inflammation | Horse Racing Free Tips

Heaves And Heart Failure: Is There A Connection?

A new study out of Canada shows that uncontrolled respiratory disease in horses may put them at risk for pulmonary artery changes that lead to heart failure.

People with severe asthma can have thickening of the pulmonary arteries, which leads to pulmonary hypertension. Severe equine asthma, like asthma in humans, presents as airway inflammation, coughing and labored breathing; therefore it's feasible that equine asthma can also lead to pulmonary artery thickening, reports EQUUS magazine.

Often called “heaves,” this condition is triggered by mold or dust in hay or the environment. The affected horse must be managed so exposure to these environmental triggers is minimized. Best management practices for horses with heaves include as much turnout as possible, removing horses from stalls when they are cleaned and rebedded, and soaking hay.

Dr. Serena Ceriotti and other researchers at the University of Montreal looked at multiple post-mortem lung samples from 18 horses — six that were in heaves episodes when they died; six with heaves that was in remission because of management practices; and six with no history of heaves.

The scientists measured arterial thickness and found that the horses experiencing active heaves episodes had thicker arteries than the other horses.

Though it's unclear why the arteries thicken, experiments in rodents suggest the low oxygen content and inflammation may increase smooth muscle in the arterial wall. This increase in the muscle decreases the area for blood to flow and may increase muscle contractions, which leads to pulmonary hypertension, minimizing blood flow and limiting cardiac function. This condition can eventually lead to the enlargement and failure of the right ventricle of the heart.

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A second portion of the study tested two potential pulmonary hypertension treatments on live horses. One involved reducing the horse's exposure to dust for an entire year and on using hay alternatives. The second used the medication fluticasone for six months then added in dust-control strategies for an additional six months.

The researchers found that both treatments lead to a reversal in artery wall thickness, but this could only be seen once the dust control measurements were enacted. The team notes that hay is the main trigger for heaves; often just changing the horse's diet to include a forage alternative is enough to control the disease.

They conclude that arterial wall remodeling is reversible, but only with strict dust control measures. Inhaled corticosteroids can rapidly improve a horse in experiencing a heaves flareup, but an improved environment is the only way to manage the condition long term.

Pharmaceutical Company Issues Voluntary Recall Of Methocarbamol Tablets Labeled In Wrong Concentration

The United States Food and Drug Administration (FDA) released the following announcement from Bryant Ranch Prepack regarding a voluntary recall of methocarbamol last week. In horses, injectable methocarbamol is FDA-approved for treatment of “acute inflammatory and traumatic conditions of the skeletal muscle to reduce muscle spasm and effect striated-muscle relaxation.”

Methocarbamol is also sometimes used off-label orally to manage and treat sore backs and muscle strain. Methocarbamol is also prescribed as a prophylactic for horses that experience exertional rhabdomyolysis or “tying up,” which can cause muscle breakdown. Methocarbamol is a depressant and may affect performance and coordination.

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Bryant Ranch Prepack is voluntarily recalling one lot of methocarbamol 500 mg tablets to the consumer level. The bottles labeled as methocarbamol 500mg tablets have been found to contain methocarbamol 750 mg Tablets.

Risk Statement: If a patient takes a 750 mg tablet of methocarbamol instead of the prescribed 500 mg tablets, it potentially could result in excessive central nervous system depression, which may result in nausea, sedation, fainting, falls, seizure, coma, and death. Bryant Ranch Prepack has not received any reports of adverse events related to this recall.

The product is used together with rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions and is packaged in a white round bottle with a red and white label, which reads methocarbamol 500 mg packaged in counts of 30 (NDC:7133517952), 60 (NDC: 7133517954), and 90 (NDC:7133517957) pills. The affected methocarbamol 500 mg lots include the following Lot Number 163935/ Exp. Date 10/22. The product can be identified by red and white label with a yellow border at the top and bottom of the label, top of the label reads “Packaged by Bryant Ranch Prepack”, labels are pictured below. The methocarbamol 500 mg was distributed nationwide to multiple physician offices.

Bryant Ranch Prepack is notifying its distributors and customers by letter and email and is arranging for return of all recalled products. Consumers that have the bottles labeled as methocarbamol 500 mg tablets which are being recalled should stop using immediately and return to place of purchase and/or contact their physician. Distributors/physicians should stop distribution and contact Bryant Ranch Prepack to return the product immediately.

Consumers with questions regarding this recall can contact Bryant Ranch Prepack by phone at 877-885-0882 Mon.-Fri. 7am-6pm PST or compliance@brppharma.com. Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this drug product.

Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax.

Complete and submit the report online
Regular Mail or Fax: Download form or call 1- 800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

This recall is being conducted with the knowledge of the U.S. Food and Drug Administration.

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Research Update: Cellular Mechanisms Of Laminitis

An international group of researchers recently proposed a theory to explain the cellular pathways involved in the development of laminitis, including the role of apoptosis, a normal process of self-destruction that helps eliminate damaged, superfluous, or unwanted cells. Unfortunately, their data showed that apoptosis did not influence the development of laminitis. Had their hypothesis held, however, targeted treatments for laminitis may have followed.

