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Biomedical subjects

P D Clegg

Publications and source records attributed to P D Clegg.

At least 19 recordsLinked to original sources

Analysis of horse race videos to identify intra-race risk factors for fatal distal limb fracture.

The objective of this study was to identify risk factors, during racing, associated with imminent fatal distal limb fracture in Thoroughbreds. One hundred and nine cases of fatal distal limb fracture were identified from all 59 UK racecourses over a 2-year period (February 1999-January 2001). Three uninjured control horses were randomly selected from the same race as the case horse. Videos of races in which fractures occurred were viewed using a defined protocol. Fractures in flat races occurred at any time during the race, whereas 74% (45/61) of cases in national hunt type races occurred in the second half of races. More than 75% (79/103) of cases were spontaneous, i.e. there was no obvious external influence such as a fall at a fence or collision with another horse. Sixty-six percent (44/67) of horses, sustaining a forelimb fracture, fractured the forelimb they were using as lead leg at the time of fracture. When case and control horses were compared, horses that were: (a) making good progress through the race, (b) reluctant to start and (c) received encouragement in the final 10s before the time of fracture, were more likely to sustain a fracture.

Animals↗

Catastrophic fracture of the lateral condyle of the third metacarpus/metatarsus in UK racehorses - fracture descriptions and pre-existing pathology.

The characteristics of, and pre-existing pathology associated with 75 cases of fatal lateral condylar fracture sustained by Thoroughbreds while racing in the UK were described. Cases were identified from 220 cases of fatal distal limb fracture submitted as part of studies designed to identify risk factors for all fatal distal limb fractures. Fractures were most common in hurdle races and affected the right forelimb twice as often as the left forelimb. Fracture dimensions were similar to previous reports, however there was a much greater prevalence of articular and diaphyseal comminution and of concurrent fractures in the current report. Pre-existing pathology was particularly common in the medial and lateral parasagittal grooves of the distal articular surfaces of the third metacarpus/metatarsus. The degree of this pathology was not associated with horse age, length of career or number of career starts.

Animals↗

TNF-alpha SNP haplotype frequencies in equidae.

Tumour necrosis factor alpha (TNF-alpha) is a pro-inflammatory cytokine that plays a crucial role in the regulation of inflammatory and immune responses. In all vertebrate species the genes encoding TNF-alpha are located within the major histocompatability complex. In the horse TNF-alpha has been ascribed a role in a variety of important disease processes. Previously two single nucleotide polymorphisms (SNPs) have been reported within the 5' un-translated region of the equine TNF-alpha gene. We have examined the equine TNF-alpha promoter region further for additional SNPs by analysing DNA from 131 horses (Equus caballus), 19 donkeys (E. asinus), 2 Grant's zebras (E. burchellii boehmi) and one onager (E. hemionus). Two further SNPs were identified at nucleotide positions 24 (T/G) and 452 (T/C) relative to the first nucleotide of the 522 bp polymerase chain reaction product. A sequence variant at position 51 was observed between equidae. SNaPSHOT genotyping assays for these and the two previously reported SNPs were performed on 457 horses comprising seven different breeds and 23 donkeys to determine the gene frequencies. SNP frequencies varied considerably between different horse breeds and also between the equine species. In total, nine different TNF-alpha promoter SNP haplotypes and their frequencies were established amongst the various equidae examined, with some haplotypes being found only in horses and others only in donkeys or zebras. The haplotype frequencies observed varied greatly between different horse breeds. Such haplotypes may relate to levels of TNF-alpha production and disease susceptibility and further investigation is required to identify associations between particular haplotypes and altered risk of disease.

Animals↗

Complete and partial hoof wall resection for keratoma removal: post operative complications and final outcome in 26 horses (1994-2004).

