The purpose of this quantitative study was to address considerations made in the move to binary grading systems by many colleges of veterinary medicine, its potential impact on intern and resident selection through the Veterinary Internship and Residency Matching Program, and the use of Standardized Letter of Reference (SLoR) scores as an alternative method for evaluating applicants. Data included de-identified Veterinary Internship and Residency Matching Program data from 91,080 applications for the years 2020-2024, provided by the American Association of Veterinary Clinicians. Conducted analyses included ANOVA and Chi-square as omnibus tests, and Bonferroni and Tukey as post hoc tests. Analyses were performed on the full sample as well as the sample limited to US citizens and permanent residents. Across both the full and limited samples, the study found that GPA and class rank were weakly correlated with SLoR scores. Furthermore, the provision of GPA and/or class rank was related to matching rate and rank, namely such that applicants who provided both had more favorable outcomes compared with those who provided neither. Finally, whereas gender was not found to moderate the relationship between the provision of GPA and/or class rank and matching outcomes, race was found to have an inconsistent and limited moderating effect. Findings indicate that SLoR scores may not serve as a valid substitute for GPA and class rank, and that the availability of GPA and class rank has implications for matching rate and rank. Future research is needed to understand how GPA, class rank, and SLoRs are used in practice to inform intern and resident selection decisions.

Background Eastern equine encephalitis (EEE) is a highly fatal neurologic disease of horses, but data describing clinical presentation, epidemiology, and prognostic factors are limited. Objectives Describe the clinicopathologic and epidemiologic features of horses with EEE and identify factors associated with survival. Animals One hundred four horses diagnosed with EEE presented with signs of diffuse brain disease. Methods Retrospective case series of horses evaluated at a Veterinary Teaching Hospital (1979-2017). Medical records were reviewed for clinical findings, diagnostic results, and outcomes. Logistic regression assessed associations between demographic, epidemiologic, and clinicopathologic variables and survival. Generalized linear models evaluated associations between climatic variables and annual case count. Results Median age was 1.4 years (0.1-13.4), predominantly Thoroughbreds and Quarter Horses. Most horses (66/104) presented during summer. In negative binomial regression adjusted for temperature and year, each 100-mm increase in annual precipitation was associated with a 43% increase in cases (IRR 1.43; 95% CI, 1.22-1.82; P < .001). Common findings included abnormal behavior (96%), hyperthermia (99%), recumbency (51%), and seizure-like activity (46%). Cerebrospinal fluid (CSF) abnormalities included discoloration (65%), high protein concentration > 80 mg/dL (80%), and neutrophilic pleocytosis (62%). Case fatality rate was 90% (94/104). Recumbency, seizure activity during hospitalization, band neutrophilia, monocytosis, and high CSF protein concentration and neutrophils were associated with death. Conclusions and clinical importance Eastern equine encephalitis is a rapidly progressive, highly fatal neurologic disease of horses, with increased case numbers during periods of higher precipitation. Clinicopathologic findings, particularly recumbency, seizure-like activity, leukogram changes and CSF abnormalities, provide prognostic indicators to guide clinical decision-making and client communication.

BACKGROUND:Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its individual components to predict infection and mortality in critically ill foals is currently unknown. OBJECTIVES:Assess the ability of history and signalment, clinical findings, laboratory results, and SIRS-related indices to predict infection and mortality in critically ill foals. ANIMALS:Retrospective, multi-center, cross-sectional study using a convenience sample of 1068 critically ill foals < 3 days of age admitted to 16 veterinary referral hospitals in 4 countries. METHODS:Data were retrieved from medical records. Infection was defined as the presence of bacteremia (positive blood culture) or clinical identification of an infected focus on admission. Univariate non-parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for statistical analysis. RESULTS:Foal age at admission and presence of toxic neutrophils were independent predictors of infection, whereas SIRS-related indices were not predictive of infection. In-hospital mortality was 24%. Independent predictors for mortality were hypokinetic pulses, cold extremities, presence of seizures, blood L-lactate concentration > 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations. CONCLUSIONS AND CLINICAL IMPORTANCE:The presence of infection in critically ill newborn foals was not predicted by SIRS indices. Cardiovascular dysfunction was strongly associated with mortality, suggesting that maintaining adequate perfusion and pulse pressure should be important treatment goals.

OBJECTIVE:Referencing growing concerns over the recruitment and retention of faculty in academic veterinary medicine, the authors hypothesized that among surveyed veterinary residents and early-career faculty, work-life balance and workplace climate and culture are stronger motivators than financial considerations, regardless of demographic factors such as gender, race/ethnicity, and area of specialization. SAMPLE:541 participants were included in data analysis. METHODS:A mixed methods approach was utilized, incorporating both quantitative data and qualitative, free-text responses to better understand veterinary career choices by contextualizing factors associated with academic medicine. RESULTS:Factors underpinning career-related decision-making were ranked by level of importance as (1) workplace environment/culture, (2) personal well-being/work-life balance, (3) salary and bonuses, (4) geographic location, (5) facilities and resources, (6) benefits, and (7) schedule flexibility. Desires for workload balance, schedule flexibility, support from leadership, and mentorship and collaboration were among the top themes of qualitative responses for both residents and early career faculty respondents. Factors influencing career decision-making for resident and early-career faculty are varied. Workplace environment, work-life balance, and schedule flexibility are areas that academic institutions can address and continue to improve and that are likely to positively impact entry into academia and the desire to stay. CLINICAL RELEVANCE:This study sought to understand factors related to career decision-making and interest in academic veterinary medicine among residents and early-career faculty. Understanding these factors can support efforts to recruit and retain faculty in academic veterinary medicine.

