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Equine Cancer: Difficult To Detect, Expensive To Treat

Diagnosing systemic cancer in horses can be difficult. Clinical signs are often vague and include things like weight loss, fever, disinterest and exercise intolerance – all issues that could be indicative of another issue.

If common causes like disease, parasites, digestive disorders, and other common ailments have been ruled out, Dr. Liya Wang and other researchers from the Swedish University of Agricultural Sciences suggest that systemic cancers should be considered. The research team also notes that cancer should be suspected if a horse doesn't respond well to traditional therapies, or if he begins to lose organ function.

Bloodwork run on horses that have cancer often comes back as nonspecific, but it may show that the horse is anemic and has elevated globulin concentrations and increased neutrophils. Though additional diagnostic work in search of conclusive results is available, it's often quite invasive and extensive.
The inability to find a reliable cancer biomarker often delays diagnosis, and results in ineffective treatments and poor chances of survival.

Wang and her team crafted a study to see if thymidine kinase 1 (TK1) could be used as a cancer biomarker in horses with lymphoma.

Serum TK1 is used as a cancer biomarker in humans. TK1 is important for DNA replication and cell proliferation. In healthy cells, TK1 degrades rapidly after cell division. In cancer cells, TK1 production is increased and leaks into the blood.

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The researchers measured serum TK1 in seven horses with lymphoma, five horses suspected to have lymphoma, 107 horses with diseases that weren't tumor related, and 42 horses with no sign of disease. Serum TK1 was significantly higher in horses with lymphoma and suspected lymphoma. Serum TK1 was also elevated in the diseased horses without lymphoma.

The team concludes that these findings indicate that serum TK1 could be used as a cancer biomarker in horses.

Read the study here.

Gastric Ulcers In Horses: Search For Biomarkers, Treatments Continues

Are you considering having your horse's stomach scoped again? Is there any other way to verify the presence of gastric ulcers? Right now, there isn't, but researchers are working on noninvasive ways to diagnose and monitor horses with equine gastric ulcer syndrome (EGUS).

Many performance horses have gastric ulcers, which are defects in the surface of the stomach lining that occur in either the glandular or nonglandular (squamous) regions. Thought to be largely due to management factors—stress due to training or competition, social isolation, diets high in concentrates or low in forages—gastric ulcers often cause poor performance, decreased appetite, and weight loss.

After diagnosing and grading ulcers via gastroscopy, veterinarians typically recommend treatments geared to decreasing the acidity of the stomach. Treatment plans for EGUS typically include diet modifications, management changes, and medications such as omeprazole, sucralfate, and ranitidine. Nutritional supplements designed to control the pH within the stomach could also be included.

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“Triacton supports gastric health by moderating acidity using ingredients shown to have greater buffering capacity. Those include a seaweed-derived source of calcium and several other highly bioavailable minerals,” said Catherine Whitehouse, M.S., a nutritionist for Kentucky Equine Research. “The form of calcium in Triacton offsets the negative effects of omeprazole on calcium digestibility compared to other commonly used sources of calcium in feeds and supplements.”

Because gastroscopies play a key role in ulcer management, repeated procedures are a necessary evil as horses may be resistant to treatment or the ulcers may return rapidly following cessation of pharmaceutical treatments like omeprazole.

Veterinary researchers recently suggested that identifying blood or salivary markers, or perhaps a combination of both, could help create a diagnostic panel for EGUS. This tool would screen patients for EGUS and monitor response to treatment, which would limit the frequency of gastroscopy.^*

Blood collected from eight mature geldings with gastric ulcers was evaluated for total antioxidant capacity. A moderate but significant correlation between blood and salivary antioxidant capacity was identified, potentially indicating that oxidative stress decreases as ulcers heal.

“The role of oxidative stress and antioxidants in EGUS requires further exploration, but these very preliminary findings suggest that antioxidants may play a role in the future management of this condition,” said Whitehouse.

While horse owners wait for this research to advance, Whitehouse suggested using diagnostics and treatments, including gastrointestinal buffers, currently recommended by veterinarians.

^*Svagerko, P., W. Bridges, E. Jesch, S. Pratt-Phillips, and K. Vernon. 2021. Equine gastric ulcers; a pilot study: Associated biomarkers and polysaccharide supplementation as a solution. Journal of Equine Veterinary Science 100:103518.

