nine randomly selected animals. Multifidus muscle adjacent to the spinous process of L2 (non-stimulated) and L4 (stimulated) was harvested 3 months after activation. Muscle spindles were identified in Van Giessen’s-stained sections. Connective tissue spindle capsule thickness, and cross-sectional area (CSA) of the spindle, its periaxial fluid and sensory elements were measured. Immunofluorescence assays evaluated Collagen-I and -III. Multifidus muscle spindle capsule thickness and Collagen-1 were significantly less in the neurostimulation animals than IVD-injury animals at L4 (stimulated muscle) (P < 0.05), but not L2 (non-stimulated muscle). Spindle capsule thickness was less in lateral than medial regions. CSA of the muscle spindle and sensory elements was less in neurostimulated animals at L4. Targeted multifidus activation reverses or prevents accumulation of connective tissue of the multifidus muscle spindle capsule caused by IVD injury. Reduced fibrosis should maintain sensory function of this important muscle mechanoreceptor and might provide an effective solution to resolve the commonly identified proprioceptive deficits in back pain and maintain healthy spine function.
OBJECTIVE:Evaluate a prototype dynamic laryngoplasty system (DLPS) in horses; a feasibility study.ANIMALS:7 healthy Standardbred adult horses.METHODS:This was an in vivo experimental study. Horses had a standing surgical procedure to induce complete laryngeal hemiplegia, which was subsequently treated using the dynamic laryngoplasty system (DLPS). Activation of the DLPS was achieved using an injection port exiting through the skin (n = 2) or a subcutaneous injection port (n = 5). For each horse, endoscopic examinations of the upper respiratory tract were performed preoperatively, intraoperatively, and 7 days postoperatively. Left-to-right quotient ratios calculated during inactivated and activated states were obtained from still images of the rima glottidis acquired during day 7. In 3 horses, the device was intentionally overinflated to evaluate for device failure, and postmortem examinations were performed on day 7. For the remaining 4 horses, upper respiratory tract endoscopy was repeated at 1 month postoperatively, with no subsequent postmortem exam.RESULTS:No perioperative complications occurred, and the DLPS was effectively delivered in all horses under standing sedation. The left-to-right quotient ratio at day 7 postoperatively could be altered from a resting position of 0.76 (± 0.06) to a maximum of 0.97 (± 0.06; P < .05). The degree of arytenoid abduction could not be significantly altered after 1 month of device implantation, suspected to be due to peri-implant fibrosis. No coughing nor tracheal contamination was observed at all time points or during inflation.CLINICAL RELEVANCE:The ability to alter the degree of abduction at 7 days postoperatively with the DLPS may be beneficial in selective cases.
OBJECTIVE:To describe left recurrent laryngeal neurectomy (LRLn) performed under standing sedation and evaluate the effect of LRLn on upper respiratory tract function using a high-speed treadmill test (HST). We hypothesized that (1) unilateral LRLn could be performed in standing horses, resulting in ipsilateral arytenoid cartilage collapse (ACC); and (2) HST after LRLn would be associated with alterations in upper respiratory function consistent with dynamic ACC.ANIMALS:6 Thoroughbred horses.METHODS:The horses were trained and underwent a baseline HST up to 14 m/s at 5% incline until fatigue. Evaluation included; airflow, pharyngeal and tracheal pressures, and dynamic upper respiratory tract endoscopy. Trans-laryngeal impedance (TLI) and left-to-right quotient angle ratio (LRQ) were calculated after testing. The following day, standing LRLn was performed in the mid-cervical region. A HST was repeated within 4 days after surgery.RESULTS:Standing LRLn was performed without complication resulting in Havemayer grade 4 ACC at rest (complete paralysis) and Rakestraw grade C or D ACC (collapse up to or beyond rima glottis midline) during exercise. Increasing treadmill speed from 11 to 14 m/s increased TLI (P < .001) and reduced LRQ (P < .001). Neurectomy resulted in an increase in TLI (P = .021) and a reduction in LRQ (P < .001).CLINICAL RELEVANCE:Standing LRLn induces laryngeal hemiplegia that can be evaluated using a HST closely after neurectomy. Standing LRLn may be useful for future prospective evaluations of surgical interventions for laryngeal hemiplegia.