AbstractBackgroundPain recognition in hospitalized horses is challenging, and the utility of pain scoring systems in horses with ocular disease has not been well‐described.Hypothesis/ObjectivesEvaluate the horse grimace scale (HGS) and behavior pain score (BPS) in hospitalized horses with ocular disease. We hypothesized that HGS and BPS would be associated with different clinical progressions.AnimalsPrivately owned horses hospitalized for ocular disease between September 2018 and September 2020.MethodsRetrospective observational study. The HGS and BPS were recorded daily throughout hospitalization. Clinical progressions were categorized as: (a) discharge from hospital after medical treatment, (b) ophthalmic surgery (eg, keratectomy, conjunctival flap, amniotic membrane transplantation, corneal transplant), or (c) enucleation. Temporal trends in HGS and BPS were assessed using linear regression. Correlations among slope, intercept, and progression were determined using the Kruskal‐Wallis test.ResultsOf 65 horses that met inclusion criteria, 29 (45%) were discharged after exclusively medical management, 28 (43%) underwent ophthalmic surgery, and 8 (12%) underwent enucleation. Two horses (3%) had 2 ophthalmic surgeries performed. The BPS scores at admission were higher in horses that were managed medically than in those that underwent enucleation (P = .01). Horses requiring enucleation had higher increases in HGS (P = .02) and BPS (P = .01) during hospitalization than horses that were medically managed and a higher increase in BPS (P = .04) than horses that required ophthalmic surgery.Conclusions and Clinical ImportancePain scoring may represent a useful tool for monitoring progression and response to treatment in hospitalized horses with ocular disease.

The American Association of Veterinary Clinicians (AAVC) convened a Diversity, Equity, and Inclusivity working group in March 2021 to address the limited diversity (including but not limited to ethnic, racial, and cultural diversity) in clinical post-DVM graduate training programs and academic faculty. Concurrent with a working group formation, the AAVC developed a strategic plan. The central mission of the AAVC is to develop, support, and connect academic leaders to fuel the future of the veterinary medical profession. House officers and their training programs are central to all goals outlined in the strategic plan. Amongst other strategic goals, the working group identified best practices for intern and resident recruitment and selection. We report herein from the current health profession literature ways to identify and recruit talented, diverse candidates especially those with non-traditional (atypical) preparation and experience. We also provide recommendations on best practices for intern and resident selection. This document highlights holistic approaches, some of which are incrementally being incorporated into the Veterinary Intern Resident Matching Program application, that emphasize diversity as a selection criteria for intern and resident selection an important step towards building a more resilient and inclusive workforce. These include expanding candidate assessment beyond grades and class rank into a more standardized method for screening candidates that includes consideration of life experiences and talents outside of veterinary medicine.

BACKGROUND Creeping Indigo (Indigofera spicata) toxicosis is an emerging problem among horses in Florida and bordering states. OBJECTIVES To quantify the putative toxins l-indospicine (IND) and 3-nitropropionic acid (NPA) in creeping indigo collected from multiple sites and to measure plasma toxin concentrations in ponies fed creeping indigo and horses with presumptive creeping indigo toxicosis. STUDY DESIGN Experimental descriptive study with descriptive observational field investigation. METHODS Air-dried creeping indigo was assayed for IND and NPA content. Five ponies were fed chopped creeping indigo containing 1 mg/kg/day of IND and trace amounts of NPA for 5 days, then observed for 28 days. Blood samples from these ponies and from horses involved in a presumptive creeping indigo toxicosis were assayed for IND and NPA. RESULTS IND in creeping indigo plants was 0.4 to 3.5 mg/g dry matter whereas NPA was <0.01 to 0.03 mg/g. During creeping indigo feeding, clinical and laboratory signs were unchanged except for significant weight loss (median 6%, range 2-9%; p = 0.04) and significant increase from baseline plasma protein concentration (median 16 g/L, range 8-25 g/L; p <0.001). These changes could not definitively be ascribed to creeping indigo ingestion. Plasma IND rose to 3.9 ± 0.52 mg/L on day 6. Pharmacokinetic modeling indicated an elimination half-life of 25 days and a steady state plasma concentration of 22 mg/L. Plasma IND concentration in sick horses during an incident of creeping indigo toxicosis was approximately twice that of clinically normal pasture-mates. Plasma NPA was <0.05 mg/L in all samples. MAIN LIMITATIONS Creeping indigo used in the feeding trial may not be representative of plants involved in creeping indigo toxicosis. There was no control group without creeping indigo in the feeding trial. CONCLUSIONS Indospicine can be detected in blood of horses consuming creeping indigo and the toxin accumulates in tissues and clears slowly. The role of NPA in the neurological signs of this syndrome is unclear.

