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EQUINE VETERINARY EDUCATION / AE / MARCH 2016


reached for common bacterial isolates, and detect toxicosis associated with high trough values. Data including weight, dose, plasma peak, and trough


gentamicin concentration, creatinine concentrations and presence of focal or systemic disease were collected from medical records of 65 hospitalised horses who were receiving once-daily gentamicin with TDM performed (99 sets). Peak concentrations measured 25–35 min after administration were included (n = 77). Data were divided into low (<7.7 mg/kg), medium (7.7–9.7 mg/kg) and high (>9.7 mg/kg) dose groups, and were grouped by the horse having focal or systemic disease. Peak concentrations resulting from doses ≥7.7 mg/kg


were 5.74 lg/ml (s.e. 2.1 lg/ml) greater than peaks from doses <7.7 mg/kg. Peak concentration was 3.6 times more likely to be >32 lg/ml if the dose was ≥7.7 mg/kg. There were no significant effects of dose on trough or creatinine concentration. At a given dose, horses with focal disease had higher peaks than those with systemic disease. The data fromthis study suggests gentamicin dosage should


be individually determined in horses using TDM, but support an initial once-daily dose of 7.7–9.7 mg/kg i.v. to achieve peaks >32 lg/ml and trough concentrations <2 lg/ml. Further studies evaluating the safety of doses >6.6 mg/kg are required.


Anatomy of nasal conchal bullae


In this study, T. Liuti and colleagues based at the University of Edinburgh describe the anatomy of the dorsal and ventral nasal conchal bullae in normal horses using computed tomographic anatomical and morphometric findings. Involvement of dorsal and ventral nasal conchal bullae


can be clinically important in sinusitis. This study aimed to describe the computed tomographic anatomy of these structures: 90 equine heads were obtained from abattoirs and their age estimated from dentition. Computed tomographic images were acquired and examined by diplomats. Specimens with dental or sinonasal disease (confirmed by skull sectioning and gross examination) were excluded from the study, leaving 60 specimens. Imaging software (OsiriX) was used to create multi-


dimensional reconstructions and measure height, length and width of dorsal and ventral bullae allowing the volume of each bulla to be calculated. Height, length and width of each head also provided a volume for each skull. The dorsal conchal bullae were found to be greater in


volume (average 24 cm3) than ventral conchal bullae (average 15 cm3) and these were related to head size. In both dorsal and ventral bullae, there were significant differences in the volumes between different age groups, with those in the youngest group (0–5 years) having significantly smaller volumes than those in the oldest group (over 16 years). In the case of the ventral conchal bullae, this could be explained by the larger size of cheek teeth alveoli protruding into the nasal cavity in younger horses. In the majority of horses (81.3%) the rostral limit of the dorsal conchal bulla was parallel to Triadan 07s. The caudal limit was parallel to Triadan 10s in 61% and the 09s in 30.5%. The rostral limit of the ventral conchal bulla was parallel to Triadan 07s in 78% and the caudal limit parallel to the 09s in 64.5% and the 10s in 32%. This shows that in some horses the caudal limits of the ventral conchal bulla can overlap with the rostral extent of the rostral maxillary sinus.


© 2016 EVJ Ltd


This study provides information on the anatomical features


of dorsal and ventral conchal bullae and their relationship with adjacent structures and will help in identifying which structures are involved in sinus disease.


Monitoring acute equine visceral pain


This study, by Johannes van Loon and Machteld Van Dierendonck from The Netherlands and Belgium, describes scale construction and clinical applicability of the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS- COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) in horses with acute colic. This cohort study was performed using 50 adult horses (25


with acute colic and 25 controls). Composite pain scores were assessed by direct observations and Visual Analog Scale (VAS) scores were assessed from video clips. Colic patients were assessed at arrival, and on the first and second mornings after arrival. Both the EQUUS-COMPASS and EQUUS-FAP scores showed high inter-observer reliability (ICC = 0.98 for EQUUS- COMPASS, ICC = 0.93 for EQUUS-FAP, P<0.001), while a moderate inter-observer reliability for the VAS scores was found (ICC = 0.63, P<0.001). The cut-off value for differentiation between healthy and colic horses for the EQUUS-COMPASS was 5, and for differentiation between conservatively treated and surgically treated or euthanased patients it was 11. For the EQUUS-FAP, cut-off values were 4 and 6, respectively. Internal sensitivity and specificity were good for both EQUUS-COMPASS (sensitivity 95.8%, specificity 84.0%) and EQUUS-FAP (sensitivity 87.5%, specificity 88.0%). The use of the EQUUS-COMPASS and EQUUS-FAP enabled repeated and objective scoring of pain in horses with acute colic. The authors plan to perform a follow- up study with new patients and control animals to further validate the constructed scales that are described in this study.


S. WRIGHT EVE Editorial Office References


Bauquier, J.R., Boston, R.C., Sweeney, R.W. and Wilkins, P.A. (2015) Plasma peak and trough gentamicin concentrations in hospitalized horses receiving intravenously administered gentamicin. J. Vet. Intern. Med. 29, 1660-1666.


Duffee, L.R., Stefanovski, D., Boston, R.C. and Boyle, A.G. (2015) Predictor variables for and complications associated with Streptococcus equi subsp equi infection in horses. J. Am. Vet. Med. Assoc. 247, 1161-1168.


Liuti, T., Reardon, R., Smith, S. and Dixon, P.M. (2015) An anatomical study of the dorsal and ventral nasal conchal bullae in normal


horses: Computed tomographic anatomical and morphometric findings. Equine Vet. J. Epub ahead of print DOI: 10.1111/ evj.12516.


van Loon, J.P. and Van Dierendonck, M.C. (2015) Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study. Vet. J. 206, 356-364.


Schweizer, C., Ramseyer, A., Gerber, V., Christen, G., Burger, D. and Wohlfender, F.D. (2015) Retrospective evaluation of all recorded horse race starts in Switzerland during a four year period focusing on discipline-specific risk factors for clinical events. Equine Vet. J. Epub ahead of print DOI: 10.1111/evj.12515.


Stewart, S., Richardson, D., Boston, R. and Schaer, T.P. (2015) Risk factors associated with survival to hospital discharge of 54 horses with fractures of the radius. Vet. Surg. 44, 1036-1041.


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