Hypoglycin A (HGA) in seeds of Acer spp. is suspected to cause seasonal pasture myopathy in North America and equine atypical myopathy (AM) in Europe, fatal diseases in horses on pasture. In previous studies, this suspicion was substantiated by the correlation of seed HGA content with the concentrations of toxic metabolites in urine and serum (MCPA-conjugates) of affected horses. However, seed sampling was conducted after rather than during an outbreak of the disease. The aim of this study was to further confirm the causality between HGA occurrence and disease outbreak by seed sampling during an outbreak and the determination of i) HGA in seeds and of ii) HGA and MCPA-conjugates in urine and serum of diseased horses. Furthermore, cograzing healthy horses, which were present on AM affected pastures, were also investigated. AM-pastures in Germany were visited to identify seeds of Acer pseudoplatanus and serum (n = 8) as well as urine (n = 6) from a total of 16 diseased horses were analyzed for amino acid composition by LC-ESI-MS/MS, with a special focus on the content of HGA. Additionally, the content of its toxic metabolite was measured in its conjugated form in body fluids (UPLC-MS/MS). The seeds contained 1.7–319.8 μg HGA/g seed. The content of HGA in serum of affected horses ranged from 387.8–8493.8 μg/L (controls < 10 μg/L), and in urine from 143.8–926.4 μg/L (controls < 10 μg/L), respectively. Healthy cograzing horses on AM-pastures showed higher serum (108.8 ± 83.76 μg/L) and urine concentrations (26.9 ± 7.39 μg/L) compared to control horses, but lower concentrations compared to diseased horses. The range of MCPA-carnitine and creatinine concentrations found in diseased horses in serum and urine were 0.17–0.65 mmol/L (controls < 0.01), and 0.34–2.05 μmol/mmoL (controls < 0.001), respectively. MCPA-glycine levels in urine of cograzing horses were higher compared to controls. Thus, the causal link between HGA intoxication and disease outbreak could be further substantiated, and the early detection of HGA in cograzing horses, which are clinically normal, might be a promising step in prophylaxis.

A knowledge of the parietal structures of the abdominal wall is necessary to minimize risks of operative procedures like laparoscopy. For means to prevent intraoperative bleeding and the occurrence of abdominal wall hematoma, we studied the course of the inferior epigastric arteries and the ascending branch of the deep circumflex iliac artery in 21 human cadavers. The abdominal wall structures were dissected and the distances of the arteries in relation to anatomic structures such as the umbilicus, pubic symphysis, superior ischial spine and lower edge of the rib-cage were measured. Comparison of the morphometric results obtained with the location of 36 trocar incision sites recommended in the common literature yields the information that about half of these incision sites incur the risk of injuring the arteries.

Zusammenfassung: Trotz der Verfügbarkeit potenter Tetanusimpfstoffe sind dramatisch verlaufende Tetanusinfektionen noch immer im Alltag des Pferdepraktikers präsent. Dies gab Anlass verschiedene Impfstrategien und die daraus resultierende humorale Immunitätslage zu überprüfen. Es standen 91 Serumproben von Pferden mit glaubhafter Impfanamnese zur Verfügung, welche mittels Doppelantigen-ELISA (DAE) untersucht wurden. Die Seroprävalenz protektiver Tetanustoxoidantikörperkonzentrationen (TTAK) von ≥0,1 IE/ml betrug 92,3 %. 89 % der Pferde waren zum Zeitpunkt der Blutentnahme ihrem jeweiligen Alter entsprechend gemäß der "Leitlinie zur Impfung von Pferden", herausgegeben von der Ständigen Impfkommission des Bundesverbandes Praktizierender Tierärzte (bpt), immunisiert. In fünf Fällen hatten diese Tiere jedoch keinen ausreichenden Impfschutz. Hierzu zählten ein fünf Monate altes Fohlen, bei welchem die maternalen Antikörper bereits unter die Schutzgrenze abgefallen waren und zwei juvenile Pferde, welche die dritte Vakzination der Grundimmunisierung (GI) noch nicht erhalten hatten. Abweichungen von der Impfempfehlung bestanden ausschließlich in Form verlängerter Abstände der Wiederholungsimpfungen von drei bis zu acht Jahren, wobei diese Tiere jedoch protektive TTAK aufwiesen. Unter alleiniger Betrachtung des Patientenalters wiesen alle Pferde über 20 Jahre (n =12) TTAK weit oberhalb der Schutzgrenze auf. Hinsichtlich der Anwendung unterschiedlicher Boosterintervalle unterschieden sich die TTAK nicht signifikant (p = 0,117). Der zeitliche Abstand zwischen letzter Tetanusimpfung und Probennahme ließ keine Prognose über die zu erwartenden TTAK zu. Selbst Pferde mit einheitlichem Impfregime reagierten sehr heterogen. Entgegen der Meinung eine bessere Immunantwort sei effektiver, je weniger Komponenten zeitgleich geimpft werden, unterschieden sich die TTAK nach Impfung mit monovalenten Vakzinen nicht signifikant von denen nach Durchführung einer Kombinationsimpfung (p=0,63). Basierend auf diesen Ergebnissen und experimentellen Daten aus Vakzinationsversuchen empfehlen wir zur Vermeidung fehlerhafter Immunisierungen vor der Erstvakzination eine Bestimmung der TTAK mit Vollendung des fünften Lebensmonats, welche zuverlässig und schnell mittels eines Streifentestes vor Ort vorgenommen werden kann. Im zweijährlichen Intervall vorgenommene Wiederholungsimpfungen sind nicht besser protektiv. Die Impfempfehlung könnte auch ein acht-bis 10-jähriges Intervall für Auffrischungsimpfungen ausweisen. Die Tetanusimmunität betreffend ergeben sich keine Nachteile bei gleichzeitiger Impfung weiterer Antigenkomponenten. Gewissheit über den tatsächlichen Immunstatus kann nur über die Bestimmung der TTAK erlangt werden, da auch die Dokumentation der Impfungen selbst fehlerhaft sein kann.Schlüsselwörter: Impfung / Prophylaxe / maternale Antikörper / Immunitätsdauer / Schnelltest / Immunologie Immunization strategies and seroprotection against tetanus in horses in central germany Despite the availability of potent tetanus vaccines, highly fatal...

