Appropriate medical care for donkeys is challenging despite being important working animals in non-industrialized countries and pets in first world countries. Although the same principles of diagnosis and therapy as in horses are commonly applied, there are differences in reference values and physiologic reaction to dynamic tests. However, donkeys seem to suffer from typical equine diseases, such as metabolic syndrome and pituitary pars intermedia dysfunction (PPID). Asinine metabolic syndrome (AMS) comprises obesity, insulin dysregulation, and laminitis. The principles of diagnosis are similar to horses. Donkey-specific reference ranges for insulin and glucose have been evaluated previously. Examinations regarding dynamic testing revealed differences in the intravenous glucose tolerance test and the combined insulin tolerance test compared to horses. The therapy of AMS is based mainly on weight loss and exercise. There are conflicting data regarding the incidence of PPID in donkeys. Laminitis and hypertrichosis were described as the main clinical signs. Species-specific and seasonal reference ranges were defined to diagnose PPID in donkeys. Furthermore, the dexamethasone suppression test, the thyrotropin releasing hormone (TRH) test and the combined dexamethasone suppression/TRH test were evaluated. Pergolide is commonly recommended for treatment.

Extraction of incisor and canine teeth is one of the most commonly performed surgical procedures in equine medicine. The present study aimed to investigate the types of bacteria found on the surface of diseased teeth and the occurrence of intra- or postoperative bacteraemia with a possible clinical relevance in operated horses. Extracted teeth showed mixed infections with a high percentage of gram-negative anaerobic bacteria. Transient bacteraemia occurred in 8 of 10 horses with every sort of manipulation on the tooth itself or its periodontium. Isolated bacteria from blood samples often corresponded with those found on the dental surface. Complications of clinical relevance associated with the detected bacteraemia are possible but rare. The use of antibiotics in horses undergoing incisor or canine tooth extraction should therefore be limited to those cases, where pronounced inflammation and infection are present locally or where systemic signs of sepsis impair the horses general health.

BACKGROUND:Transient bacteraemia can occur during tooth extraction in humans, and dogs and can lead to severe infectious sequelae. Several case reports describe distant site infections following equine tooth extraction, but the occurrence of bacteraemia during dental surgery has not been evaluated in the horse.OBJECTIVES:To determine if transient bacteraemia occurs during tooth extraction in horses, describe isolated organisms and compare these with those found in the diseased teeth.STUDY DESIGN:Prospective, observational study.METHODS:Blood was collected aseptically for blood culture before, during and after oral extraction of incisor, canine or cheek teeth from 20 adult horses undergoing dental extraction that had not received antimicrobial agents for at least 4 weeks prior to surgery. Bacteria found in blood cultures were compared with those found in swab samples obtained from the extracted teeth.RESULTS:Eighteen of 20 horses had positive blood cultures at one or more time points. Streptococcus spp., Actinomyces spp., Fusobacterium spp. and Prevotella spp. were most commonly found. Bacterial genera isolated from swab samples of extracted teeth largely corresponded with those identified in blood cultures.MAIN LIMITATIONS:This study was limited by its use of only conventional bacterial culture, the lack of statistical analysis to explore associations between gingiva score and the occurrence of bacteraemia, and the lack of an age-matched control group of horses not undergoing exodontia.CONCLUSIONS:Transient bacteraemia of oral origin commonly occurs during dental extraction in horses. As none of the horses developed complications associated with bacteraemia during the observation period after surgery, the significance of this bacteraemia remains uncertain. The Summary is available in Chinese - see Supporting Information.

