Veterinary Clinics of North America-Equine Practice最新文献

Myofibrillar myopathy (MFM) is characterized by segmental disarray of myofibrils and ectopic accumulation of a protein called desmin. Previously thought to be a glycogen storage disease, MFM is now recognized as a stand-alone myopathy. Endurance Arabians with MFM usually present with exertional rhabdomyolysis (MFM-ER) at the end of races, elevated serum muscle enzymes, and myoglobinuria. Warmblood horses with MFM (MFM-WB) usually present with pain-associated behaviors such as exercise intolerance, reluctance to engage hind quarter muscles, shifting lameness and normal serum muscle enzymes. Both forms have evidence of decreased cysteine-based antioxidants and, additionally, MFM-WB has molecular signatures of a maladaptive training response.

Many myopathies in horses can be managed by exercise regimes and dietary modifications. This includes modifying the amount of nonstructural carbohydrate, fat, amino acids, vitamin E, and selenium based on the horse's specific myopathy, metabolic status, exercise program, and optimal body weight. Because dietary recommendations differ substantially between myopathies, it is imperative to establish a specific diagnosis. A nutritionist will help practitioners select from the myriad of offered products to ensure a balanced diet. This article provides detailed recommendations for a variety of myopathies affecting performance horses.

Exercise intolerance, chronic cough, and hyperpnea are the clinical hallmarks of equine asthma. Diagnosis of severe equine asthma in horses is multistep; determination of the phenotype will help guide future recommendations. Management of equine asthma is largely reduction/elimination of triggering agents/conditions. Immunosuppressive therapies and bronchodilators are the mainstay of treatment of equine asthma. Rescue therapy with short-acting bronchodilators is the first goal when managing a horse with hyperpnea. The second goal is to control/reduce inflammation and airway remodeling. Immunosuppressive therapies alone will not be effective. Environmental and management changes must be established to minimize or eliminate exposure to triggering agents/factors.

Rehabilitation following muscle injury is critical in restoring the equine athlete to full function. Rehabilitation protocols should be tailored to each patient's global functional assessment, taking into account sports-specific demands, goals for return-to-performance, and overall prognosis. Rehabilitation protocols are often designed to modulate pain, enhance repair, improve proprioception, increase flexibility, restore muscle strength, joint range-of-motion, and neuromotor control. This article will review mechanisms of muscle injury, various physical modalities commonly employed in the rehabilitation period following muscle injury, and injury prevention.

Pre-existing muscle disorders in horses can often be subtle and may only become evident during or after anesthesia. Advancements in veterinary medicine, along with increased knowledge and research in this field, help minimize anesthesia-related problems. Adequate preanesthesia assessment, early disease diagnosis, and proper management are crucial in minimizing risks to the neuromuscular system during general anesthesia.

Knowledge of immunodeficiencies is crucial to neonatal medicine, in that they predispose to sepsis in the newborn and neonatal foal, as well as recurrent infections in older foals. The most common immunodeficiency in newborn and neonatal foals is failure of passive transfer, which is an example of an acquired immunodeficiency. Congenital or developmental immunodeficiencies may be transient or permanent, and can either affect the cell-mediated or humoral arms of immunity, and in some cases both. Affected foals often have chronic or recurrent respiratory or gastrointestinal infections, often with opportunistic pathogens.

Muscle biopsy is often required to provide a definitive diagnosis for neuromuscular disorders and can be performed using open surgical or percutaneous needle biopsy techniques. Fresh samples that are subsequently frozen in the laboratory are preferred by laboratories engaged in research, whereas formalin-fixed muscle is processed by diagnostic laboratories with specialized tinctorial and immunohistochemical techniques. Interpretation by an experienced histopathologist, combined with the signalment, history, and clinical input, is essential for establishing a diagnosis. This article outlines best practices to select, obtain, and ship a muscle sample to a laboratory and a summary of laboratory techniques.