Retrospective analysis of 74 horses with disorders of the oesophagus 74 cases of horses which had been admitted to the Department of Large Animal Internal Medicine between 2000 and the beginning of 2010, have been analyzed retrospectively. Five of these horses are described in detail. A primary obstruction of the esophagus was diagnosed in 60 horses. The diagnosis based on the inability to pass a nasogastric tube and the treatment of choice was the esophageal lavage technique. Other diseases were esophageal dysfunction without any morphological changes, esophageal diverticula, hypertrophy of the esophageal musculature following a chronic dilatation of the stomach, distinctive ulceration of the esophagus, esophagitis because of reflux, esophageal perforation and megaesophagus. Diagnostic was made by endoscopy and radiology (with or without contrast medium). In four horses, the esophageal obstruction was removed at the time of admission in the large animal hospital. The most common localisation of obstruction was the thoracic inlet. The gullets were obstipated with beet pulp, hay or straw, pellets or beets. All horses with primary esophageal obstruction could be cured and discharged. In two cases with diverticula of the esophagus, a surgical therapy was not possible due to the localisation. Based on the poor prognosis, horses A and B were euthanized as well as horse C with chronic dilatation of the stomach, one stallion with a perforation of the esophagus (horse E) and one mare (horse F) with high grade esophagitis. Necropsy of horse A revealed a false diverticulum (11.5 x 11.0 x 8.5 cm) of Pars abdominalis of the esophagus. This outpouching contained 560 g of compact plant-derived material. Horse B showed a false diverticulum of Pars thoracica of the esophagus (length: 18 cm, maximum circumference: 32.5 cm). Cardia and Pars proventricularis were obstructed with a firm and dry conglomerate of wood shavings. Besides gastric alterations consistent with chronic dilatation of the stomach, horse C also exhibited chronic changes of the rear part of the esophagus: interstitial fibrosis in conjunction with muscular degeneration and hypertrophy, respectively. Regarding horse E, two complete transections could be detected 19 and 35 cm behind the epiglottis. Tissue surrounding esophagus was characterized by a severe chronic-active purulent and necrotisizing inflammation, which extended to the diverticula tubae auditivae. One mare (horse D) with a high-grade ulcerative primary esophagitis has been treated with omeprazol, prednisolone, amoxicillin and gentamicin. After three weeks of treatment with omeprazol and prednisolone, endoscopy showed that the esophagitis had been cured almost completely. The horse was released from the clinic with a good prognosis. If recurrent esophageal obstructions occur in adult horses, esophageal diverticula have to be considered as one differential diagnosis. Regarding the two described cases, the morphological alterations have to be classified as pulsion diverticula (false diverticula). In cont...

A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the reasonable suspicion of a guttural pouch mycosis with a high degree of purulent-necrotic inflammation and invasion of fungal hyphae. There were no signs of neoplasia, such as melanoma. Daily guttural pouch irrigations with a clotrimazole emulsion (20 g Canesten® Gyn4 solved in 500 ml water), led to a good recovery of the mucosa above the nerve. Periodic endoscopic examination of the left guttural pouch showed that local thickening and distal atrophy of this pharyngeal ramus did not improve, neither did the clinical symptoms. Due to progressive weight loss, acute respiratory distress and aspiration pneumonia, the 20-year-old pony mare unfortunately had to be euthanized three weeks after discharge. This case report emphasizes the enormous importance of a single nerve for the realization of the swallowing process. The one-sided loss of function of the pharyngeal branch of the vagal nerve cannot be compensated neither by the remaining ipsilateral nerves nor by the contralateral normal functioning glossopharyngeal and vagal nerves and thus inevitably leads to severe dysphagia.