Summary of research projects currently on-going at the Philip Leverhulme Equine Hospital. Updated Summer 2015.

NAME(s) OF STUDY SUPERVISOR(s)

PROJECT TITLE

START DATE

END DATE

LAY SUMMARY

Professor Debra Archer/ Professor Cathy McGowan

The effects of post-operative rehabilitation on abdominal and back conformation after colic surgery. VREC229

June 2014

June 2017

This research describes the development of a post-operative clinical protocol of static and dynamic exercise and monitoring involving a veterinary-physiotherapy team. Post-operative rehabilitation is essential for return to function post abdominal surgery, but our current clinical protocols have not been evaluated. We will be comparing our existing protocol with a new protocol of post operative programme of rehabilitation by non-invasively monitoring abdominal and back conformation.

Mr David Bardell

Effect of epidural versus systemic administration of morphine on isofluorane requirements and quality of recovery of horses anaesthetised for hind limb surgery. VREC324

June 2015

June 2018

This study compares whether morphine (a pain killer) is more effective at improving the quality of anaesthesia if it is injected intravenously or epidurally in horses undergoing hindlimb surgery.It will allow us to determine if there is an observable difference in quality of anaesthesia and recovery from anaesthesia depending on whether morphine is given via epidural or intravenous (systemic) route. If we can identify an advantage of one method over the other it will allow us to make more effective use of one of our main painkilling drugs, so benefitting our equine patients. 

Mr David Bardell/Dr Peter Milner

Measuring markers of redox balance in relation to survival following surgical management of equine colic. VREC219

May 2014

May 2017

This study aims to identify whether naturally occurring anti-oxidant substances are present in sufficient quantities to be able to protect the intestine following surger from further damage by measuring their levels in the blood and peritoneal fluid (which are routinely taken during colic investigations) of horses admitted for investigation of colic. Where surgery is necessary and a section of the small intestine has to be removed, samples of tissue from the removed portion will be retained and subjected to additional testing to measure cell damage and identify whether damage has occurred which may be due to the anti-oxidant substances being unable to neutralize the reactive chemicals produced within the intestinal cells. The aim is to determine whether measuring these changes can be used as an aid to predicting survival of the horse. 

Mr Harry Carslake

Creation of a large scale, tissue microarray (TMA) equine sarcoid bank, and TMA based investigation of phenotypic and prognostic markers of equine sarcoids. VREC271

 

 

 

Mr Harry Carslake

An epidemiological study of equine narcolepsy.

 

 

 

Dr Alex Dugdale

Effects of opioid analgesics (pain-killers) on the characteristics of sedation and anaesthesia in horses. VREC205

 

April 2014

December 2016

General anaesthesia of horses carries a higher risk of patient injury or even death than of people or dogs and cats (around 1 in 100-200 cases may suffer some form of injury, usually during recovery from anaesthesia). We continually strive to reduce these risks and to improve the provision of pain-relief (analgesia) for all our patients.

We commonly use morphine-like pain-killers (called 'opioids') in horses because these are excellent analgesics. Occasionally, however, their administration causes muzzle-twitching or head-nodding. Although we don't believe that these behaviours impact on anaesthetic risk, because we have used these drugs for over 10 years now without noticable problems, we would like to able to prove this, so that other people providing equine anaesthesia will not be afraid of using opioids to provide good analgesia.

Dr Elizabeth Laird

(non-clinical Senior Lecturer in Orthopaedic Sciences)

 

Inflamm-ageing and tissue homeostasis: how does the inflammatory mediator TGFβ regulate the synthesis of degradation-resistant type I collagen (I)? VREC186a

September 2013

September 2017

The aim of the study is to investigate the regulation of the genes encoding type I collagen in musculoskeletal inflammation and ageing. This will involve gene and protein expression analysis with cells stimulated with inflammatory mediator TGF-beta. Transcription factor binding and DNA methylation will also be analyse in stimulated cells.  

Dr Elizabeth Laird

(non-clinical Senior Lecturer in Orthopaedic Sciences)

 

Investigating the changes in ligament and tendon stem cells and their environment with ageing and disease. VREC187a

April 2014

December 2016

The aim of this study is to characterise equine tendon stem cells and the tendon stem cell niche and how this is altered in ageing and disease. This would involve isolation and analysis of cells (including stem cells) and material from post mortem tendon and bone marrow.

