ORCID Profile
0000-0002-2464-3954
Current Organisations
Equine Medical Consulting
,
SLU Institutionen för vatten och miljö
,
University of Queensland - Gatton Campus
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Publisher: Wiley
Date: 22-10-2010
Publisher: Wiley
Date: 24-12-2021
DOI: 10.1111/JVIM.16017
Abstract: Diagnosis of pituitary pars intermedia dysfunction (PPID) is problematic because of large variations in ACTH concentrations. Compare the test characteristics of baseline and post–thyrotropin‐releasing hormone (TRH) stimulation plasma ACTH concentrations in horses using diagnostic cutoff values (DCOVs) and reference intervals (RIs) and determine the clinical consequences of using each method. One hundred six mature horses: 72 control cases and 34 PPID cases. Prospective case‐controlled study. Horses underwent monthly TRH stimulation tests. Diagnostic cutoff values were determined monthly by receiver operating characteristic curves using the Youden index. Reference intervals were determined monthly by a robust method. For each case age, sex and body condition score (BCS) were recorded. Baseline ACTH concentrations varied by month ( P .001) with significant “month × age” ( P = .003), “month × sex” ( P = .003), and “month × BCS” ( P = .007) effects. Baseline ACTH concentrations were accurate to diagnose PPID (0.91 ± 0.06) with DCOVs increasing the test sensitivity (0.61 ± 0.21 to 0.87 ± 0.05, P = .002) and RI increasing test specificity (0.85 ± 0.12 to 0.98 ± 0.01, P = .01). Thyrotropin‐releasing hormone stimulation improved test accuracy (0.91 ± 0.06 to 0.97 ± 0.03, P = .004). ACTH concentrations follow a circannual rhythm and vary with physiological factors. As using DCOVs increases the ability to detect mild cases and using RI decreases the risk of unnecessary treatments, ACTH concentrations should be interpreted within a specific clinical context. The TRH stimulation test improves the diagnosis of PPID.
Publisher: American Veterinary Medical Association (AVMA)
Date: 12-2004
Publisher: Wiley
Date: 06-2007
Publisher: MDPI AG
Date: 17-10-2022
Abstract: Poor recognition of subtle clinical abnormalities and equivocal ACTH concentrations make early diagnosis of PPID difficult. Progressive clinical findings and corresponding ACTH concentrations in horses transitioning to PPID over time have not been documented. Seven horses with ACTH concentrations equivocal for PPID (utilizing locally derived, seasonally adjusted diagnostic-cut off values (DCOV)) and no clinical signs of PPID were selected. Sequential measurement of basal and thyrotropin-releasing hormone (TRH)-stimulated ACTH concentrations and recording of clinical findings occurred from October 2017 to November 2021 in a prospective case series. In two horses, marked hypertrichosis developed. Although 1/11 basal ACTH concentrations were below DCOV in 2018, subsequently all basal ACTH concentrations in these two horses without treatment were greater than DCOV. One horse was treated with pergolide which normalized basal ACTH concentrations. Four horses developed intermittent, mild hypertrichosis, and one horse never developed hypertrichosis. Basal ACTH concentrations in these five horses were greater than DCOV in 63/133 (47.4%) of testing points. TRH-stimulated ACTH concentrations in these five horses were greater than DCOV in 77/133 (57.9%) of testing points, sometimes markedly increased and greater than the assay upper limit of detection (LoD) of 1250pg/mL. TRH-stimulated ACTH concentrations were most frequently positive in late summer and early autumn, with 24/37 (64.9%) of TRH-stimulated ACTH concentrations greater than the DCOV in February and March. Horses transitioning to PPID can have subtle clinical signs and equivocal ACTH concentrations. However, TRH-stimulated ACTH concentrations can be markedly greater than DCOV, especially in late summer and early autumn (February and March) allowing for identification of subclinical and transitional cases.
Publisher: Wiley
Date: 26-12-2014
Publisher: Wiley
Date: 11-2022
DOI: 10.1111/JVIM.16574
Abstract: Although dog-to-dog bite wounds (DBW) are common, few studies worldwide have evaluated antimicrobial usage patterns or appropriateness of use. Report frequency and results of DBW cultures, including antimicrobial susceptibility patterns. Determine the most commonly prescribed antimicrobials and their appropriateness for the treatment of DBW, and if antimicrobial importance is associated with wound severity, clinic type or year. One thousand five hundred twenty-six dog bite events involving 1436 dogs presenting with DBW from 3 Australian university clinics from 1999 to 2019. Retrospective study. Medical records were reviewed for presenting signs, culture and susceptibility testing, antimicrobial treatment, and outcome. A partial proportional odds model was used to determine if use of higher importance antimicrobials was associated with wound severity, clinic, or year. Antimicrobials were prescribed in 88.1% (1344/1526) of DBW. Amoxicillin-clavulanic acid was prescribed in 73.4% (1121/1526) of dogs, followed by first-generation cephalosporins, 18.1% (277/1526). Of a total of 1647 antimicrobial prescriptions, underdosing occurred in 13.4% for AMC (220/1647) and 26.1% (81/310) of dogs prescribed first generation cephalosporins. There was an association between the increased use of high-importance antimicrobials and wound severity (P < .001), antimicrobial polytherapy (P < .001) and year (P < .001). The odds of the clinic with specialists prescribing high-importance antimicrobials compared to those of medium importance for DBW was 82% less than that of a semi-rural, mixed and general practice. Culture and susceptibility (C&S) testing was performed in 1.8% of dogs. Empirical use of amoxicillin-clavulanic acid was common for DBW. Increasing wound severity was associated with greater use of high-importance antimicrobials. While C&S testing was rarely performed, routine susceptibility profiles are recommended to optimize antimicrobial stewardship.
Publisher: Wiley
Date: 12-2007
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.THERIOGENOLOGY.2010.08.014
Abstract: Hyaluronan (HA), a glycosaminoglycan, is a major component of the pericellular matrix which envelopes mammalian cells. Binding of hyaluronan to one of its specific receptors, CD44, modulates transduction of intracellular signals which direct a variety of processes, including embryogenesis, wound healing, inflammation, and neoplasia. Since regulation of these processes is critical to equine reproductive success, localization of constitutive CD44 expression was evaluated by immunohistochemical methods in ovarian, oviductal, and uterine tissues from healthy mares. Ovarian stroma contained thecal cells with varying CD44 immunopositivity. Follicular and granulosa cells of some antral and atretic follicles were positive for CD44. In the oviduct, the luminal epithelium was variably positive for CD44, with overall decreasing intensity of immunostaining from the infundibulum to the isthmus. The CD44 molecule was expressed strongly by surface epithelial cells of the uterine endometrium, but was present only rarely among cells of uterine glands. In addition, CD44 was expressed by smooth muscle cells of vascular walls, oviduct, and uterus. Since CD44 is known to modulate cell movement and differentiation, and was present at multiple sites in the reproductive tract of normal mares, we inferred there may be an important role for the HA-CD44 signaling pathway in reproductive function and inflammation.