Previous studies investigating the potential involvement of viruses in airway inflammation were based either on serological tests or on PCR from nasal swabs only. The objectives of this study were to determine the incidence of welland less-characterised viruses in the equine airways, and their association with clinical signs. In a 2-year prospective longitudinal study, nasal swabs (NS) and tracheal washes (TW) were collected monthly on 52 Standardbred racehorses at training (581 samples). Equine aand g-herpesviruses, equine rhinitis virus-A and -B, equine adenovirus-A, and equine influenza virus were investigated by qPCR. Any positive sample was subcategorised as non-quantifiable (>LOD and LOQ). Clinical signs (nasal discharge, coughing), and tracheal mucus score were simultaneously recorded. In TW, respective monthly incidences were 27.9% (EHV-5), 24.8% (EHV-2), 7.1% (ERBV), 3.8% (EHV-4), 1.9% (EAdV1) and 0.2% (EHV-1, ERAV). EIV has not been detected in any sample. Molecular detection of EHV-2 and ERBV in TW were significantly associated with coughing (OR 3.1; 95% CI 1.4-7.1; P1⁄40.01 and OR 5.3; 95% CI 2.1-14.0; P<0.001, respectively). Positive samples for EHV-2 in TW were significantly associated with tracheal mucus score 2 (OR 2.1; 95% CI 1.2-3.8; P1⁄40.02). When based on quantifiable detection, ERBV only was significantly associated with coughing (OR 15.0; 95% CI 3.7-60.0; P<0.001). Positive samples for any virus in NS were not associated with clinical signs. Based on our data, detecting ERBV in TW is a major risk-factor of coughing. This virus should be considered when investigating horses with inflammatory airway disease.

The aim of this study was to determine the effect of the anabolic steroid testosterone on the testicular vascularization, angiogenesis and expression of angiogenic factors, and their receptors in testes of peripubertal stallions. Seven peripubertal stallions were treated with Durateston and castrated either 4 (treatment group 1 [TG1]) or 12 weeks (TG2) after the last injection. The castration of seven untreated control stallions (control group [CG]) took place within the same time. In the testicular specimens, volume density (VD), numerical density (ND), and area of vessels were determined morphometrically. Immunohistochemically, the expression of vascular endothelial growth factor (VEGF) and its receptor VEGF-R2; angiopoietin 2 (Ang2) and its receptor Tie2 as well as of transforming growth factor α (TGF-α) was investigated. Morphometrically, the VD of TG1 (P = 0.000) and TG2 (P = 0.001) vessels and the ND of arterioles and venules and capillaries were higher (TG1, TG2: P < 0.05), and the area of capillary cross sections was smaller (TG1, TG2: P < 0.05) than that in the CG. Compared to TG2 horses, TG1 animals showed a higher (P < 0.05) VD and ND of vascular structures and a smaller (P < 0.05) area of capillary cross sections. In numerous vascular structures, especially of TG1, the TGF-α and, to a less extent, the Ang2 and VEGF-R2 expression was significantly higher (P < 0.05) than that in the CG. Sertoli cells in TG2 were characterized by a significantly higher expression (P < 0.05) of VEGF-R2 than in the CG. In summary, the most and smallest vessels could be detected in the testes of TG1. Most likely this is explainable by the highest expression of some angiogenic factors (TGF-α, Ang2) and receptors (VEGF-R2) investigated. This expression behavior may be stimulated by testosterone. As a significant decrease of morphometric parameters could be detected in TG2 compared to TG1, the stimulatory effect of testosterone seems to be temporary.

In the equine endometrium, the subclassification of lymphocytes may provide further insights into the immune defense and the pathogenesis of a non-suppurative endometritis. In routine formalin-fixed paraffin embedded tissue, there is no preservation of CD4 and CD8 antigens of T-helper cells and cytotoxic T cells, respectively. So far, the immunohistochemical detection of CD4- and CD8-immunopositive lymphocytes in the equine endometrium was only achieved by the use of frozen cryostat sectioned tissue samples. The aim of the present study on the equine endometrium was 1) to explore alternative fixation methods for the immunohistochemical detection of CD4 and CD8 antigens, 2) to reveal the method most suitable for the routine diagnostic work-up in conjunction with an immunohistochemical characterization of lymphocyte subpopulations and 3) to examine the distribution of CD4- and CD8-immunopositive lymphocytes in the equine endometrium without and with a non-suppurative endometritis. Using the zinc-salt and the Hope (R)-fixative as alternative fixatives, the immunohistochemical detection of CD4- and CD8-immunopositive lymphocytes was possible. In haemalaun eosin stained tissue sections, however, only zinc-salt fixed tissue had an optimal tissue morphology comparable to the tissue preservation in formalin-fixed tissue. The immunohistochemical examination of endometrial tissue samples of 2 mares without endometritis and 7 mares with a mild superficial non-suppurative endometritis showed the presence of CD4- and CD8-immunopositive subpopulations within the stratum compactum and stratum spongiosum. The mild non-suppurative endometritis was associated with increased numbers of CD4- and CD8-immunopositive lymphocytes within the stratum compactum. This study on the equine endometrium shows that 1) CD4- and CD8-immunopositive T cell subpopulations can also be detected in fixed tissue samples (IHC Zinc Fixative and Hope (R)-fixation), 2) the IHC Zinc Fixative is an excellent method to combine the routine histopathological evaluation with the analysis of T cell subpopulations, 3) the equine endometrium is equipped with an adaptive immune defense acting against intracellular and extracellular pathogens, 4) a non-suppurative endometritis is associated with an increase in both cell populations indicative of an immune mediated pathogenesis. Further studies are necessary to characterise the lymphocyte populations in the equine endometrium and the described method will provide a powerful diagnostic tool.