Purpose Aerobic exercise produces beneficial outcomes in patients with low back pain and partially attenuates the fibrotic changes to the multifidus in a model of intervertebral disc (IVD) degeneration. More targeted exercise might be required to fully attenuate these fibrotic alterations. This study aimed to investigate whether activation of the multifidus induced by neurostimulation could reduce fibrosis of the multifidus in a model of IVD degeneration in sheep.Methods IVD degeneration was induced in 18 merino sheep via a partial thickness unilateral annulus fibrosus lesion to the L1/2 and L3/4 IVDs. All sheep received an implantable neurostimulation device that provides stimulation of the L2 medial branch of the dorsal ramus. Three months after surgery, the animals were assigned to Injury or Activated groups. Activated animals received neurostimulation and the Injury group received no stimulation. Six months after surgery, the multifidus was harvested at L2 and L4. Van Gieson's, Sirius Red and immunofluorescence staining for Collagen-I and -III and quantitative PCR was used to examine fibrosis. Muscle harvested from a previous study without IVD injury was used as a control.Results Neurostimulation of the multifidus attenuated IVD degeneration dependent increases in the connective tissue, including Collagen-I but not Collagen-III, compared to the Injury group at L4. No measures of the multifidus muscle at L2, which received no stimulation, differed between the Injury and Activated groups.Conclusions These data reveal that targeted activation of the multifidus muscle attenuates IVD degeneration dependent fibrotic alterations to the multifidus.
IntroductionThe veterinary yearling pre-sale repository radiographs have the potential to impact both vendor and prospective purchaser. The primary aim of this study was to determine inter-observer agreement for orthopaedic lesions identified in thoroughbred yearling repository radiographs. A secondary goal was to determine agreement when using a pre-defined risk rating classification.MethodsThree experienced specialist equine surgeons (2 ACVS & 1 FANZCVS) interpreted thirty repository radiographs once each for radiographic abnormalities. Each radiographic abnormality was given an associated risk assessment for future racing performance.ResultsThe use of a pre-defined risk rating grading scale resulted in good to excellent agreement as observers reached a consensus on risk ratings for lesions 97.1% of the time. The highest agreement was for the proximal interphalangeal joint and distal interphalangeal joint, with 99.9 and 98.2% agreement, respectively. The tarsal region was the joint with the highest disagreement with respect to pathology, with observers disagreeing 5.2% of the time.DiscussionThis study found that experienced veterinary surgeons reliably agreed on the absence of lesions but showed disagreement on the specific risk rating of common lesions.
OBJECTIVE:To identify thoroughbred industry stakeholders' views on the yearling sales endoscopy in Australia. DESIGN:Semi-structured qualitative group interviews with equine veterinarians, thoroughbred breeders and yearling purchasers. METHODS:Twenty-nine experienced thoroughbred industry stakeholders participated in online focus groups: (1) equine veterinarians involved in yearling endoscopy; (2) thoroughbred breeders; and (3) yearling buyers. The focus groups were audio and video recorded and digital whiteboards were available. Data was transcribed, live-coded and analysed thematically. RESULTS:The main themes identified included the uncertainty surrounding the relationship between yearling laryngeal function and future performance, especially the significance of yearlings with grade 3 out of 5 laryngeal function; interobserver variability in the laryngeal function grade assigned by veterinarians to the same endoscopic exam; and the presence of intra-horse variability in laryngeal function over different time points. DISCUSSION:Stakeholders raised multiple concerns about the current yearling sales endoscopy process in Australia. Recommendations to address these concerns include further investigation into the race performance of yearlings identified with grade 3 laryngeal function; training of veterinarians to reduce inter-observer variability; and the need to determine the most appropriate grading system to use in yearlings. Future research should evaluate the significance of intra-horse variability in a yearling population.