Publisher: American Veterinary Medical Association (AVMA)
Date: 07-2011
Abstract: Objective —To determine the pharmacokinetics of tramadol and its metabolites O-desmethyltramadol (ODT) and N-desmethyltramadol (NDT) in adult horses. Animals —12 mixed-breed horses. Procedures —Horses received tramadol IV (5 mg/kg, over 3 minutes) and orally (10 mg/kg) with a 6-day washout period in a randomized crossover design. Serum s les were collected over 48 hours. Serum tramadol, ODT, and NDT concentrations were measured via high-performance liquid chromatography and analyzed via noncompartmental analysis. Results —Maximum mean ± SEM serum concentrations after IV administration for tramadol, ODT, and NDT were 5,027 ± 638 ng/mL, 0 ng/mL, and 73.7 ± 12.9 ng/mL, respectively. For tramadol, half-life, volume of distribution, area under the curve, and total body clearance after IV administration were 2.55 ± 0.88 hours, 4.02 ± 1.35 L/kg, 2,701 ± 275 h•ng/mL, and 30.1 ± 2.56 mL/min/kg, respectively. Maximal serum concentrations after oral administration for tramadol, ODT, and NDT were 238 ± 41.3 ng/mL, 86.8 ± 17.8 ng/mL, and 159 ± 20.4 ng/mL, respectively. After oral administration, half-life for tramadol, ODT, and NDT was 2.14 ± 0.50 hours, 1.01 ± 0.15 hours, and 2.62 ± 0.49 hours, respectively. Bioavailability of tramadol was 9.50 ± 1.28%. After oral administration, concentrations achieved minimum therapeutic ranges for humans for tramadol ( 100 ng/mL) and ODT ( 10 ng/mL) for 2.2 ± 0.46 hours and 2.04 ± 0.30 hours, respectively. Conclusions and Clinical Relevance —Duration of analgesia after oral administration of tramadol might be 3 hours in horses, with ODT and the parent compound contributing equally.
Publisher: MDPI AG
Date: 04-08-2023
DOI: 10.3390/ANI13152514
Abstract: Insect Bite Hypersensitivity (IBH, Queensland itch, sweet itch, equine summer eczema) is the most common pruritic disease of horses. It is most often caused by sensitivity to the saliva of Culicoides spp. of biting midges however, it can also be caused by hypersensitivity to other insect species. The prevalence of IBH in horses is reported to be as high as 60% in some parts of the world. Due to the severe pruritus and effects of secondary self-trauma, IBH has animal welfare concerns, and there is currently no cure. Management of this condition is life-long, time consuming and costly. New grading systems to document disease severity are being validated, which will allow the comparison of clinical trial results of new and existing therapies. Management involves the minimisation of insect bites by use of stabling, fans, rugs and repellents. Symptomatic therapy involves the administration of systemic or topical corticosteroids, systemic antihistamines, and creams and sprays to promote skin healing and decrease inflammation. New immune-mediated therapeutics including vaccines, in addition to desensitisation procedures, show promise at controlling hypersensitivity reactions. This article will review aetiologic agents, pathophysiology, scoring systems and current and new therapies.
Publisher: Wiley
Date: 29-09-2010
Publisher: American Veterinary Medical Association (AVMA)
Date: 15-09-2011
Abstract: Objective —To determine the lowest ACTH dose that would induce a maximum increase in serum cortisol concentration in healthy adult horses and identify the time to peak cortisol concentration. Design —Evaluation study. Animals —8 healthy adult horses. Procedures —Saline (0.9% NaCl) solution or 1 of 4 doses (0.02, 0.1, 0.25, and 0.5 μg/kg [0.009, 0.045, 0.114, and 0.227 μg/lb]) of cosyntropin (synthetic ACTH) were administered IV (5 treatments/horse). Serum cortisol concentrations were measured before and 30, 60, 90, 120, 180, and 240 minutes after injection of cosyntropin or saline solution CBCs were performed before and 30, 60, 120, and 240 minutes after injection. Results —For all 4 doses, serum cortisol concentration was significantly increased, compared with the baseline value, by 30 minutes after administration of cosyntropin no significant differences were detected among maximum serum cortisol concentrations obtained in response to administration of doses of 0.1, 0.25, and 0.5 μg/kg. Serum cortisol concentration peaked 30 minutes after administration of cosyntropin at a dose of 0.02 or 0.1 μg/kg, with peak concentrations 1.5 and 1.9 times, respectively, the baseline concentration. Serum cortisol concentration peaked 90 minutes after administration of cosyntropin at a dose of 0.25 or 0.5 μg/kg, with peak concentrations 2.0 and 2.3 times, respectively, the baseline concentration. Cosyntropin administration significantly affected WBC, neutrophil, and eosinophil counts and the neutrophil-to-lymphocyte ratio. Conclusions and Clinical Relevance —Results suggested that in healthy horses, administration of cosyntropin at a dose of 0.1 μg/kg resulted in maximum adrenal stimulation, with peak cortisol concentration 30 minutes after cosyntropin administration.