ZusammenfassungDieser Übersichtsartikel beschreibt stufenweise den rektalen und transrektal-sonographischen Nachweis der Frühgravidität beim Pferd. Die morphologischen und physiologischen Verhältnisse in den einzelnen Frühgraviditätsstadien werden in Korrelation zur möglichen klinischen Befunderhebung dargestellt. Die hohe Bedeutung der embryonalen und frühfetalen Verluste wird dargelegt. Eingegangen wird auch auf Befundmitteilung und Dokumentation. Der letzte Abschnitt des Artikels widmet sich der Bewertung des Untersuchungsaufwandes. Dabei wird aufgrund der Sachlage herausgestellt, dass die gynäkologische Untersuchung mit dem Auftrag, bei Stuten einen Graviditätszustand nachzuweisen oder auszuschließen, im Sinne eines Dienstvertrages einzuordnen ist.

This review describes stepwise the recto-manual and transrectal ultrasonographic evidence of early pregnancy detection in the horse. The morphological and physiological conditions in the individual phases of early pregnancy are presented in correlation to the potential clinical findings. The importance of embryonic and early foetal losses is presented. Communication and documentation of findings are also addressed. The final section is devoted to the evaluation of the examination effort. In this regard, it is emphasized that the gynaecological examination for the evaluation of the pregnancy status represents a service contract.

Colic in the pregnant and periparturient mare distribution, survival and abortion rateThe case records of 243 pregnant and periparturient mares referred to the clinic over a seven year period with a history of acute colic were reviewed to determine types and distribution of intestinal and extraintestinal lesions, outcome and abortion rate. Beside of different types of intestinal lesions which may affect any horse, uterine torsion, uterine flexion, dystocia, hydrallantois, genital injury, abdominal wall herniation and haemorrhage due to rupture of the uterine artery were found to cause colic symptoms in these mares and were treated medically or surgically. Mares were divided into group 1 (gestation length day 100-210), group 2 (gestation length day 211-320) and group 3 (periparturient period, gestation length >320 days to 10 days post partum). No significant differences could be found out in types of lesions affecting mares of the three groups. Overall survival rate to termination of pregnancy was 67.5%. Mares in the periparturient period at initial examination were associated with a significantly (p <0.05) lower survival rate than were mares with a gestation length <320 days. Clenbuterol was administered in all mares following surgical treatment or with the beginning of medical treatment for a minimum time of 10 days after termination of colic symptoms up to a gestation length of 320 days. Abortion rate in surviving mares with a gestation length <321 days was low at 8.4%.

Horses have to be sedated to allow a complete, specific and detailed dental examination. Physical examination and sedation have to be performed by a veterinarian. Besides better practicability of a dental examination with the horse sedated, the procedures are as safe as possible for the veterinarian, other participants and the horse itself. Diverse drugs are available for sedation of the horse. Normally, horses are calmed down for a dental check with a combination of an alpha(2)-agonist and an opioide. Particular dosage differs depending on examination range and treatment, temperament of the horse and the underlying disease.