Dr Elizabeth Laird

(non-clinical Senior Lecturer in Orthopaedic Sciences)

 

Identification of abnormal collagen in stem cells and disease. VREC186

April 2014

September 2017

The aim of this study is to identify an abnormal form of collagen that may be responsible for musculoskeletal diseases. We will test whether this collagen may be associated with stem-cell activity, what determines how much unusual collagen is produced by cells and how it can be controlled. To do this we plan to analyse normal and diseased musculoskeletal and connective post mortem tissues (tendon, cartilage, synovium, skin, bone and bone marrow) as well as stem cells isolated from these tissues.

Mr Fernando Malalana

Epidemiology, risk factors and features associated with recurrence of Equine Uveitis in the UK. VREC150

July 2013

June 2019

The aim of this study is to investigate the epidemiological factors associated with Equine Recurrent Uveitis (ERU) in the UK, including elucidation of the risk factors involved in the development of an episode of inflammation in the eye and the features that may determine their recurrence. Additionally we would like to describe the gross pathological and histopathological changes in post mortem (enucleated) eyes affected by ERU and determine the level of intraocular leptospiral antibody levels, a common risk factor in European studies.

Mr Fernando Malalana

Complications of dorsal versus inferomedial placement of subpalpebral lavage systems in horses. VREC292

April 2015

April 2019

Subpalpebral lavage systems are commonly placed in equine patients with eye disease with the aim to facilitate administration of topical medication. Currently there are a number of commercial systems available which can be placed within the dorsal or the inferiomedial conjunctival fornix (space between the eyelid and the eyeball). The choice of  placement is dictated in some cases by the location of the problem, but in most instances is done entirely based on clinician preference. In this study any horse that requires placement of a lavage system, and in which the location of the ocular pathology does not preclude a specific location, will be randomly allocated to one of the two (dorsal or inferomedial) locations. Any complication associated with the lavage system will be recorded, together with details of the horse's signalment, pathology and duration of treatment. The rate of complications will then be compared between locations to determine if there is any difference.

Professor Cathy McGowan

Retrospective data analysis of metabolic management at the PLEH. VREC248

July 2014

July 2017

Dietary and exercise management of equine metabolic diseases is poorly understood. Yet dietary and exercise management remain the mainstay  of treatment with or without drug therapy In 2010 a consensus statement from the American College of Veterinary Internal Medicine was published outlining best practice for management of these diseases Since then, we have used the evidence and our clinical experience to develop a fixed price procedure clinical protocol for management of clinical cases referred for these diseases called the PLEH metabolic management clinic. This is a three visit protocol where metabolic disease is evaluated using dynamic endocrine testing and a diet and exercise management programme, tailored to the individual horse/pony and adjusted depending on the responses offered to the owner. In order to determine the success of clinical protocols incorporated into practice, data should be periodically audited and analysed. Responses to the management will be compared against the scientific literature and expected responses. Specifically, body weight, body condition score, and endocrine results can be compared from the first to the final visit for each horse or pony.

Dr Luis Rubio-Martinez

Serum amyloid A and D-lactate concentrations in synovial fluid as diagnostic and prognostic indicators for septic synovitis in horses. VREC175

January 2014

December 2017

The concentrations of serum amyloid A, L-lactate and D-lactate will be determined in synovial fluid samples collected form horses with different synovial conditions. The diagnostic and prognostic values of these markers in cases of synovial sepsis will be evaluated.

Dr Luis Rubio-Martinez

Fractures of the medial intermediate tuberosity of the tibia in horses: a retrospective study. VREC276

September 2014

December 2016

Joint fractures of the stifle, especially those involving the bone protuberance of the tibia named medial intercondylar eminence (MICET) are uncommon in horses. Here at the PLEH we have recently treated a few cases.  We have approached other equine hospitals within the UK and overseas and they are willing to contribute to a multi-centre case review study.  By compiling and analysing the details of the stifle injuries of these horses, treatments applied and response to treatment of these cases we will be able to provide new information valuable to veterinarians attending horses with these fractures.  The study will include the revision of the clinical records of the cases presented here at the PLEH and other participant hospitals.  Follow-up information on the horses included in the study will also be sought be telephone contact with the owners.  Anonymity of the horses’ details and owners will be assured throughout the study.