REASONS FOR PERFORMING STUDY: There are no data on the frequency of post operative complications following keratoma removal, such as recurrence, hoof wall instability and excessive granulation tissue formation, or their relation to the method of surgical removal. OBJECTIVE: To identify important factors in the outcome for horses undergoing surgical removal of a keratoma and compare the post operative complications encountered following keratoma removal by complete hoof wall resection (CR) and partial hoof wall resection (PR). HYPOTHESIS: Horses undergoing PR would have fewer post operative complications and would return to work more quickly than those undergoing CR. METHODS: A retrospective review of medical records from one equine hospital identified 26 horses that underwent removal of a keratoma by CR or PR. Clinical, radiological and surgical findings and outcome were analysed. RESULTS: Common clinical signs included lameness and the presence of a subsolar abscess. Fourteen horses underwent CR and 12 PR. The complication rate following CR (71%) was significantly lower than that following PR (25%) (P<0.01). Complications encountered included excess granulation tissue formation, hoof crack formation and keratoma recurrence at the surgical site. The time taken to return to full work post operatively was significantly shorter in horses undergoing PR compared to CR (P<0.01). All horses, except one, returned to their previous exercise level. CONCLUSIONS: PR resulted in fewer post operative complications and a more rapid return to athletic activity than CR. POTENTIAL RELEVANCE: Although the overall complication rate for CR was higher than for PR, the overall prognosis for return to soundness and the previous performance level is very good.

Animals↗

Post anaesthetic colic in horses: a preventable complication?

REASONS FOR PERFORMING STUDY: There is little information on the prevalence of, and risk factors associated with, post anaesthetic colic (PAC) in horses undergoing nonabdominal operations. OBJECTIVES: To undertake the first prospective study of prevalence of PAC and identify risk factors in its development in nonabdominal procedures. METHODS: A multicentre prospective case-control study was conducted, on every horse undergoing anaesthesia for a nonabdominal procedure between April 2004 and June 2005. Colic cases were defined as any horse with recognised signs of abdominal pain within 72 h of general anaesthesia that could not be attributed to any concurrent disease. Five control horses per case were selected randomly from the study population at all hospitals. Multivariable logistic regression analysis was used to examine the relationship between predictor variables and the risk of developing PAC. RESULTS: The estimated mean prevalence of PAC in the study population was 5.2% (95% CI, 2.8, 8.0). However, the prevalence of colic varied between each centre. The most commonly diagnosed cause of colic was impaction. Multivariable analyses showed that the centre involved and the type of surgery performed were associated with an increased risk of PAC. Preoperative food deprivation and the use of opioid drugs were confounding factors. CONCLUSIONS: Prevalence of PAC varied significantly between the 4 hospitals studied; there may be hospital-related covariates that account for this. The type of surgery performed influenced the risk of PAC. POTENTIAL RELEVANCE: Identifying the risk factors for PAC is a prerequisite for its prevention. This study indicates horses at increased risk of PAC that might benefit from a more critical evaluation of post anaesthetic gastrointestinal function and/or the provision of preventative measures. Further investigation is required to explain the variation in prevalence of PAC between centres.

Anesthesia↗

Skeletal scintigraphy in the horse: current indications and validity as a diagnostic test.

Gamma scintigraphy is a well established imaging modality, which in equine practice is predominantly used in the investigation of lameness and suspected musculoskeletal problems. Whilst there is a growing literature on the indications for scintigraphy in the horse, there has been little emphasis so far on identifying the validity of scintigraphy as a diagnostic test. In particular, to what extent can the results of a scintigraphic examination be trusted? In this opinionated review the current indications for skeletal scintigraphy in the horse are considered and its validity as a diagnostic test reviewed. It is concluded that in the majority of published studies, inherent biases in study design make it difficult to assess accurately the validity of skeletal scintigraphy in the horse. Further well designed, prospective studies are required to assess the validity of skeletal scintigraphy as a diagnostic tool, particularly in horses with subtle alterations in radiopharmaceutical uptake.

Animals↗

Quantitative analysis of voltage-gated potassium currents from primary equine (Equus caballus) and elephant (Loxodonta africana) articular chondrocytes.

In this comparative study, we have established in vitro models of equine and elephant articular chondrocytes, examined their basic morphology, and characterized the biophysical properties of their primary voltage-gated potassium channel (Kv) currents. Using whole cell patch-clamp electrophysiological recording from first-expansion and first-passage cells, we measured a maximum Kv conductance of 0.15 +/- 0.04 pS/pF (n = 10) in equine chondrocytes, whereas that in elephant chondrocytes was significantly larger (0.8 +/- 0.4 pS/pF, n = 4, P </= 0.05). Steady-state activation parameters of elephant chondrocytes (V = -22 +/- 6 mV, k = 11.8 +/- 3 mV, n = 4) were not significantly different from those of horse chondrocytes (V = -12.5 +/- 4.3 mV, k = 12 +/- 2, n = 10). This suggests that there would be slightly more resting Kv activation in elephant chondrocytes than in their equine counterparts. Kinetic analysis revealed that both horse and elephant chondrocyte Kv currents had similar activation and inactivation parameters. Pharmacological investigation of equine chondrocyte Kv currents showed them to be powerfully inhibited by the potassium channel blockers tetraethylammonium and 4-aminopyridine but not by dendrotoxin-I. Immunohistochemical studies using polyclonal antibodies to Kv1.1-Kv1.5 provided evidence for expression of Kv1.4 in equine chondrocytes. This is the first electrophysiological study of equine or elephant chondrocytes. The data support the notion that voltage-gated potassium channels play an important role in regulating the membrane potential of articular chondrocytes and will prove useful in future modeling of electromechanotransduction of fully differentiated articular chondrocytes in these and other species.