14 horses of different breeds with an average age of three years were referred with the clinical signs of an auricular fistula or a swollen base of the ear. Diagnostic procedures included clinical examination with insertion of a probe into the sinus tract. Digital radiographic examination including contrast fistulography or with a metal probe within the tract was performed with lateral and oblique projections. Computed tomography of the head was added in seven of the 14 horses. In 12 horses, an aural fistula with mucous exudation was present close to the ear respectively at the margin of the ear cartilage. A swelling close to the base of the ear was present in another two horses. In ten of the 14 horses a heterotopic polyodontia could be detected radiographically with dense structures close to the temporal bone or multiple teeth like structures with enamel folds. A definite determination of the number and localization of teeth and furthermore detection of secondary lesions of surrounding bone and neurologic tissue due to compression could only be obtained with computed tomography. Following diagnostic procedures, surgical treatment was performed in 13 of the horses with complete removal of the sinus formation and heterotopic teeth. One horse did not receive surgical treatment due to the decision of the owner and to a poor prognosis for a surgical benefit. No intra- and postoperative complications could be observed except in one horse with a temporary unilateral ptosis. Functional and cosmetic results were considered to be good. It was a remarkable fact that all horses with a diagnosis of heterotopic polyodontia in this study were mares. In the majority of cases, heterotopic polyodontia was associated with the clinical presence of an aural fistula. Reversely, the primary etiology of an aural fistula was not a heterotopic polyodontia in any case, since a dermoid cyst was diagnosed in four of the horses. Despite the good surgical results in this study, surgical therapy of an auricular fistula with or without heterotopic polyodontia remains a serious procedure with the risk of complications due to the complex anatomy of the area.

Evaluation of the periovulatory uterine perfusion by Doppler sonography and sonographic texture analysis in horses The aim of the present study was to quantify and characterize the dynamics of the periovulatory uterine perfusion. Ten mares were examined on a doily base in the periovulatory period from five days (d-5) prior to the ovulation up to three days (d 3) following ovulation. The uterine perfusion was investigated using transrectal Doppler ultrasonography of the uterine artery and computer assisted grey scale analysis of ultrasonographic images of the endometrium. Resistance to uterine blood flow described by the resistance index (RI) was significantly decreasing from 0.81 +/- 0.07 (mean +/- standard deviation SD) at day -5 to 0.70 +/- 0.06 at day -3 to reach a plateau phase during day - 3 to the day of ovulation. Between days 3 and the day of ovulation, no signifficant difference of RI could be registered. Following a significant (p<0.01) increase in vascular resistance from 0.75 +/- 0.08 (mean +/- SD) at the day of ovulation to 0.84 +/- 0.051 (mean +/- SD) at day 1 of the cycle, a decrease of RI was noticed the subsequent days. The mean median of the grey scale histograms of the mares showed a significant (p<0.05) preovulatory decrease from day -5 with 56.55 +/- 12.3 (mean +/- SD) to day -3 with 35.58 +/- 6.32. After this preovulatory decrease, the mean median increased continously and significantly (p<0.05) till day 3 with 76.36 +/- 9.81. A considerable dynamic in uterine perfusion was found to be characteristic for the periovulotory period in mares with a significant preovulatory rise of blood flow and endometrial edema. Furthermore, it was concluded that, in particular the preovulatory period can not be recommended for an operative hysteroscopy due to the maximum endometrial edema and blood flow with the risk of unsufficient intrauterine surgery and perioperative hemorrhage.

During a three year period, 41 horses were referred to the Clinic for Horses with the symptom of a mandibular fistula. Diagnostic procedures included clinical examination with oral examination and insertion of a probe in the sinus tract. Digital radiographic examination including contrast fistulography or with a metal probe within the tract was performed with lateral and oblique projections. Computed tomography of the head was added in 19 of the 41 horses. In 39 of the 41 horses, the origin of the fistula or sinus tract formation could be detected prior to surgery. A sinus tract formation caused by apical cheek teeth infection was present in 31 of the 41 horses with the rostral mandibular cheek teeth P2-P4 (06-09) the most common. In 10 horses the sinus tract formation was a result of traumatic or infectious damage to the mandibular bone or the parotic gland. A bone sequester could be detected in six of those horses. Following diagnostic procedures, surgical treatment was performed in 40 of the horses, One horse did not obtain surgical treatment due to the decision of the owner. In case of dentogenous fistula formation, the treatment of the affected cheek teeth included tooth repulsion, oral extraction or endodontic therapy. The sinus tract and infected and necrotic tooth and bone tissue were resected completely or bone curettage was performed. In two horses, a second surgical intervention was undertaken due to sequester formation or continuing osteomyelitis and purulent exudation. One horse had to be euthanatized because of a limb fracture. Following surgery, all horses could be discharged with complete or uncomplicated wound healing. Complete primary or secondary wound healing could be confirmed in all the horses during the hospitalization or as a result of a follow-up control.