Dr Mark Senior

Preliminary investigation into the fate of MUC6 in the equine stomach (understanding the function of secreted mucus in the horse's stomach. VREC 273

January 2015

 

For protection, the gastro-intestinal tract lining is covered by mucus in which the main constituents are the secreted gel-forming mucins. Mucins are a family of very large proteins that also contain a large amount of sugar residues. In the stomach, the main secreted mucin type is MUC5AC, which is secreted by cells of the stomach lining. Recently we have identified another member of the mucin family (MUC6) that is present in glands found beneath the stomach lining of horses, yet we cannot find evidence for the presence MUC6 in the surface-lining mucus layer. Our hypothesis is that MUC6 is not present on the surface-lining mucus layer because it is secreted directly into ingested food material and may play a role in facilitating digestion.  To investigate this we would like to obtain post mortem ingested food material from the stomach of a horse alongside a small full thickness section of the glandular portion of the horse's stomach. We wish to obtain sample sets from three horses in this pilot study.

Dr Ellen Singer

A cadaveric study investigating the myofascial attachments and innervation of the supraspinous and interspinous ligaments in the equine thoracolumbar spine. VREC 261

July 2014

December 2015

Back pain related to the area of the thoracolumbar spine is a common condition in the equine athlete. Over-riding or impinging dorsal spinous processes (DSPs) is a condition believed to cause back pain in horses and has mainly been described in the area between T14 and L1. Very little is known about the nervous supply to the connective tissue (myofascia) adjacent to the DSPs in the horse and the role of myofascial tissue in the origin of back pain in the horse. The aim of this study is to describe the anatomy of the fascial planes that insert on the DSPs, the supraspinous and interspinous ligaments and to assess this tissue’s innervation in the equine thoracolumbar spine.Detailed investigation and knowledge of the interconnected tensional network of the equine thoracolumbar spine has a potential relevance for the diagnosis and treatment of back pathology in the equine athlete.

David Bardell and Stefania Scarabelli

Investigation into ocular damage and microbial contamination sustained by horses undergoing general anaesthesia. VREC342

August 2015

August 2018

During general anaesthesia horses eyes remain open, the protective blink reflex is abolished and tear production is severely reduced or completely absent. This makes the front of the eye (cornea) susceptible to drying out. To counteract this, it is common practice to apply a bland ophthalmic ointment to the front of the eye to form a protective barrier until the horse regains consciousness and the normal protective mechanisms are restored. This study will see if horses may be suffering from undetected damage to their eyes, either directly due to the absence of the protective blink reflex allowing the surface of the eye to come into contact with drapes or other surfaces, or indirectly by allowing introduction of bacterial or fungal contamination. It will look at whether general anaesthesia is associated with development of corneal ulcers (damage to the layer of cells covering the front of the eye) and whether there is a change in the normal population of micro-organisms (bacteria and fungi) which are found in the eyes of healthy horses. We will also check whether contamination of the ophthalmic ointment occurs over the course of its use and whether this contributes to any change in the micro-organisms which are found in the eyes.

Prof. P. D. Clegg

Post-natal development of the tendon inter-fascicular matrix for long term tendon health.

(How do tendons develop their function from birth to adulthood) VREC352

 September 2015  August 2018  Tendon injuries remain one of the most common problems in the Thoroughbred racehorse; however, how tendons function and how they become injured are both poorly understood. Tendons which are particularly prone to injury are highly loaded during use and have to be stretchy to make locomotion more efficient. We have recently discovered the mechanisms by which such tendons work to allow stretching and recoil during locomotion. We have also shown that tendons develop this specific ability to stretch and recoil after birth, and this specialist property is fully developed by 2 years old. We will study developing tendons to fully understand the process by which a key tendon develops its unique properties which are vital for orthopaedic function by understanding the cell biology of the inter-fascicular component of the tendon during development.

Prof. Stuart Carter

Identifying the bacteria responsible for canker in horses. VREC392

February 2016 June 2017 Canker is a lesion on horse feet associated with damp conditions and poor husbandry. The lesion has a bacterial basis and this project is designed to identify the specific bacteria in the foot lesions with a view to developing means of prevention and/or treatment.  Samples of lesions will be obtained after discard for surgical treatment and molecular technologies used to identify bacteria in the lesions and compare with normal foot tissues.