Publisher: American Veterinary Medical Association (AVMA)
Date: 08-2013
Abstract: Objective —To determine the lowest ACTH dose that would induce a significant increase in serum cortisol concentration and identify the time to peak cortisol concentration in healthy neonatal foals. Design —Prospective randomized crossover study. Animals —11 healthy neonatal foals. Procedures —Saline (0.9% NaCl) solution or 1 of 4 doses (0.02, 0.1, 0.25, and 0.5 μg/kg [0.009, 0.045, 0.114, and 0.227 μg/lb]) of cosyntropin (synthetic ACTH) was administered IV. Serum cortisol concentrations were measured before and 10, 20, 30, 60, 90, 120, 180, and 240 minutes after administration of cosyntropin or saline solution CBCs were performed before and 30, 60, 120, and 240 minutes after administration. Results —Serum cortisol concentration was significantly increased, compared with baseline, by 10 minutes after cosyntropin administration at doses of 0.1, 0.25, and 0.5 μg/kg. Serum cortisol concentration peaked 20 minutes after administration of cosyntropin at doses of 0.02, 0.1, and 0.25 μg/kg, with peak concentrations 1.7, 2.0, and 1.9 times the baseline concentration, respectively. Serum cortisol concentration peaked 30 minutes after cosyntropin administration at a dose of 0.5 μg/kg, with peak concentration 2.2 times the baseline concentration. No significant differences were detected among peak serum cortisol concentrations obtained with cosyntropin administration at doses of 0.25 and 0.5 μg/kg. Cosyntropin administration significantly affected the lymphocyte count and the neutrophil-to-lymphocyte ratio. Conclusions and Clinical Relevance —Results suggested that in healthy neonatal foals, the lowest dose of cosyntropin to result in significant adrenal gland stimulation was 0.25 μg/kg, with peak cortisol concentration 20 minutes after cosyntropin administration.
Publisher: Wiley
Date: 06-10-2023
DOI: 10.1111/JVIM.16884
Publisher: Wiley
Date: 05-2023
DOI: 10.1111/JVIM.16723
Abstract: The HMGA2 :c.83G A variant was identified in Welsh ponies having pleiotropic effects on height and insulin concentration. Determine whether the HMGA2 :c.83G A variant is associated with decreased height and higher basal insulin concentrations across pony breeds. Two hundred thirty‐six ponies across 6 breeds. Cross‐sectional study. Ponies were genotyped for the HMGA2 :c.83G A variant and phenotyped for height and basal insulin concentrations. Stepwise regression was performed for model analysis using a linear regression model for height and mixed linear model for insulin with farm as a random effect. Coefficient of determination, pairwise comparison of the estimated marginal means and partial correlation coefficients (parcor) were calculated to assess the relationship between HMGA2 genotype and height or insulin. Breed and genotype accounted for 90.5% of the variation in height across breeds, and genotype explained 21% to 44% of the variation within breeds. Breed, genotype, cresty neck score, sex, age, and farm accounted for 45.5% of the variation in insulin, with genotype accounting for 7.1%. The HMGA2 A allele frequency was 62% and correlated with both height (parcor = −0.39 P .001) and insulin (parcor = 0.22 P = .02). Pairwise comparisons found A/A ponies were cm shorter than other genotypes. Compared with G/G in iduals, A/A and G/A in iduals had 4.3 μIU/mL (95% confidence interval [CI]: 1.8‐10.5) and 2.7 μIU/mL (95% CI: 1.4‐5.3) higher basal insulin concentrations, respectively. These data demonstrate the pleiotropic effects of the HMGA2 :c.83G A variant and its role in identifying ponies at increased risk for insulin dysregulation.
Publisher: Elsevier
Date: 2004
Publisher: MDPI AG
Date: 10-10-2022
Abstract: Substantial morbidity results from pituitary pars intermedia dysfunction (PPID) which is often underestimated by owners and veterinarians. Clinical signs, pathophysiology, diagnostic tests, and treatment protocols of this condition are reviewed. The importance of improved recognition of early clinical signs and diagnosis are highlighted, as initiation of treatment will result in improved quality of life. Future research should be targeted at improving the accuracy of the diagnosis of PPID, as basal adrenocorticotropic hormone (ACTH) concentration can lack sensitivity and thyrotropin releasing hormone (TRH) used to assess ACTH response to TRH stimulation is not commercially available as a sterile registered product in many countries. The relationship between PPID and insulin dysregulation and its association with laminitis, as well as additional management practices and long-term responses to treatment with pergolide also require further investigation.
Publisher: American Veterinary Medical Association (AVMA)
Date: 15-09-2009
Abstract: Case Description —A 7-year-old 509-kg (1,120-lb) Tennessee Walking Horse mare was evaluated because of bilateral mucosanguinous nasal discharge, intermittent right-sided epistaxis, and worsening dyspnea of 9 months' duration. Clinical Findings —Multiple masses in the nasopharynx were detected via endoscopic and radiographic examinations. Cytologic and histologic examinations of biopsy specimens of 1 mass revealed round yeasts with thick nonstaining capsules and occasional narrow-based budding that resembled cryptococcal organisms. Treatment and Outcome —Oral administration of fluconazole and organic ethylenediamine dihydriodide and intermittent intralesional injections with fluconazole, hotericin B, and formalin resulted in resolution of lesions for a period of 2.5 years. The horse then developed exophthalmos, recurring clinical signs, and extensive nasopharyngeal masses. The masses were surgically debulked via a large frontonasal bone flap, and the horse was treated with IV injections of hotericin B and long-term oral administration of fluconazole. Clinical signs did not recur in the following 2-year period. A presumptive diagnosis of cryptococcosis was made following cytologic and histologic evaluations of the masses results of serologic analysis and fungal culture confirmed infection with Cryptococcus neoformans . Clinical Relevance —Cryptococcal infection of the upper respiratory tract in horses has previously been described as a uniformly fatal disease. As this case report illustrates, medical and surgical treatment of sinonasal cryptococcal granulomas in horses may be successful, but the importance of long-term follow-up and the potential for disease recrudescence should be considered. As efficacious antifungal agents become less expensive, their increased use will likely decrease mortality rates in horses with fungal infections.
Publisher: Wiley
Date: 24-08-2011
DOI: 10.1111/J.1365-2885.2011.01332.X
Abstract: Tramadol, a centrally acting opioid analgesic with monamine reuptake inhibition, was administered to six alpacas (43-71 kg) randomly assigned to two treatment groups, using an open, single-dose, two-period, randomized cross-over design at a dose of 3.4-4.4 mg/kg intravenously (i.v.) and, after a washout period, 11 mg/kg orally. Serum s les were collected and stored at -80°C until assayed by HPLC. Pharmacokinetic parameters were calculated. The mean half-lives (t(1/2)) i.v. were 0.85±0.463 and 0.520±0.256 h orally. The Cp(0) i.v. was 2467±540 ng/mL, and the C(max) was 1202±1319 ng/mL orally. T(max) occurred at 0.111±0.068 h orally. The area under the curve (AUC(0-∞)) i.v. was 895±189 and 373±217 ng*h/mL orally. The volume of distribution (V(d[area])) i.v. was 5.50±2.66 L/kg. Total body clearance (Cl) i.v. was 4.62±1.09 h Cl/F for oral administration was 39.5±23 L/h/kg. The i.v. mean residence time (MRT) was 0.720±0.264. Oral adsorption (F) was low (5.9-19.1%) at almost three times the i.v. dosage with a large inter-subject variation. This may be due to binding with the rumen contents or enzymatic destruction. Assuming linear nonsaturable pharmacokinetics and absorption processes, a dosage of 6.7 times orally would be needed to achieve the same i.v. serum concentration of tramadol. The t(1/2) of all three metabolites was longer than the parent drug however, O-DMT, N-DMT, and Di-DMT metabolites were not detectable in all of the alpacas. Because of the poor bioavailability and adverse effects noted in this study, the oral administration of tramadol in alpacas cannot be recommended without further research.