4-Aminopyridine↗

Effect of age at presentation on outcome following arthroscopic debridement of subchondral cystic lesions of the medial femoral condyle: 85 horses (1993--2003).

REASONS FOR PERFORMING STUDY: Subchondral cystic lesions of the medial femoral condyle (SCMFC) are well documented in horses < or =3 years; arthroscopic debridement or enucleation of the cyst is currently the surgical treatment of choice. However, studies of occurence and outcome following surgery in older horses are lacking. OBJECTIVE: To identify factors important in outcome for horses with SCMFC treated by arthroscopic debridement. HYPOTHESIS: Age of horse at presentation has a significant influence on return to work following arthroscopic treatment for SCMFC. Clinical and diagnostic findings are also significant with respect to prognosis. METHODS: A retrospective review of medical records from 6 equine referral centres identified 85 horses that underwent arthroscopic debridement of SCMFC. Clinical examination, radiographic and arthroscopic findings were analysed together with follow-up data. Univariable analysis and multivariable logistic regression models were used to determine factors affecting return to soundness. Event-time analysis was performed to evaluate return to work. RESULTS: Older horses (>3 years) were less likely to return to soundness (P = 0.02) or to work (P = 0.04) than younger horses (< or = 3 years). Of 39 horses age 0-3 years, 25 (64%, 95% CI 49-79%) returned to soundness. Of 46 horses age >3 years, 16 (35%,95% CI 21-49%) returned to soundness. In addition, cartilage damage at sites other than the SCMFC negatively affected prognosis (P = 0.05). The hospital where treatment was performed had no influence on return to soundness. CONCLUSIONS: Older horses carry a worse prognosis for both return to soundness and return to work. POTENTIAL RELEVANCE: It is important for clients to be made aware of the difference in outcome between age groups.

Age Factors↗

Risk factors for fatal lateral condylar fracture of the third metacarpus/metatarsus in UK racing.

REASONS FOR PERFORMING STUDY: Lateral condylar fractures of the third metacarpus/metatarsus are the most common cause of equine fatality on UK racecourses. Identification of risk factors for such injuries and the subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities. OBJECTIVES: To identify horse-, race- and course-level risk factors for fatal lateral condylar fracture in Thoroughbreds on UK racecourses. METHODS: Case-control study designs were used. Case horses were defined as those that were subjected to euthanasia having sustained an irreparable lateral condylar fracture while racing at any of the 59 UK racecourses. Case races were defined as those in which one or more horses sustained a fatal lateral condylar fracture. Three controls for each case horse were selected at random from the race in which the case was running. Three controls for each case race were selected at random from all races of the same type held in the same year. Ninety-eight cases were included in the study. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture. RESULTS: Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have started racing as 3- or 4-year-olds. Fractures were found to be more likely in longer races with a larger number of runners, races in which professional jockeys were not permitted to ride and races in which the going was described as firm or hard. CONCLUSIONS AND POTENTIAL RELEVANCE: Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal lateral condylar fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 201 m (1 furlong) and 1609 m (8 furlongs) per week. The association with age at first race requires further investigation for flat and National Hunt racing separately. A reduction in the number of races taking place on very firm going could have an impact on the number of lateral condylar fractures.

Age Factors↗

Septic tenosynovitis of the tarsal sheath of an Arab gelding and suspected sepsis of the lateral digital flexor tendon subsequent to bacterial peritonitis.