Laminitis is the painful separation of the lamellar layers of the hoof, which often results in profound lameness, prolonged and expensive supportive care, and possible euthanasia. Despite extensive research in this field, many of the underlying mechanisms associated with the development of laminitis remain unclear.

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The abovementioned theory proposed that sepsis-related laminitis, such as that induced by carbohydrate overload and black walnut exposure, involves apoptosis of cells that bind the lamellar layers of the hoof. The integrity of those cells helps suspend the third coffin bone inside the hoof. Researchers suggested that apoptosis occurs early in the disease process, even before signs of lameness manifest. Specifically, they proposed that exaggerated inflammation occurring with the presence of bacteria in the bloodstream could serve as a source of free radicals, which are known to induce apoptosis.

To test their theory, the researchers used hoof samples from horses subjected to carbohydrate overload or exposed to black walnut extract. Both models induce lamellar inflammation and sepsis. “When the researchers counted inflammatory and apoptotic cells microscopically, no increase in apoptosis was observed during either the development phase of laminitis or at the time of lameness onset,” relayed Whitehouse.

Though disappointing, these results sent researchers back to the drawing board in search of other mechanisms that contribute to the development of laminitis.

Meanwhile, horse owners must continue to employ management and nutritional strategies that keep horses safe from the ravages of laminitis. “In addition to avoiding management triggers, ensure horses have adequate nutrients to support the well-being of all body systems, including the integumentary system, which includes skin, hair, and hooves,” explained Catherine Whitehouse, M.S., a nutrition advisor for Kentucky Equine Research.

“To dodge potential nutrient shortages, all horses should receive a fortified feed suitable for their energy needs,” she said. This feed may come in the form of a traditional textured or pelleted concentrate or it may come as a balancer pellet, which is often useful for horses that can maintain their weight on forages alone.

Horses with compromised hooves may require additional support in the form of a high-quality hoof supplement. “A comprehensive hoof supplement provides more than just biotin to foster hoof growth and integrity. In addition to diet, routine management such as trimming or shoeing plays a vital role in maintaining and achieving hoof health that will also serve the horse well in the face of a laminitis episode,” Whitehouse explained.

Chronic inflammatory conditions, like laminitis, often respond to supplementation with omega-3 fatty acids, especially DHA and EPA. The omega-3s found in certain marine-derived products, like EO-3, are more available to horses than those found in plant-based sources.

^*Catunda, A.P.N., G.E.S. Alves, F.O.P. Leme, A.M. Carvalho, B.S. Leise, P.J. Johnson, and R.R. Faleiros. 2021. Apoptosis in epithelial cells and its correlation with leukocyte accumulation in lamellar tissue from horses subjected to experimental sepsis-associate

Reprinted courtesy of Kentucky Equine Research. Visit ker.com for the latest in equine nutrition and management, and subscribe to Equinews to receive these articles directly.

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Omega-3s And Inflammation In Athletic Horses

Inflammation is part and parcel to building strength and fitness in equine athletes. One key to training, however, is keeping inflammation at controllable levels after exercise so recovery occurs quickly and training continues unhindered. New findings from Kentucky Equine Research (KER) suggest long-chain omega-3s may be useful in managing inflammation in hard-working horses.

Using eight Thoroughbreds in race training, the researchers designed a 28-day study to determine the effect of long-chain omega-3 (EO-3) supplementation and exercise on blood serum gamma-glutamyl transferase (GGT) levels and inflammation. The enzyme GGT breaks down glutathione, a potent antioxidant. As levels of GGT rise, less glutathione is available to neutralize free radicals, leaving more cells susceptible to the damaging effects of oxidation.

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“Interest in the effect of omega-3s on inflammation stemmed from consistently high concentrations of the enzyme GGT in blood samples of some racing Thoroughbreds,” said Laura Petroski-Rose, B.V.M.S., a veterinarian with Kentucky Equine Research.

In the study, four of the horses were supplemented daily with 60 mL (2 ounces) of EO-3, while four horses served as controls and received the same feed without EO-3. All horses were fed 13to 15 pounds (6-7 kg) of a commercial racing feed (12 percent protein, 8 percent fat) with free-choice timothy hay. During the study, the horses were galloped three times per week (1-1.5 miles per session) on a racetrack and jogged three times per week (30 minutes per session) on a mechanical exerciser. At the conclusion of the 28 days, the horses performed an exercise test on the racetrack that consisted of a warm-up jog, ten-furlong (2,000-meter) gallop, and a two-furlong (400-meter) breeze. Blood samples were taken before exercise as well as two and four hours post-exercise.

The horses supplemented with EO-3 had significantly lower GGT levels two and four hours post-exercise compared to the control horses. This may have resulted from a reduction in inflammation observed post-exercise in the horses fed EO-3. Read more about the study.