Publisher: Wiley
Date: 14-01-2016
DOI: 10.1111/VCP.12315
Abstract: Hemophilia A is an X-chromosome-linked disorder caused by a deficiency in factor VIII (FVIII). Although foals have been diagnosed with hemophilia A based on deficiency in FVIII activity, causative gene mutations have not been identified. The genomic DNA and cDNA encoding FVIII of a Tennesee Walking Horse colt affected with hemophilia A and the genomic DNA of his dam and a normal unrelated horse were analyzed with no splice site or coding sequence abnormalities identified in any of the horses. Polymerase chain reactions (PCR) were then performed on hepatic cDNA from the affected colt and an unrelated normal horse, and no product was obtained for the sequence between and including exon 1 and exon 2 in the affected colt. Based on these results, suspected mutations were identified in the noncoding region of FVIII (intron 1), and genomic sequencing of intron 1 in the dam and the affected colt suggested maternal inheritance.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.CVEQ.2014.11.005
Abstract: Fungal respiratory disease is a rare occurrence in horses. Fungal organisms are ubiquitous in the equine environment however, there is a geographic predisposition for disease development, with fungal respiratory infections seen more commonly by practitioners working in tropical or subtropical environments. Diagnosis and treatment of fungal respiratory infections pose a challenge for the equine practitioner, and the prognosis for complete resolution of infection is often guarded however, new antifungal medications are likely to improve treatment success. This article summarizes the available literature regarding the cause, diagnosis, and treatment of equine fungal respiratory disease.
Publisher: Wiley
Date: 25-05-2018
DOI: 10.1111/OBR.12703
Abstract: Cellular transport of ions, especially by ion channels, regulates physiological function. The transient receptor potential (TRP) channels, with 30 identified so far, are cation channels with high calcium permeability. These ion channels are present in metabolically active tissues including adipose tissue, liver, gastrointestinal tract, brain (hypothalamus), pancreas and skeletal muscle, which suggests a potential role in metabolic disorders including obesity. TRP channels have potentially important roles in adipogenesis, obesity development and its prevention and therapy because of their physiological properties including calcium permeability, thermosensation and taste perception, involvement in cell metabolic signalling and hormone release. This wide range of actions means that organ-specific actions are unlikely, thus increasing the possibility of adverse effects. Delineation of responses to TRP channels has been limited by the poor selectivity of available agonists and antagonists. Food constituents that can modulate TRP channels are of interest in controlling metabolic status. TRP vanilloid 1 channels modulated by capsaicin have been the most studied, suggesting that this may be the first target for effective pharmacological modulation in obesity. This review shows that most of the TRP channels are potential targets to reduce metabolic disorders through a range of mechanisms.
Publisher: Elsevier BV
Date: 04-2006
Publisher: Elsevier BV
Date: 04-2006
Publisher: Wiley
Date: 04-2011
DOI: 10.1111/J.1939-1676.2011.0712.X
Abstract: Results of diagnostic tests for equine pituitary pars intermedia dysfunction (PPID), including endogenous ACTH concentration and the overnight dexamethasone suppression test (DST), are affected by season. New and potentially more sensitive diagnostic tests for equine PPID, such as thyrotropin-releasing hormone (TRH)-stimulated ACTH response, have been developed, but have had limited evaluation of seasonality. Our purpose was to evaluate seasonal changes in plasma ACTH and alpha-melanocyte-stimulating hormone (α-MSH) responses to TRH administration. Nine, healthy, aged horses with normal DST results. Synthetic TRH (1 mg) was administered IV. Plasma ACTH and α-MSH concentrations were measured at 0, 5, 10, 15, 20, 25, 30, 45, 60, and 180 minutes. Testing was performed in February, July, August, September, October, and November. Mean TRH-stimulated ACTH and α-MSH concentrations were compared across months and time by repeated measures analysis of variance. Significance was set at the P < .05 level. Concentrations of ACTH and α-MSH significantly increased after TRH administration. Endogenous and TRH-stimulated ACTH and α-MSH concentrations were significantly different across months with higher concentrations in the summer and fall compared with February. Plasma ACTH and α-MSH responses to TRH administration experience seasonal variation, with TRH-stimulated ACTH and α-MSH concentrations increasing from summer through fall. These results support previous evidence of a seasonal influence on the equine pituitary-adrenal axis. More research is warranted with a larger number of horses to determine if seasonal reference ranges for TRH stimulation testing need to be defined.
Publisher: Wiley
Date: 09-2019
DOI: 10.1111/JVIM.15620
Abstract: Plasma adrenocorticotropic hormone (ACTH) and serum cortisol concentrations increase with illness‐associated stress. Dynamics of plasma ACTH and serum cortisol concentrations in adult horses with systemic illness are undocumented. To determine whether ACTH and cortisol concentrations and the ACTH/cortisol ratio vary with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or throughout hospitalization. One hundred fifty‐one adult horses. Prospective study measuring serum cortisol and plasma ACTH at admission and on days 2, 4, and 6 of hospitalization. Horses were grouped by outcome (survival, SIRS status, number of SIRS criteria [SIRS score], SIRS severity group, and the presence of an ischemic lesion). Differences between groups and over time for ACTH, cortisol, and ACTH/cortisol ratio were investigated with a mixed effect model. Receiving operator characteristic curves and odds ratios were calculated for survival and ischemia. In all groups, ACTH, cortisol, and ACTH/cortisol ratio significantly decreased over time ( P .0001). ACTH, cortisol, and ACTH/cortisol ratio were higher at admission in nonsurvivors, and ACTH and cortisol were higher in horses with ischemic lesions ( P .01). Horses with ACTH above reference interval at admission were 6.10 (2.73‐13.68 [95% confidence interval]) times less likely to survive ( P .0001). No significant difference in ACTH, cortisol, and ACTH/cortisol ratio between horses with different SIRS status, scores, or groups were detected, although nonsurvivors had a higher SIRS score ( P .0001). Pituitary and adrenal responses are altered in nonsurviving horses and those with an ischemic gastrointestinal lesion.