Background: Yearling laryngeal function (YLF) is frequently assessed at the time of sale and the outcomes of these assessments can have significant economic implications. The YLF of horses that subsequently underwent a prosthetic laryngoplasty (PL) is unknown. Objectives: We hypothesised horses with YLF >= grade II.2 would be at increased risk of requiring PL, compared with YLF = grade II.2 had an OR of 4.61 (3.0, 7.1, p < 0.001) compared with = grade III.1 had an OR of 10.7 (5.6, 20.4, p < 0.001) compared with
A 3-month-old Warmblood colt was referred for evaluation of coughing and dysphagia. An asymmetrical, short defect of the soft palate and secondary aspiration pneumonia was diagnosed and surgically treated with a standing laryngeal tie-forward procedure. Intraoperative endoscopy was used to guide the procedure and confirm appropriate epiglottic positioning. By 4 days post-operatively, the dysphagia resolved. Upper respiratory tract endoscopy performed 2 days post-operatively confirmed maintenance of the intraoperative laryngohyoid positioning. When contacted 2 years post-operatively, the owner reported being satisfied with the outcome of surgery. Clinical signs of dysphagia had resolved in 4 days and pneumonia within 2 months of surgery. This report demonstrates that small cleft palate defects can be treated successfully in foals using a standing laryngeal tie-forward. When used in appropriate cases, the technique provides a valid alternative to primary closure, which mitigates the need for general anaesthesia in a potentially high-risk population.
Abstract Background Little is known about potential differences in the left recurrent laryngeal nerve (Lrln) and left cricoarytenoideus dorsalis (LCAD) muscle between domestic and feral horse populations. If a difference exists, feral horses may provide a useful control population for research related to recurrent laryngeal neuropathy (RLN) and increase our understanding of potential population pressures influencing the incidence RLN. Objectives The objective of this study was to compare the Lrln and LCAD of domestic and feral horses using histological and immunohistochemical techniques (IHC). Methods Sixteen horses, domestic (n = 8) and feral (n = 8), without clinical or ancillary examinations that were processed at an abattoir had the Lrln and LCAD muscle harvested immediately following death. Carcass weights were recorded. Subjective and morphometric histologic assessment were performed on Lrln sections. The LCAD was assessed for myosin heavy chain (fibre type proportion, diameter and grouping using IHC. Results Fibre‐type grouping consistent with RLN was seen in both groups. Regenerating fibre clusters were more common in domestic compared to feral horses (p = 0.04). No other histologic differences occurred between groups. Muscle fibre typing demonstrated a lower mean percentage of type IIX fibres in the feral group compared to the domestic group (p = 0.03). There was no difference in type I or IIA proportions or mean diameter of any fibre type between the groups. Conclusions The domestic population showed evidence of nerve regeneration suggesting RLN in this group, yet this was not supported by the higher proportion of type IIX muscle fibres compared to the feral population. Further evaluation to clarify the significance and wider occurrence of the differences is indicated.
Most catastrophic injuries in Thoroughbred racehorses involve the fetlock. There is no description of comparative imaging in Thoroughbreds entering racehorse training. The aim was to describe MRI, CT and radiographic findings in the metacarpophalangeal joint of non-lame Thoroughbred yearlings. Forty Thoroughbreds underwent low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints. Images were assessed subjectively. A hypoattenuating lesion of the sagittal ridge of the third metacarpal bone (McIII) was identified in 33/80 limbs in CT reconstructions. Cone-shaped mineralisation in the sagittal ridge was detected in MR images (n = 17) and in CT images (n = 5). Mild hyperattenuation was common in trabecular bone in the dorsomedial (36/80) and palmarolateral (25/80) metacarpal condyles in CT reconstructions. A focal lesion in the subchondral bone was seen in the proximal phalanx (n = 19) and in McIII (n = 11). Enlarged vascular channels were detected in the metacarpal condyles in 57/80 limbs and in the proximal sesamoid bones in all limbs. Signs of bone modelling are seen in yearling Thoroughbred fetlocks. Sagittal ridge lesions were common and are likely associated with osteochondrosis or other developmental osteochondral defects. Focal lesions in the subchondral bone of McIII and proximal phalanx can indicate developmental abnormalities or subtle subchondral bone injuries.