Objective: The importance of partial crown fractures has been underestimated by veterinarians for a long time. In this study clinical signs, localization and extent of crown fractures were evaluated, and predisposing factors were determined. Material and methods: Twenty-six horses with a total of 31 partial crown fractures of their cheek teeth were examined clinically and radiographically. In addition, some horses were examined endoscopically and with computed tomography. Finally 18 horses underwent dental surgery. Results: Partial crown fractures were more common in adult horses after completion of tooth eruption (range: 11.7 +/- 4.4 years). They occurred more frequently in the upper jaw (n = 21) than in the lower jaw In = 10), and there tooth number 9 (M1) was affected most often (n = 19). The tooth crown in the lower jaw usually was damaged lingually (n = 9), while in the upper jaw most fractures occurred on the buccal side (n = 17). In 20 of all horses removal of the entire affected tooth was indicated. Conclusion: Partial crown fractures in horses usually are followed by endo- and periodontal diseases with the result of secondary damage to the surrounding bone and the maxillary sinus and eventually the loss of the affected tooth. Diseased cheek teeth often have to be removed via retrograde repulsion, because oral extraction is not successful in highly damaged crowns. Clinical relevance: A potential cause for the fractures can be the use of the Schoupe mouth gag. The authors therefore strongly discourage the use of this instrument.

The aim of the present study was an (immuno-) histological characterisation of endometrial functional morphology in mule mares with respect to clinical and endocrinological parameters. The results were also compared to observations in the horse. From six mule mares (13-23 years old) endometrial biopsies (n=97) were recurrently collected over a period of approximately 4 months (April-August). Clinically, two mules showed an erratic estrus cycle with considerably varying serum estradiol and progesterone values. Histologically, these two animals revealed a variable functional morphology with marked endometrial maldifferentiation. The proliferation activity and expression of steroid hormone receptors was also variable. These results resemble findings in the transitory period between ovulatory season and winter anestrous in horses. No correlation between the clinical or endocrinological data and the endometrial functional morphology could be observed in either mule. Four mule mares showed acyclia during the whole period of clinical observation. Serum hormone concentrations remained on a rather constant level. Histologically, the four mules presented an inactive but irregular differentiated endometrium with variable estrogen and progesterone receptor expression and little proliferation activity. The described findings are comparable with observations in winter anestrus or inactivity during the breeding season in horses.

Zusammenfassung Gegenstand und Ziel: Kronenteilfrakturen werden vom Untersucher häufig unterbewertet oder nicht erkannt. Klinische Symptome, Lokalisation sowie Ausdehnung solcher Frakturen wurden untersucht und prädisponierende Faktoren bestimmt. Material und Methoden: Bei 26 Pferden mit insgesamt 31 Kronenteilfrakturen im Bereich der Backenzähne erfolgten eine klinische, röntgenologische und zum Teil endoskopische und computertomographische Untersuchung. Einem dentalchirurgischen Eingriff wurden 18 Pferde unterzogen. Ergebnisse: Kronenteilfrakturen kamen gehäuft bei Pferden mittleren Alters (11,7 ± 4,4 Jahre) vor, die den Zahnwechsel bereits abgeschlossen hatten. Diese Frakturen traten häufiger im Oberkiefer (n = 21) als im Unterkiefer (n = 10) auf, wobei der M1 (n = 19) der mit Abstand am häufigsten betroffene Zahn war. Die Beschädigung der Zahnkrone lag am Unterkieferbackenzahn meist lingual (n = 9) und am Oberkieferbackenzahn meist bukkal (n = 17). Die chirurgische Entfernung des betroffenen Zahns war bei 20 Pferden indiziert. Schlussfolgerung: Kronenteilfrakturen der Backenzähne führen beim Pferd meist zu fortschreitenden endo- oder periodontischen Erkrankungen, die sekundäre Schäden am umliegenden Knochen und im Sinus maxillaris und letztendlich den Verlust des Zahnes zur Folge haben. Die erkrankten Zähne werden meist expulsiert, da die beschädigten Kronen eine Extraktion erschweren oder unmöglich machen. Klinische Relevanz: Als mögliche Ursache für derartige Kronenteilfrakturen kann der Einsatz des Schoupé- Maulkeils angesehen werden. Die Autoren raten daher dringend von seinem Einsatz im Rahmen der Maulhöhlenuntersuchung ab.