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.CVEQ.2010.12.009
Abstract: Magnesium (Mg) is an essential macroelement that is required for cellular energy-dependent reactions involving adenosine triphosphate and for the regulation of calcium channel function. Subclinical hypomagnesemia is common in critically ill humans and animals and increases the severity of the systemic inflammatory response syndrome worsens the systemic response to endotoxins and can lead to ileus, cardiac arrhythmias, refractory hypokalemia, and hypocalcemia. This article discusses the clinical signs, consequences, and treatment of hypomagnesemia in horses and describes the association of Mg and endotoxemia, insulin resistance, and brain injury.
Publisher: MDPI AG
Date: 23-06-2023
DOI: 10.3390/ANI13132082
Abstract: Crofton weed (Ageratina adenophora) is a global and highly invasive weed, with ingestion causing severe respiratory disease in horses, leading to irreversible and untreatable pulmonary fibrosis and oedema. While reports of equine pneumotoxicity remain common in Australia and New Zealand, equine pneumotoxicity may be underdiagnosed in other countries where Crofton weed is endemic but poorly differentiated. The pathogenesis of Crofton weed toxicity following ingestion has been well described in a number of different animal models, including rodents, rabbits, and goats. However, induced toxicity is organ-selective across different animal species, and these vastly differ from the pathogenesis described in horses, both clinically and after experimental exposure. Sources of variation may include species-specific susceptibility to different toxins present in the plant, different mechanistic processes of toxicity, and species differences in toxin biotransformation and bioactivation across different organs. Considering disease severity and Crofton weed’s invasiveness globally, assessing published toxicological and exposure data is necessary to advance research, identify specific toxins for horses, and possible prophylactic and therapeutic strategies. This review presents an overview of the available literature on equine toxicity, parallels between toxicity in horses and other animal species, and important aspects to be included in the future research agenda.
Publisher: Wiley
Date: 19-03-2014
DOI: 10.1111/EVE.12163
Publisher: Wiley
Date: 04-12-2021
DOI: 10.1111/EVE.13372
Abstract: A 3‐day‐old Australian Stock Horse filly presented with fulminant acute kidney injury after receiving 4 g of intravenous oxytetracycline at 24 and 48 h of age for medical management of flexural deformities. The filly’s clinical status initially improved, but worsening azotaemia prompted euthanasia after 55 h of supportive care. Necropsy confirmed proximal tubular necrosis. Nephropathy in association with oxytetracycline administration has been rarely reported. This case describes severe nephropathy in an apparently normal foal and highlights the need for thorough case evaluation prior to use of high‐dose oxytetracycline therapy for correction of flexural deformities in foals.
Publisher: American Veterinary Medical Association (AVMA)
Date: 15-07-2012
Abstract: Objective —To determine whether seasonal variations exist in endogenous plasma ACTH, plasma α-melanocyte—stimulating hormone (α-MSH), serum cortisol, and serum insulin concentrations and in the results of a dexamethasone suppression test for older, clinically normal geldings in Alabama. Design —Cohort study. Animals —15 healthy mixed-breed geldings (median age, 14 years). Procedures —S le collection was repeated monthly for 12 months. Dexamethasone (0.04 mg/kg [0.02 mg/lb], IM) was administered and cortisol concentrations were determined at 15 and 19 hours. Radioimmunoassays were used to measure ACTH, α-MSH, cortisol, and insulin concentrations at each testing time. Hormone concentrations were compared between months via repeated-measures ANOVA and correlated with age within each month. Results —A significant time effect was found between months for α-MSH and insulin concentrations. Endogenous cortisol and ACTH concentrations remained within existing reference ranges. Significant correlations were detected between age and ACTH concentration for several fall and winter months and between age and insulin concentration for September. Conclusions and Clinical Relevance —Older horses have higher ACTH concentrations in several fall and winter months and higher insulin concentrations in September than do younger horses. Seasonally specific reference ranges are required for α-MSH and insulin concentrations, with significantly higher concentrations detected in the fall. Practitioners should be advised to submit s les only to local laboratories that can provide such reference ranges for their local geographic region.
Publisher: Wiley
Date: 15-06-2015
DOI: 10.1111/EVE.12365
Publisher: MDPI AG
Date: 26-10-2022
DOI: 10.3390/ANI12212939
Abstract: Effective pain management in horses can be a challenge despite the understanding that appropriate analgesia improves animal welfare and increases treatment success. The administration of NSAID drugs, particularly phenylbutazone and flunixin, are common practice in equine veterinary patients. Known for their analgesic and anti-inflammatory properties, NSAIDs are used for the treatment of a variety of conditions in horses, from gastrointestinal to orthopedic pain. Despite extensive usage, NSAIDs have a narrow margin of safety and the body of literature documenting the efficacy and side effects of different NSAIDs is broad. The three main side effects associated with excessive or prolonged NSAID usage in horses include gastroduodenal ulceration, right dorsal colitis (RDC) and renal papillary necrosis. The use of cyclooxygenase-2 selective NSAIDS, such as firocoxib, are theoretically safer. The aim of this paper is to review the current literature on the use and efficacy of different NSAIDs, summarise the associated side effects of NSAID usage and evaluate the current state of knowledge for the diagnosis and treatment of such toxicities.
Publisher: Wiley
Date: 09-02-2010
Publisher: SAGE Publications
Date: 28-11-2020
Abstract: Prudent use of antimicrobials is paramount to slow the development of resistance and for successful treatment. The use of cumulative antibiograms will allow evidence-based antimicrobial selection with consideration of local resistance patterns. We generated a “first-isolate-per-patient” cumulative antibiogram for a regional equine referral hospital. Bacterial organisms cultured from horses between 2011 and 2018, s le origin, antimicrobial susceptibilities, and multidrug-resistant (MDR) status were tabulated. Of 1,176 s les, 50% were culture positive. Overall, 93 of 374 (25%) were MDR. Of the MDR isolates, 11 (12%) were susceptible to high-importance antimicrobials only (as defined by the Australian Strategic and Technical Advisory Group on antimicrobial resistance). β-hemolytic streptococci were uniformly susceptible to penicillin (76 of 76) 17 of 20 (85%) non–β-hemolytic Streptococcus spp. were susceptible to penicillin. Despite veterinary-specific challenges in constructing an antibiogram, our study provides an exemplar of the clinical utility of regional-, farm-, or hospital-specific cumulative antibiograms for evidence-based empirical antimicrobial selection by veterinarians prior to susceptibility result availability.