BACKGROUND:Overstrain of the superficial digital flexor tendon (SDFT) is a common Thoroughbred racehorse limb injury requiring treatment. OBJECTIVES:To determine whether treatment of SDFT lesions in flat Thoroughbred racehorses with autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) or allogenic adipose-derived mesenchymal stem cells (A-MSCs) is associated with improved likelihood of returning to racing, when compared to racehorses managed with a controlled exercise rehabilitation program (CERP) alone. STUDY DESIGN:Retrospective cohort study combining clinical treatment records with race records. METHODS:A total of 213 Thoroughbred racehorses were identified. All were prescribed the same 12-month CERP and 66 also received intralesional BM-MSC and 17 A-MSC treatment. Follow-up was a minimum of 2 years after return to full race training. Multivariable logistic regression models were used to investigate associations between the treatments and the likelihood of returning to racing and completing five or more (C5+) races post-injury. RESULTS:Compared to CERP alone, BM-MSC treatment was associated with increased odds of returning to racing (OR 3.19; 95% CI 1.55-6.81) and C5+ races post-injury (OR 2.64; 95% CI 1.32-5.33). Older age and increasing lesion length were associated with a reduced likelihood of returning to racing. Male sex and increased number of pre-injury starts were associated with increased odds of returning to racing. There was no observed increased likelihood of return to racing or C5+ races associated with treatment with A-MSCs compared to CERP alone. MAIN LIMITATIONS:Due to the retrospective nature of the study it was not possible to ascertain how strictly the CERP was followed. Due to the novelty of the method, the A-MSC treatment group included a limited number of horses. CONCLUSIONS:In the study population, intralesional BM-MSC treatment was significantly associated with an increased likelihood of returning to racing and C5+ races post-injury compared to CERP alone. Intralesional A-MSC showed no significant association between treatment and the two investigated outcomes.
June 2022, Vol. 12, No. 3 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons. org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com © Ahern, Crawford Perspectives Investigations into Thoroughbred racehorse welfare in Queensland Australia focused on musculoskeletal injuries and retirement
The calcaneal tuberosity, due to its superficial location and prominent positioning, is predisposed to traumatic injury and synovial infection. Frequently, injury also involves the superficial digital flexor tendon either directly or through inflammation, swelling, adhesions and proliferative osteitis resulting in increased tension and persistent pain. This case report describes permanent superficial digital flexor tendon luxation to improve surgical access to the calcaneal tuber and alleviate pain associated with tension of the superficial digital flexor tendon following chronic septic calcaneal osteomyelitis and bursitis.
Pigs are commonly maintained on total intravenous anaesthesia when used in comparative medical research to study controlled manual ventilation of the lung. In this case study, four pigs were anaesthetised with a total intravenous anaesthetic infusion of alfaxalone and dexmedetomidine for up to 24 h whilst being mechanically ventilated. Cardiovascular parameters, blood gas values and body temperature were minimally affected throughout the anaesthetic period. Additional analgesia is recommended when utilising this drug combination for procedures that involve noxious stimuli.
Introduction Upper airway endoscopy of thoroughbred (TB) yearlings is commonly used in an attempt to predict laryngeal function (LF) and its impact on future race performance. The aim of this study was to determine if different grading systems and laryngeal grades were correlated with future performance. Materials and Methods Postsale endoscopic recordings were obtained from an Australian TB yearling sale during a four‐year period from 2008 to 2011. Horses were included if they had a diagnostic postsale video endoscopic recording and raced within Australia. Recordings were graded using the Havemeyer system and subsequently recategorised according to the Lane scale and two condensed scales. Performance data were sourced from Racing Australia and comparisons were made between groups. Results A total of 1244 horses met the inclusion criteria. There were no significant differences in sex or sales price between groups. There were no significant differences in the number of starts or wins between groups for any grading system. For the condensed Havemeyer scale, horses with intermediate LF were separated into two groups. Significant differences in earnings were found between ‘normal’ and ‘abnormal’ (P = 0.02) and ‘intermediate‐low’ and ‘abnormal’ grades (P = 0.03). There were no significant differences between horses with ‘intermediate‐high’ and ‘abnormal’ grades (P = 0.40). No significant differences were found between the two intermediate grades (P = 0.60) or between horses with normal LF and either ‘intermediate‐low’ or ‘intermediate‐high’ grades (P = 0.99). Discussion Resting LF in Australian yearling TBs assessed using a condensed Havemeyer grading scale had some predictive value for future racing performance. This information should be considered when performing yearling endoscopic examinations.