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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Joint Care: Provide Support After Wounds, Infection

Viscous and transparent, synovial fluid acts as a biological lubricant within musculoskeletal mechanisms. Penetrating wounds to joints and tendon sheaths cause most infections, though pathogens carried in the bloodstream, as with foals diagnosed with joint ill, have been implicated, as has contamination at the time of intraarticular injection or surgery. Veterinarians refer to infection that sets up in any structure containing synovial fluid, namely joints, tendons, and bursas, as synovial sepsis.

Prompt diagnosis and aggressive treatment minimize damage to septic structures and often prevent career- and life-threatening consequences. To determine if infection is present, bacterial isolation through culture is the best diagnostic tool, yet low sensitivity and long laboratory turnaround time often preclude a definite diagnosis in the face of emergency situations and treatment decisions, which may include joint irrigation and surgery. Because of these limitations, researchers have sought alternative ways to quickly identify the presence of infection.

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Austrian researchers recently evaluated the presence of specific biomarkers, called antimicrobial proteins, in synovial fluid as a way to confirm infection.^* These proteins are activated by the immune system in response to a pathogenic challenge, so their existence in the fluid indicates sepsis. According to the researchers, “using enzyme activity as a biomarker of synovial sepsis enables the development of a point-of-care diagnostic test, which would allow veterinarians to perform, analyze, and act on test results stall-side, in a matter of minutes.”

In the study, researchers collected synovial fluid samples from three groups of horses: healthy controls, horses with aseptic synovitis (inflammation without infection), and horses with septic synovitis. Enzyme activity assays were compared with standard synovial fluid parameters and broad-range bacterial DNA extraction.

The researchers found enzyme activities were significantly different between septic synovial samples and aseptic and control samples, leading them to believe that measurement of enzyme activities would allow for reliable, rapid diagnosis of synovial sepsis and immediate therapeutic interventions.

Joint health depends largely on conscientious management of exercise, including frequency and intensity of athletic bouts, and the provision of high-quality nutritional supplements formulated specifically for joint support. While synovial sepsis typically develops from injuries that compromise the joint capsule, it can occur following routine intraarticular injection of hyaluronic acid and corticosteroids, though the incidence of infection is uncommon.^° The prophylactic use of joint supplements in high-performance horses and prospects can delay the need for joint injections, thus postponing any risk associated with invasive procedures.

^*Haralambus, R., A. Florczyk, E. Sigl, S. Gultekin, C. Vogl, S. Brandt, M. Schierer, C. Gamerith, and F. Jenner. 2021. Detection of synovial sepsis in horses using enzymes as biomarker. Equine Veterinary Journal. In press.

^°Steel, C.M., R.R. Pannirselvam, and G.A. Anderson. 2013. Risk of septic arthritis after intra-articular medication: A study of 16,624 injections in Thoroughbred racehorses. Australian Veterinary Journal 91(7):268-273.

Cornell Equine Seminar Series Presents ‘The Ins And Outs Of Equine Asthma’

Equine asthma affects many horses to varying degrees and can ultimately inhibit performance and cause quality of life concerns. This month the signs, causes, diagnostic and treatment options for equine asthma will be presented during the College of Veterinary Medicine's Equine Seminar Series, on Tuesday, April 20, from 6 to 7 p.m. via Zoom.

WHAT: Joy Tomlinson, DVM, DACVIM Large Animal Internal Medicine Specialists and Research Associate will talk about the signs and causes of equine asthma along with diagnostic and treatment options.

WHEN: Tuesday, April 20, 2021, 6 – 7 p.m.

WHERE: Via zoom, register here.

Presenter Dr. Tomlinson received her DVM from Cornell University in 2010 and completed a large animal internal medicine residency at New Bolton Center, University of Pennsylvania in 2014. She has been a clinician at Cornell's Equine Hospital since 2014. Dr. Tomlinson is also a Research Associate at the Baker Institute for Animal Health in the Van de Walle lab.

Her current research focuses on the characterization of two recently discovered equine hepatitis viruses: equine parvovirus-hepatitis, the suspected cause of Theiler's disease in horses, and equine hepacivirus, a cause of chronic hepatitis. Her clinical research includes investigation of Equine multinodular pulmonary fibrosis (EMPF), which can be mistaken for asthma.

The Cornell Equine Seminar Series is presented by the Cornell University College of Veterinary Medicine's Equine Hospital, the New York State 4-H Horse Program and Cornell Cooperative Extension. Held on the second Tuesday of most months, equine experts present on important equine health and management topics. The event is free and open to the public.