Publisher: Wiley
Date: 02-2010
DOI: 10.1111/J.1365-2885.2009.01099.X
Abstract: The purpose of this study was to assess safety and alterations in body fluid concentrations of voriconazole in normal horses on days 7 and 14 following once daily dose of 4 mg/kg of voriconazole orally for 14 days. Body fluid drug concentrations were determined by the use of high performance liquid chromatography (HPLC). On day 7, mean voriconazole concentrations of plasma, peritoneal, synovial and cerebrospinal fluids, aqueous humor, epithelial lining fluid (ELF), and urine were 1.47 +/- 0.63, 0.61 +/- 0.22, 0.70 +/- 0.20, 0.62 +/- 0.26, 0.55 +/- 0.32, 79.45 +/- 69.4, and 1.83 +/- 0.44 microg/mL respectively. Mean voriconazole concentrations in the plasma, peritoneal, synovial and cerebrospinal fluids, aqueous humor, ELF and urine on day 14 were 1.60 +/- 0.37, 1.02 +/- 0.27, 0.86 +/- 0.25, 0.64 +/- 0.21, 0.68 +/- 0.13, 47.76 +/- 45.4 and 3.34 +/- 2.17 respectively. Voriconazole concentrations in the bronchoalveolar cell pellet were below the limit of detection. There was no statistically significant difference between voriconazole concentrations of body fluids when comparing days 7 and 14. Results indicated that voriconazole distributes widely into body fluids.
Publisher: MDPI AG
Date: 28-01-2022
DOI: 10.3390/ANI12030324
Abstract: Pituitary pars intermedia dysfunction (PPID) is diagnosed by increased basal or post thyrotropin-releasing hormone (TRH) stimulation ACTH concentrations. ACTH is known to be unstable however, the effect of different temperatures and TRH stimulation on equine ACTH stability is poorly described. In total, 15 horses, including 8 PPID positive (ACTH 35 pg/mL at baseline or pg/mL 30 min after TRH stimulation), were ided into 2 groups: 9, including 5 PPID positive, with basal ACTH concentrations and 6, including 3 PPID positive, with post TRH stimulation ACTH concentrations. Whole blood was stored for 1 h at 4, 20, 30, 40, or 70 °C. After centrifugation, immunoreactive ACTH concentrations were determined using a chemiluminescent assay. Linear mixed effect models were used to detect the effects of temperature, PPID status, and TRH stimulation on the immunoreactive ACTH concentration. Temperature had a significant effect (p = 0.003) on immunoreactive ACTH concentrations, and this effect was greater in PPID-negative horses (p = 0.01), with the changes in immunoreactive ACTH concentrations being slightly unpredictably higher or lower than s les stored at 4 °C. Even at 20 °C, mean immunoreactive ACTH concentrations minimally changed by 5% in PPID horses and 12% in non-PPID horses after 1 h. No significant effect of TRH stimulation was identified. Although ACTH concentrations should ideally be determined from s les kept at 4 °C, s les inadvertently left at temperatures of up to 40 °C can provide valid results if analyzed within 1 h however, this increases the risks of altered ACTH concentrations, occasionally influencing the diagnosis of PPID.
Publisher: MDPI AG
Date: 02-01-2022
DOI: 10.3390/ANTIBIOTICS11010055
Abstract: Although dog-to-dog bite wounds (DBW) are a common presentation to veterinary clinics, antimicrobial prescribing habits of Australian clinics have not been reported. This study determined the frequency and results of DBW cultures antimicrobial selection and importance class of antimicrobials prescribed relative to wound severity, geographic location, or year. A systematic s le of 72,507 patient records was retrieved from the VetCompass Australia database. Records for 1713 dog bite events involving 1655 dogs were reviewed for presenting signs, results of culture and susceptibility testing (C& S), antimicrobial treatment, geographical location, and outcome. A crossed random effects multivariable logistic regression model was used to determine if antimicrobial importance was associated with wound severity, year, and location, and to assess the differences in antimicrobial prescription between geographical locations, clinics, and veterinarians. Antimicrobials were prescribed in 86.1% of DBW. Amoxicillin-clavulanic acid was prescribed in 70% (1202/1713) with underdosing in 15.8% (191/1202). High-importance antimicrobial use was associated with wound severity (p 0.001), year category (p = 0.007), and surgery (p = 0.03). C& S testing was recorded as having been performed in only one case. Differences in in idual veterinarian prescribing habits were stronger than the clinic culture, suggesting that education utilizing clinic-wide antimicrobial guidelines may aid in improving antimicrobial stewardship.
Publisher: Elsevier BV
Date: 12-2011
Publisher: Wiley
Date: 03-2015
DOI: 10.1111/JVIM.12545
Publisher: Elsevier BV
Date: 04-2006
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1016/J.VETIMM.2008.11.001
Abstract: The liver and lung are not only described as "target organs" in sepsis in most species, but are purported to be sources of circulating inflammatory mediators central to the systemic inflammatory response syndrome (SIRS). As we have recently reported an inflammatory response in the laminar tissue in laminitis similar to that described in "target organs" in human sepsis, we investigated the inflammatory response of the lung and liver in the black walnut extract (BWE) model of equine laminitis to determine (1) if a similar systemic inflammatory response occurs in this laminitis model as described for these organs in human sepsis, and (2) if these organs may be an important source of the inflammatory mediators leading to laminar inflammation. Real-time quantitative PCR (RT-qPCR) was used to measure hepatic and pulmonary mRNA concentrations of IL-1beta, IL-4, IL-6, IL-8, IL-10, TNF-alpha, COX-1 and COX-2. Hepatic s les were assessed from two time points in the developmental rodromal period: (1) 1.5h post-BWE administration (BWE-1.5H, n = 5), and (2) the "developmental time point" (onset of leukopenia, approximately 3h post-BWE administration, BWE-DEV, n = 5). Pulmonary s les were only assessed for the BWE-DEV group. One control group (CON-3H, n = 5) was used for both the 1.5H and DEV groups. Finally, CD13 immunohistochemistry was performed to assess leukocyte emigration into hepatic and pulmonary parenchyma. Hepatic and pulmonary mRNA concentrations of the proinflammatory cytokines IL-6, IL-8 and TNF-alpha were significantly increased (P < 0.05) in BWE-1.5H and BWE-DEV groups compared to the control group IL-1beta mRNA concentrations were only increased in the lung. The "anti-inflammatory" cytokines, IL-10 and IL-4, underwent transient decreases at different time points. Significant increases in parenchymal leukocyte numbers occurred in both the lung and liver at the BWE-DEV time point. Hepatic and pulmonary proinflammatory cytokine expression differ from that previously reported for the laminae in that TNF-alpha was increased in the hepatic and pulmonary tissues, the increases in expression of IL-6 and IL-8 are dramatically smaller for the liver and lung compared to those reported for the laminae, and the peak changes appear to occur later in the disease process in the liver than in the laminae (BWE-DEV in liver vs. 1.5H in the laminae).