A 21-year-old Arab gelding with clinical signs of acute peritonitis had a perforating ulcer on the mesenteric border of the jejunum which resulted in localised contamination of the abdomen with ingesta. The affected segment of jejunum was resected and the abdomen was lavaged extensively. Postoperatively, the gelding was treated with broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs and intravenous fluids, but after four days it became acutely non-weight bearing on its right hindlimb, and a tendonitis of the lateral digital flexor tendon within the tarsal sheath was identified ultrasonographically. The septic tendonitis was treated with broad-spectrum antibiotics but progressed proximodistally within the tendon until it involved both the tarsal sheath and the associated tarsocrural joint, necessitating the euthanasia of the gelding.

Animals↗

Retrospective study of the risk factors and prevalence of colic in horses after orthopaedic surgery.

The records of 496 orthopaedic operations on 428 horses were reviewed to estimate the prevalence of, and identify the risk factors for, the development of colic in horses after surgery. Colic was defined as any recognised sign of abdominal pain that could not be attributed to a concurrent disease. Fourteen of the horses developed colic; eight of them were undiagnosed, three were classified as impactions, one as tympanic colic of the colon, one as incarceration of the small intestine in the epiploic foramen, and one as left dorsal displacement of the colon in the nephrosplenic space. Morphine was associated with a four-fold increased risk of colic compared with the use of no opioid or butorphanol, and out-of-hours surgery was also associated with an increased risk.

Animals↗

Cultivation of human tenocytes in high-density culture.

Limited supplies of tendon tissue for use in reconstructive surgery require development of phenotypically stable tenocytes cultivated in vitro. Tenocytes in monolayer culture display an unstable phenotype and tend to dedifferentiate, but those in three-dimensional culture may remain phenotypically and functionally differentiated. In this study we established a three-dimensional high-density culture system for cultivation of human tenocytes for tissue engineering. Human tenocytes were expanded in monolayer culture before transfer to high-density culture. The synthesis of major extracellular matrix proteins and the ultrastructural morphology of the three-dimensional cultures were investigated for up to 2 weeks by electron microscopy, immunohistochemistry, immunoblotting and quantitative, real-time PCR. Differentiated tenocytes were able to survive over a period of 14 days in high-density culture. During the culture period tenocytes exhibited a typical tenocyte morphology embedded in an extensive extracellular matrix containing cross-striated collagen type I fibrils and proteoglycans. Moreover, expression of the tendon-specific marker scleraxis underlined the tenocytic identity of these cells. Taken together, we conclude that the three-dimensional high-density cultures may be useful as a new approach for obtaining differentiated tenocytes for autologous tenocyte transplantation to support tendon and ligament healing and to investigate the effect of tendon-affecting agents on tendon in vitro.

Basic Helix-Loop-Helix Proteins↗

Case-control investigation of the factors affecting the risk of horses falling during steeplechase racing in the UK.

A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.

Accidental Falls↗

Risk of fatal distal limb fractures among Thoroughbreds involved in the five types of racing in the United Kingdom.

The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the third metacarpus were the most common, and they were also the most common in national hunt-type races (hurdle, steeplechase and national hunt flat races). In all-weather flat racing biaxial proximal sesamoid fractures were most common, and in turf flat racing fractures of the first phalanx were most common. The risk of fractures of more than one bone was greater in national hunt-type races.

Animals↗

Horse injuries and racing practices in National Hunt racehorses in the UK: the results of a prospective cohort study.

A prospective cohort study was conducted on horses starting in hurdle and steeplechase races on six UK racecourses in 2000 and 2001. Trainers or carers were questioned on the horses' pre-race routine and observational data were collected in the stables and parade ring. Some practices were common to many starters, such as withholding food and water before racing whereas other practices, such as schooling frequency, were more variable. There was a total of 2879 starts and a total of 83 injuries or medical events (28.8/1000 starts). The commonest types of injury were tendon/suspensory injuries and lacerations/wounds. Multivariable logistic regression models were used to identify the relationship between predictor variables and the risk of injury. Risk of injury or medical event was associated with distance of the race and weight carried. The risk of injury, excluding medical events, was associated with the speed of the race and foot conformation.

Animal Husbandry↗

A prospective cohort study to investigate risk factors for horse falls in UK hurdle and steeplechase racing.