222 barren mares of different breeds underwent operative hysteroscopy for the treatment of uterine cysts during an eleven year period. Hysteroscopy was performed under sedation. Mares were in dior anoestrus. Uterine distension was standardized with an intrauterine pressure between 20-30 mm Hg. Thermical preparation was achieved with high-frequency electrosurgery using micro instruments through the working channel of the endoscope. All visible cysts were resected with an electrosurgical loop. The loop was tightened around the base of the cyst and the cyst pulled towards the uterine lumen before resection. Small cysts which could not be fixed with the loop were coagulated. With the standard procedures, operative hysteroscopy could be completed with resection of all visible cysts in all the mares without complications. Therefore, the technique described here proved to be safe and efficient in a large number of treated mares. Compared to other preparation techniques, risk of recurrence is minimized, trauma of the tissue is only superficial and the wound healing is uncomplicated. The results of patho-histological examination of endometrial biopsies and of clinical follow-up with high rates of treated mares conceiving and foaling are presented in the second part of this study by Köllmann et al. (2008).

Diseased cheek teeth are rarely worth preserving. Besides the seldom used buccotomy, the expulsion and the repulsion are established therapeutic techniques. The aim of the present study was to compare data about clinical outcome and complications after the extraction and the repulsion of cheek teeth. The patients' records of 20 horses undergoing expulsion or repulsion were analysed retrospectively. Additionally, the owners and referral veterinarians of the patients were interviewed in order to assess the outcome of the cases after the horses were discharged from the clinic. Only horses of the some age range and with similar teeth being affected were included in the study in order to allow comparison between groups. The repulsion via bone flap or trephination which was performed under general anaesthesia allowed removal of the affected tooth in all cases (success rate of 100%). One patient fractured a leg during recovery phase and was euthanized. The extraction was performed in twelve out of 20 horses in the standing, sedated and, if required, locally anaesthetised horse. This technique was unsuccessful in three out of 20 horses (success rate of 85%). In these horses, the diseased tooth had to be removed using a Steinmann pin or a dental punch. The procedure was performed in the standing, sedated horse in one case and under general anaesthesia in two horses. After repulsion, the short term complication rate (< six weeks) was 52.6% (10 out of 19 horses) and included fractured mandibles, persistent nasal discharge, delayed wound healing and complications associated with anaesthesia. After extraction, the short term complication rate was 17.7% (three out of 17 horses). Residual parts of bones and teeth and damage to neighbouring teeth resulted in long term complication rate of 21.1% (four out of 19 horses) in the expulsion group. Such complications were not observed in the repulsion group. Due to the necessity of general anaesthesia and the higher rate of postoperative complications, the total costs were significantly higher in the repulsion group than in the extraction group. Furthermore, the horses of the repulsion group stayed significantly longer in the clinic. In accordance with the results of the present study, the extraction is the recommended first therapeutic choice for removing diseased cheek teeth. An appropriate local anaesthesia, sedation and analgesia have a great impact on the success rate. If repulsion needs to be performed, the bone flap is the preferred surgical approach compared to the trephination. The sinus can be inspected in more detail and it can be closed completely after repulsion of the tooth and sinus flushing resulting in a less time consuming after care.