Dr Ellen Singer

Short incomplete proximal P1 fractures. VREC386

January 2016 January 2017 This study will investigate what is the best treatment for small fractures of the top end of the long pastern bone.

Dr Ellen Singer and Anna Ehrle

Do results of flexion tests correlate with final diagnosis for hind limb lameness in horses? VREC385

February 2016 December 2016 Flexion tests are undertaken routinely during most lameness examinations but it is unclear if these tests are joint specific and if they actually assist us to reach a specific diagnosis. We want to test the efficacy of these tests by studying our lameness cases retrospectively. We are working on the hypothesis that flexion tests will have a poor sensitivity to and specificity, therefore lacking the ability to provide a specific prediction about the exact anatomic location of hind limb lameness. If flexion tests prove to facilitate identification of the site of lameness, they should continue to be used as part of an examination. If this is not the case, this time consuming & potentially dangerous portion of the lameness evaluation may be avoided.

Prof. P. D. Clegg

Role of the inter-fascicular matrix in age related deterioration of equine tendon mechanical function. VREC214

April 2014 December 2016 We have recently discovered a novel mechanism which allows specific tendons eg. The equine superficial digital flexor tendon (SDFT) to withstand large amounts of extension and recall, as well as allowing energy storage to allow easy and efficient movement.  This structure, known as the inter-fascicular matrix (IFM) is vital for how tendons work.  We have evidence that this matrix changes and stiffens with ageing, likely to lead to increased risk as the animal becomes older.  This study aims to fully understand how this particular part of the tendon works throughout life, and ageing, in the equine SDFT.  By characterising this structure within tendon IFM, we aim to identify novel treatments, as well as ways of diagnosing tendon injuries.  Our overall long term aim is to both prevent and treat equine tendon disease more effectively.

Dr Ellen Singer

Investigation of subchondral bone thickness of the proximal P1 on MRI of TB racehorses with lameness localized to the fetlock region. VREC418

January 2016 January 2017 This study will retrospectively describe the subchondral bone (SCB) thickness of the long pastern bone (P1) on MR images of race-fit Thoroughbreds with lameness localized to the fetlock region. The MRI images will be anonymised by the removal of the personal identifiers from the images prior to the performance of the measurement of the SCB thickness.

Dr Luis Rubio Martinez

Comparison of 2 different physiotherapy programmes for the rehabilitation of horses with back pain. VREC390

June 2016 June 2018 The purpose of this study is to improve the equine welfare by developing a better understanding and assessing the efficacy of physiotherapy as a complimentary treatment for the management of back pain in horses. Our goal is to compare the benefits of two different physiotherapy programmes on the clinical outcome of horses with back pain. This study will provide valuable information for veterinary surgeons treating horses with back pain that are considering the use of physiotherapy.

Dr Gina Pinchbeck and Cajsa Isgren

The emerging problem of antimicrobial resistance in equines: Investigating faecal carriage and infections with multidrug resistant bacteria in horses. VREC447

August 2016 August 2018 Antimicrobials are widely used in the treatment of, and prophylaxis against, bacterial infections in both humans and animals. However, the development of antimicrobial resistance (AMR) in many bacterial species is threatening their efficacy leaving populations at risk of morbidity and mortality associated with such infections. The aim of this project is to determine the epidemiology of AMR in hospitalised horses in the UK. We will investigate the types and resistance patterns of bacteria present in faecal samples from horses during hospitalisation.  Bacterial samples will also be obtained from any surgical site infections that develop during hospitalisations. We are trying to see how much antibiotic resistance there is in the normal bacteria that animals carry. This will give us a greater understanding of how antibiotic resistance occurs in hospitals and hopefully can lead to the development of new ways to combat the problem.

Prof. D. Archer and Dr Gina Pinchbeck

Randomised controlled trial to evaluate two different methods of protecting the abdominal incision during recovery from general anaesthesia in order to reduce the risk of incisional infection occurring. VREC172

 January 2014  December 2017 This is a randomised controlled trial conducted in horses undergoing exploratory laparotomy (primarily for diagnosis and treatment of colic). This will evaluate two clinically recognised methods of protecting the abdominal incision immediately following completion of abdominal surgery to determine whether one method is any better than the other at reducing the risk of incisional infection occurring at the site. The ultimate aim of this study is to reduce the chances of this type of complication occurring following abdominal surgery which will have benefits to both horses (improved welfare) and owners (reduced costs of treatment).