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 26-05-2017
Abstract: To determine in vitro release profiles, transcorneal permeation, and ocular injection characteristics of a voriconazole-containing thermogel suitable for injection into the subconjunctival space (SCS). In vitro release rate of voriconazole (0.3% and 1.5%) from poly (DL-lactide-co-glycolide-b-ethylene glycol-b-DL-lactide-co-glycolide) (PLGA-PEG-PLGA) thermogel was determined for 28 days. A Franz cell diffusion chamber was used to evaluate equine transcorneal and transscleral permeation of voriconazole (1.5% topical solution, 0.3% and 1.5% voriconazole-thermogel) for 24 hours. Antifungal activity of voriconazole released from the 1.5% voriconazole-thermogel was determined via the agar disk diffusion method. Ex vivo equine eyes were injected with liquid voriconazole-thermogel (4°C). Distension of the SCS was assessed ultrasonographically and macroscopically. SCS voriconazole-thermogel injections were performed in a horse 1 week and 2 hours before euthanasia and histopathologic analysis of ocular tissues performed. Voriconazole was released from the PLGA-PEG-PLGA thermogel for more than 21 days in all groups. Release followed first-order kinetics. Voriconazole diffused through the cornea and sclera in all groups. Permeation was greater through the sclerae than corneas. Voriconazole released from the 1.5% voriconazole-thermogel showed antifungal activity in vitro. Voriconazole-thermogel was easily able to be injected into the dorsal SCS where it formed a discrete gel deposit. Voriconazole-thermogel was easily injected in vivo and did not induce any adverse reactions. Voriconazole-containing thermogels have potential application in treatment of keratomycosis. Further research is required to evaluate their performance in vivo.
Publisher: Wiley
Date: 02-12-2021
DOI: 10.1111/AVJ.13136
Abstract: Chronic oroantral fistulae (OAF) with secondary sinusitis can occur following repulsion of cheek teeth in horses. An 8‐year‐old Andalusian cross gelding presented with an iatrogenic clinical crown fracture of tooth 209, which underwent repulsion of its apical portion (day 0). The horse was treated with intramuscular penicillin and intravenous gentamicin (5 days), followed by oral trimethoprim‐sulphonamide (10 days) and then oral doxycycline (14 days). The acute iatrogenic OAF created during the initial repulsion persisted a chronic OAF was identified on day 24. On day 48, septic sinusitis with multidrug‐resistant (MDR) Escherichia coli was confirmed. Although susceptible to enrofloxacin in vitro, 30 days of therapy was unsuccessful. Subsequent serial cultures grew multiple MDR and extensively drug‐resistant (XDR) gram‐negative microorganisms. Whole‐genome sequencing (WGS) revealed multiple sequence types of E. coli , with a range of resistance and virulence genes. The orientation of the OAF, regional osteomyelitis and septic sinusitis were confirmed with computed tomography on day 70. On day 74, enteral nutrition was provided through a cervical oesophagostomy tube for 3 months for prevention of oral feed contamination. The OAF was treated with various alternative therapeutics, including apple cider vinegar, propolis and amikacin impregnated products, until resolution on day 116. These non‐conventional therapeutics, antimicrobials and long‐term oesophagostomy contributed to the successful treatment of a complicated OAF. In the future, WGS may be useful to inform antimicrobial selection when MDR or XDR organisms are identified.
Publisher: Wiley
Date: 10-05-2018
DOI: 10.1111/JVIM.15138
Publisher: Wiley
Date: 08-2020
DOI: 10.1111/AVJ.12963
Publisher: American Veterinary Medical Association (AVMA)
Date: 04-2004
Abstract: Objective —To evaluate the diagnostic value of serum concentrations of total magnesium (tMg) and ionized magnesium (iMg), concentrations of magnesium (Mg) in muscle, intracellular Mg (icMg) concentrations, urinary Mg excretion (E Mg ), Mg clearance (C Mg ), and fractional clearance of Mg (FC Mg ) in horses fed diets with Mg content above and below National Research Council recommendations. Animals —9 young female horses. Procedures —6 horses were fed a reduced-Mg diet for 29 days followed by an Mg-supplemented diet for 24 days. Control horses (n = 3) were fed grass hay exclusively. Blood, urine, and tissue s les were collected, and an Mg retention test was performed before and after restriction and supplementation of Mg intake. Serum tMg, serum iMg, muscle Mg, icMg, and urine Mg concentrations were measured, and 24-hour E Mg , C Mg , and FC Mg were calculated. Results —Reductions in urinary 24-hour E Mg , C Mg , and FC Mg were evident after 13 days of feeding a reduced-Mg diet. Serum tMg and iMg concentrations, muscle Mg content, and results of the Mg retention test were not affected by feeding the Mg-deficient diet. Spot urine s le FC Mg accurately reflected FC Mg calculated from 6- and 24-hour pooled urine s les. Mean ± SD FC tMg of horses eating grass hay was 29 ± 8%, whereas mean FC tMg for horses fed a reduced-Mg diet for 29 days was 6 ± 3%. Conclusions and Clinical Relevance —The 24-hour E Mg was the most sensitive indicator of reduced Mg intake in horses. Spot s le FC Mg can be conveniently used to identify horses consuming a diet deficient in Mg. ( Am J Vet Res 2004 :422–430)
Publisher: Elsevier BV
Date: 2017
Publisher: Wiley
Date: 15-05-2017
DOI: 10.1111/JVP.12417
Abstract: Nine horses received 20 mg/kg of intravenous (LEV
Publisher: Wiley
Date: 03-06-2018
DOI: 10.1111/AVJ.12716
Abstract: The purpose of this article is to provide a review of the current knowledge and opinions about the epidemiology, clinical findings (including sequelae), diagnosis, treatment and monitoring of equine pituitary pars intermedia dysfunction, particularly in the Australian context. This information and the recommendations provided will assist practitioners in making informed decisions regarding the diagnosis and management of this disorder.