Aims: To compare urine urinary pH, blood pH and concentration of electrolytes in blood of healthy horses fed an anionic salt supplement to achieve diets with a dietary cation-anion difference (DCAD) of -40 or 0 mEq/kg DM, with horses a fed a diet with a DCAD of 85 mEq/kg DM. Methods: Eight healthy horses received each of three diets in a randomised crossover design. Diets consisted of grass hay and concentrate feed, with a varying amount of an anionic supplement to achieve a DCAD of 85 (control), 0 or -40 mEq/kg DM. They were fed for 14 days each with a washout period of 7 days between. Urine pH was measured daily and blood samples were collected on Days 0, 7 and 14 of each study period for the measurement of pH and concentration of electrolytes. Results: Four horses voluntarily consumed the anionic supplement with their feed, but four horses required oral supplement administration via dose syringe. During the study period mean urine pH was lower in horses fed diets with a DCAD of 0 (6.91; SD 0.04) and -40 (6.83; SD 0.04) mEq/kg DM compared to the control diet (7.30; SD 0.04). Compared with horses fed the control diet, mean urine pH was lower in horses fed the 0 and -40 mEq/kg DM diets on Days 1-12 and 14 (p < 0.05) of the study period. On Day 13 it was only lower in horses fed the -40 mEq/kg DM diet (p < 0.01). Urine pH was similar for horses fed the 0 and -40 mEq/kg DM diets (p = 0.151). The DCAD of the diet had no effect on blood pH, ionised Ca or anion gap. Mean concentrations of bicarbonate in blood were affected by diet (p = 0.049); they were lower when horses were fed the 0 mEq/kg diet relative to the control diet on Day 14.

BACKGROUNDLimited information exists on the long-term outcome of foals that survive following hospitalisation for disease as a neonate. Significant financial investment is required to raise foals to racing age, therefore improved understanding of factors that affect long-term outcome and future athletic performance is important.OBJECTIVESTo analyse racing performance in Thoroughbred foals hospitalised as neonates, compared with their maternal siblings and to determine factors associated with failure to race and racing performance.STUDY DESIGNRetrospective cohort study.METHODSMedical records of Thoroughbred foals admitted to a neonatal intensive care unit between 1982 and 2008 were reviewed. Surviving foals of registered mares were included. Data including the foal's primary and concurrent diseases were extracted from the medical record. Racing records for foals and maternal siblings were evaluated. Multivariable logistic regression was used to identify disorders associated with failure to race and decreased racing performance.RESULTSTwo-hundred and sixty-nine of 454 previously hospitalised foals (59%) raced. Sixty-eight percent (269/394) of registered foals raced, compared with 79% (697/880) of registered siblings. Foals with prematurity/dysmaturity (P = 0.002) and those with orthopaedic disease (P = 0.007) were significantly less likely to race than their siblings. Premature/dysmature foals also had significantly fewer starts and wins and lower earnings than siblings. Foals with orthopaedic disorders had a lower percentage of wins, relative to their siblings. There was no significant association between racing performance and other disease categories.MAIN LIMITATIONSSmall sample size in some disease categories and retrospective nature of study.CONCLUSIONSFoals hospitalised due to prematurity/dysmaturity or orthopaedic disorders were less likely to race than their maternal siblings and those that did race had decreased performance.

Digesta retention time within specific segments of the equine gastrointestinal tract (GIT) may be more relevant to scientific inquiries than total tract mean retention time (TTMRT); however, measuring retention time in individual segments requires access to the digestive tract. The objective of this study was to compare prececal, cecal, and colonic mean retention time (MRT) with model-derived compartment MRT. A cecally fistulated gelding was fed indigestible particulate and liquid markers to determine TTMRT and dosed with different pairs of particulate and liquid markers into the cecum (hindgut MRT) and into the right ventral colon through the cecocolic orifice (colon MRT). Fecal marker concentrations were fit to stochastic and mechanistic models using nonlinear least squares methods (MATLAB). Total tract MRT and MRT for each GIT segment were compared with model-derived compartment MRT using paired t-test to determine differences and two one-sided tests to determine equivalence. All models resulted in parameter estimates and an acceptable fit to fecal marker excretion curves, but some parameter estimates did not differ from zero (95% CI included 0). Model-derived TTMRT were equivalent (P < .05) to arithmetically calculated MRT. Most GIT segment MRT differed (P < .05) from model-derived compartment MRT. Differences ranged from -26.1 hours to 25.8 hours. In these exploratory data, model derived compartment retention times failed to pair with MRT in different GIT segments. Significant methodological and analytical challenges remain to describe retention time in individual segments of the equine GIT. (C) 2020 Elsevier Inc. All rights reserved.