Objective To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model. Study design Ex vivo, repeated measures. Sample population Twenty cadaveric equine larynges. Methods The right arytenoid cartilage was maximally abducted in all larynges. Each larynx was assigned a Rakestraw grade A or B, and the left arytenoid was abducted accordingly. Each larynx was tested under 3 conditions: intact, left vocal cordectomy (LVC), and bilateral vocal cordectomy (BVC). Translaryngeal pressure and airflow were measured, and digital video footage was obtained. Translaryngeal impedance (TLI) was calculated, and the arytenoid left-to-right quotient angle (LRQ) and rima glottis cross-sectional area (CSA) were measured from standardized still images. Results Vocal cordectomy reduced TLI by 14.5% in LVC in comparison with intact larynges at Rakestraw grade B (P = .014). In Rakestraw grade A position, neither unilateral nor bilateral vocal cordectomy had any effect on TLI. Regardless of Rakestraw allocation, both LVC and BVC increased CSA in comparison with intact larynges (P < .005), with BVC larynges experiencing a greater effect than LVC (P < .0001). Conclusion Using a unilateral airflow model, LVC improved TLI in larynges where arytenoid position approximated Rakestraw grade B. However, when the arytenoid position approximated Rakestraw grade A, there was no effect on TLI following LVC or BVC. Clinical significance Surgeons considering a vocal cordectomy should take into account the degree of arytenoid abduction before performing the procedure, as it may not be warranted from a TLI point of view.
Alpha2 receptor agonists are frequently used to provide sedation and analgesia in sheep. There are numerous reports of adverse pulmonary effects following intravenous (IV) injection; however, adverse effects following subarachnoid injection (SAI) are underreported. An adult Merino wether was one of eighteen animals anaesthetised during an experimental trial modelling intervertebral disc injury. The animal was premedicated with methadone 0.1 mg/kg and midazolam 0.3 mg/kg IV. Anaesthesia was induced using alfaxalone IV and it was maintained using isoflurane, delivered in 100% oxygen by controlled mechanical ventilation. An SAI of xylazine 0.05 mg/kg diluted to 1 mL with 0.9% saline was performed at the lumbosacral site prior to recovery. This resulted in rapid narcosis, oxygen dependency and ventilatory compromise. Treatment with frusemide 1 mg/kg IV and salbutamol 0.2 mg inhaled did not attenuate the adverse cardiopulmonary effects. A rapid improvement in all physiological variables was seen following high dose atipamezole 0.05 mg/kg IV. This case report adds to the current knowledge regarding the risk for potential side effects when using alpha2 receptor agonists, such as xylazine, for the sedation or regional analgesia in sheep.
ObjectivesTo investigate the feasibility and describe the clinical experience of performing laryngeal tie-forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). Study designExperimental study and case series. AnimalsFive normal experimental controls and five client owned horses affected by iDDSP. MethodsStanding LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was performed under endoscopic guidance with horses sedated and the surgical site desensitized with local anesthetic solution. Short term outcome was assessed using radiography, resting and (in clinical cases) dynamic upper respiratory tract (URT) endoscopy. ResultsStanding LTF was well tolerated and completed in all horses. Radiographic assessment demonstrated that compared to preoperatively, the basihyoid bone and thyrohyoid-thyroid articulation were positioned dorsally (9.6 mm, p = .006 and 20.4 mm, p = .007, respectively) at 2 days postoperatively. During repeat dynamic URT endoscopy at 48 hours postoperatively, 3/5 horses showed resolution of iDDSP and 2/5 marked improvement. One horse experienced brief iDDSP associated with neck flexion which corrected after swallowing. The second achieved a greater speed and total distance prior to iDDSP. ConclusionsStanding LTF did not incur any major peri- or postoperative complications. The laryngohyoid apparatus was repositioned dorsally and in a small case series had a similar surgical effect on laryngeal position. Clinical significanceStanding LTF is feasible, mitigates the risk of general anesthesia related complications and reduces cost.