Publisher: Wiley
Date: 18-11-2022
DOI: 10.1111/EVE.13586
Publisher: Wiley
Date: 25-07-2020
DOI: 10.1111/EVE.13146
Publisher: Wiley
Date: 22-02-0011
DOI: 10.1111/EVJ.12393
Abstract: Critically ill foals often present to veterinary hospitals with impaired organ perfusion which can be demonstrated by increased blood L-lactate concentrations. As a compensatory mechanism to low blood pressure and electrolyte abnormalities, aldosterone and arginine vasopressin (AVP) are released to restore organ perfusion and function. Several studies have investigated the ability of blood L-lactate concentrations to predict severity of disease and outcome in critically ill human patients, adult horses and foals. However, information on the aldosterone and AVP response to hypoperfusion and its association with L-lactate concentrations in neonatal foals is limited. To determine the association between clinical hypoperfusion and endocrine markers of reduced tissue perfusion in normo- and hypoperfused foals. Prospective, multicentre, cross-sectional observational study. Blood s les were collected on admission from 72 clinically hypoperfused, 110 normoperfused (73 hospitalised and 37 healthy) foals of ≤4 days of age. Foals were considered clinically hypoperfused if they had L-lactate concentrations ≥2.5 mmol/l and one of the 3 following findings: heart rate >120 beats/min, packed cell volume (PCV) >0.44 l/l or azotaemia (increased creatinine and blood urea nitrogen [BUN]). Blood concentrations of aldosterone and AVP were determined by radioimmunoassays. Aldosterone, AVP, creatinine and BUN concentrations and heart rate, PCV and blood osmolality were higher in clinically hypoperfused compared with normoperfused foals (P<0.05). Risk of hypoperfusion increased with the presence of hypothermic extremities (OR = 5.26) and with each one unit increase in albumin concentrations (OR = 3.5) (P<0.05). The proposed admission L-lactate cut-off value above which nonsurvival could be reliably predicted in hospitalised foals was 10.6 mmol/l with 82% of sensitivity and 74% of specificity. Hyperaldosteronaemia and hypervasopressinaemia as well as hypothermic extremities and increased albumin concentrations are potent predictors of hypoperfusion in hospitalised foals.
Publisher: Wiley
Date: 07-04-2020
DOI: 10.1111/JVIM.15771
Abstract: Determination of plasma adrenocotrophic hormone (ACTH) concentration (endogenous or thyrotropin‐releasing hormone [TRH] stimulation test) is the most commonly used diagnostic test for pituitary pars intermedia dysfunction (PPID) in horses. Because ACTH is unstable, s les often are frozen to be shipped to laboratories or to allow for batch analysis of research s les. However, the effect of multiple freeze‐thaw cycles on equine ACTH is unknown. To determine the effects of multiple freeze‐thaw cycles on immunoreactive ACTH concentration. Twenty‐eight horses ranging from 10 to 27 years of age were used. Prospective study. Horses were ided into 4 groups: group 1, PPID‐negative, without TRH stimulation group 2, PPID‐negative, with TRH stimulation group 3, PPID‐positive, without TRH stimulation and group 4, PPID‐positive, with TRH stimulation. Whole blood was collected from each horse at baseline or 30 minutes after TRH stimulation. Immunoreactive plasma ACTH concentration was determined using a chemiluminescence assay. Plasma s les then were frozen at −80°C hours, thawed at 4°C and reanalyzed for 5 freeze‐thaw cycles. Changes in plasma ACTH concentration were analyzed using a linear mixed‐effect model. Significant effects of freeze‐thaw cycles ( P = .001) and PPID status ( P = .04) on plasma ACTH concentration were observed, but no significant effect of TRH stimulation was identified. The plasma ACTH concentration is altered by freeze‐thaw cycles, and the effect is observed sooner in horses with PPID. To diagnose PPID, multiple freeze‐thaw cycles should be avoided when measuring plasma ACTH concentration.
Publisher: Wiley
Date: 31-10-2019
DOI: 10.1111/EVE.12852
Publisher: Wiley
Date: 02-2009
Publisher: Wiley
Date: 20-06-2021
DOI: 10.1111/AVJ.13093
Abstract: Dog‐to‐dog bite wounds are a common veterinary emergency presentation: despite this, there is insufficient information to guide veterinarians on appropriate empirical antimicrobial management. Investigate the effectiveness of amoxicillin–clavulanic acid with and without enrofloxacin in the treatment of moderate grade dog bite wounds (DBW). To describe common pathogens and their antimicrobial susceptibility patterns. In a single‐centre parallel group pragmatic trial, 50 dogs presenting with moderate grade DBW were prospectively randomised to receive amoxicillin–clavulanic acid (group A) or amoxicillin–clavulanic acid and enrofloxacin (group B). Swabs were taken for culture and susceptibility testing at admission. Stabilisation, wound care and surgical debridement were performed at the discretion of admitting clinicians. The primary outcome was complication due to infection at 10 days, with Bayesian inference used to estimate the difference in proportions between treatment groups. Of the 24 dogs in treatment group A, 1 required the addition of enrofloxacin at re‐examination. None of the 26 dogs in group B required alteration of antimicrobial coverage. The difference in complication rate due to infection between treatment groups was 4.2%. Twenty‐one different organisms were identified: Staphylococcus pseudintermedius , Neisseria spp., Pasteurella multocida and P . canis were the most common. Over 90% of gram‐negative and gram‐positive isolates were susceptible to amoxicillin–clavulanic acid. Ninety‐six percent of gram‐negative and 86% of gram‐positive isolates were susceptible to enrofloxacin. Amoxicillin–clavulanic acid is an appropriate empirical antimicrobial choice for moderate DBW in South East Queensland. Reduced empirical enrofloxacin use will promote antimicrobial stewardship and potentially antimicrobial resistance.
Location: United States of America
No related grants have been discovered for Allison Stewart.