REASONS FOR PERFORMING STUDY: Equine fatalities during racing continue to be a major welfare concern and falls at fences are responsible for a proportion of all equine fatalities recorded on racecourses. OBJECTIVES: To identify and quantify risk factors for horse falls in National Hunt (NH) racing and to report the frequency of falling and falling-associated fatalities. METHODS: A prospective cohort study was conducted on 2879 horse starts in hurdle and steeplechase races on 6 UK racecourses. Any horse that suffered a fall at a steeplechase or hurdle fence during the race was defined as a case. Data were obtained by interview and observations in the parade ring and from commercial databases. Multivariable logistic regression models, allowing for clustering at the level of the track, were used to identify the relationship between variables and the risk of falling. RESULTS: There were 124 falling cases (32 in hurdling and 92 in steeplechasing) identified. The injury risk of fallers was 8.9% and fatality risk 6.5%. Duration of journey to the racecourse, behaviour in the parade ring and weather at the time of the race were associated with falling in both hurdle and steeplechase racing. Age, amount of rainfall and going were also associated with falling in steeplechase racing. CONCLUSIONS: Falls at fences are significant contributors to equine fatalities during NH racing. Potentially modifiable risk factors identified were the condition of track surfaces and journey time to the racecourse. POTENTIAL RELEVANCE: It is hoped that information from this study may be used in future interventions to improve horse and jockey safety in racing. The study has also identified areas requiring further research, such as equine behaviour and its effect on racing performance, and the effect of light conditions on jumping ability.

Accidental Falls↗

Whip use and race progress are associated with horse falls in hurdle and steeplechase racing in the UK.

REASONS FOR PERFORMING STUDY: Falls during racing present a risk of injury to both horse and jockey and a risk of fatality to horses. OBJECTIVES: To use video recordings of races to describe the circumstances surrounding horse falls at hurdle and steeplechase fences and to identify and quantify within-race risk factors for horse falls in National Hunt racing in the UK. METHODS: A retrospective, matched, nested case-control study using video recordings of races was conducted on 6 UK racecourses. Cases and controls were matched on both race type and jump number at which the fall occurred. Conditional logistic regression analysis was used to examine the univariable and multivariable relationship between predictor variables and the risk of falling. RESULTS: The risk of falling was significantly associated with whip use and race progress. Horses which were being whipped and progressing through the race were at greater than 7 times the risk of falling compared to horses which were not being whipped and which had no change in position or lost position through the field. CONCLUSIONS: This study has identified whip use and the position of the horse with respect to others in the field as potential risk factors for horse falls. POTENTIAL RELEVANCE: If these findings are confirmed by the use of intervention trials (e.g. with whip-free or restricted whip use races), modifications could be introduced which would reduce the frequency of horse falls, leading to improved equine welfare.

Accidental Falls↗

Chronic equine laminitis is characterised by loss of GLUT1, GLUT4 and ENaC positive laminar keratinocytes.

REASONS FOR PERFORMING STUDY: Equine laminitis is a multifactorial connective tissue disorder with major implications for the welfare of horses. There are few published studies on phenotypic markers for identification of equine laminar keratinocytes using immunohistochemical techniques. OBJECTIVES: To establish whether the epithelial sodium channel (ENaC) and the GLUT1 and GLUT4 facilitative glucose transporters may be used as phenotypic markers for identification of equine laminar keratinocytes using immunohistochemical techniques to monitor changes in the keratinocyte population in laminitis. METHODS: Histology and immunohistochemistry using polyclonal antibodies to the alpha subunit of ENaC (alphaENaC), GLUT1 and GLUT4 were used to compare the distribution of these proteins in normal and laminitic equine laminae. RESULTS: Immunohistochemistry with antibodies to alphaENaC, GLUT1 and GLUT4 confirmed the abundant expression of all 3 membrane proteins in healthy laminar keratinocytes. However, in laminitis, the Haematoxylin Van Gieson (HVG) technique revealed disordered laminar arrays and replacement with fibrous scar tissue. Immunostaining of laminitic samples confirmed the loss of alphaENaC, GLUT1 and GLUT4 positive keratinocytes. Other connective tissue cells did not stain positive for these proteins. CONCLUSIONS: This is the first report of alphaENaC and GLUT1/GLUT4 protein expression in equine laminar keratinocytes, which also confirms that the loss of laminar structure and function in chronic laminitis is accompanied by the loss of laminar keratinocytes. POTENTIAL RELEVANCE: alphaENaC, GLUT1 and GLUT4 may be used as phenotypic markers of metabolically active, differentiated equine laminar keratinocytes. Further in vitro studies are necessary to determine the effects of hypoxia, bacterial endotoxins, vasoactive amines, lactic acid and prostaglandins on the expression and activity of these plasma membrane keratinocyte markers.

Animals↗