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New guidelines on preventing and treating ‘equine strep throat’

Just as strep throat can run rampant in elementary schools, strangles, the “strep throat” of horses, caused by a different Streptococcus bacterium, Streptococcus equi sp equi, is highly contagious. Lymph nodes in the head and neck region become swollen and develop abscesses, resulting in nasal discharge and drainage from the throat. Though rarely fatal, strangles cases can range from mild to severe, and complications that impair eating and breathing can arise in some instances. Altogether, it’s a disease that horse owners want to keep far from their stables.

Veterinarians have an important role to play not only in treating the disease, but also in ensuring that infected horses are kept away from other animals until they have fully recovered from the illness. This recovery is not always so clear cut, as many animals remain carriers of the bacteria even after they appear healthy.

To assist veterinarians, and owners, in understanding the most up-to-date clinical recommendations when it comes to treating strangles, Ashley Boyle, an associate professor of medicine at the University of Pennsylvania’s School of Veterinary Medicine, took the lead in writing a new consensus statement, issued by the American College of Veterinary Internal Medicine, on treating, controlling, and preventing strangles in horses.

“From a practical standpoint, the consensus statement serves to advise all veterinarians on what we recommend as a way to treat and deal with the disease,” Boyle says. “I’m an internist who sees this disease as a primary care doctor at the horse farms as well as a field researcher. The authors of the consensus statement are a collection of experts in the field of Streptococcal diseases in horses including veterinary microbiologists, epidemiologists, and veterinarians who research this disease, as well as internists who encounter the disease frequently.”

Boyle coauthored the report with John Timoney of the Gluck Equine Research Center at the University of Kentucky, Richard Newton and Andrew Waller of Animal Health Trust in the United Kingdom, Melissa T. Hines of the University of Tennessee, and Ben Buchanan of Brazo Valley Equine Hospital in Texas.

The last consensus statement was issued in 2005; the lead author of that report was Corinne Sweeney, professor of medicine and associate dean at Penn Vet’s New Bolton Center. Starting around 2012, Boyle began hearing from colleagues that it was time for an update. Sweeney suggested that Boyle take on the project.

Along with an international team of coauthors, some of whom had contributed to the earlier statement, Boyle set about reviewing information on prevention, treatment and control and finding where updates were necessary.

One of the key areas where the guidance has shifted in the new statement is how to determine when an animal is free of disease. This is a critical component of strangles control, as 10 to 40 percent of animals who have had the disease can remain carriers, able to pass on disease to other animals even when they appear healthy.

The previous consensus statement indicated a throat wash should be tested three times to be sure the horse was free of disease.

“But it was hard to get owners and clients to do that three times,” Boyle says. “And multiple studies have shown that those three may not even be good enough.”

In the new statement, Boyle and colleagues instead recommend “guttural pouch sampling,” a technique that tests the fluid that sits in an area between a horse’s ear and throat, akin to the human Eustachian tube, in combination with using an endoscope to visually assess the area for unruptured absesses.

“We’re trying to encourage more primary care veterinarians to do this, even though it’s time consuming, because this is how the disease perpetuates itself,” says Boyle. “In the end it is easier, faster, and more effective than doing the three throat washes. That’s one of our big take-home messages.”

Another change is a shift away from considering bacterial culture to be the gold standard of diagnosis.

“We no longer consider this the gold standard,” Boyle says, as horses with low levels of bacteria may still be carriers but not give a positive result on this test. The authors see DNA amplification technologies such as polymerase chain reaction (PCR) along with visualization of the guttural pouch as replacing culture as this standard.

“There is also a lot of work being done by my colleagues in Europe looking at genomic sequencing,” she says. “At some point in the future we may be able to use this technology to trace from where an outbreak came.”

The publication lays out best practices for quarantine and examination in order to prevent the spread of disease, and biosecurity protocols to reduce transmission in facilities where infected horses have been housed. It spells out treatment protocols, urging judicious use of antibiotics, and explains how to recognize, evaluate the risk for, and treat one of the more serious complications of strangles, an autoimmune reaction known as purpura hemorrhagica, which can be fatal. It also explores the pros and cons of strangles vaccines,the use of different blood tests that can measure previous exposure to disease and determine when it is safe to give vaccines..

While the consensus statement is aimed at veterinarians, Boyle says owners often read them directly, and can implement some of the recommendations. For example, horses are not thought to be contagious until 24 to 48 hours after the onset of fever.

“An owner can start thinking about monitoring their horses’ temperatures if they suspect an outbreak, and isolate horses when they first spike a fever,” Boyle says. “That way they can catch it right at the beginning and spare any other horses from getting sick.”

Even though strangles is not typically deadly, it is a global problem and quite costly, as management protocols can be extensive.

“There are huge financial repercussions not only from dealing with the disease but from quarantining barns and screening potential carriers,” Boyle says. “It’s also a big problem in the population of rescued horses, as they often come from different locations and are housed in close quarters resulting in the spread of disease.”

Boyle and her colleagues hope that the new guidelines will help veterinarians and owners navigate strangles cases more effectively, ideally mitigating the disease’s health and financial costs.

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New treatment strategies for chronic kidney disease from the animal kingdom

The field of biomimetics offers an innovative approach to solving human problems by imitating strategies found in nature. Medical research could also benefit from biomimetics, as a group of international experts from various fields, including a wildlife veterinarian and wildlife ecologists from Vetmeduni Vienna, point out using the example of chronic kidney disease. In future research, they intend to study the mechanisms that protect the muscles, organs and bones of certain animals during extreme conditions such as hibernation. The possibilities were published in Nature Reviews.

Through certain genetic modifications, the process of evolution has resulted in a great variety of adaptations to different environments in the animal kingdom. Many species have developed fascinating mechanisms that provide resistance to disease or help protect their cells against ageing and oxidative stress in extreme conditions. It would therefore make sense to investigate these mechanisms in other species and adapt the insights gained to develop new strategies in the field of human medicine.

An increased focus on biomimetics, the field of research that studies this approach, could lead to a medical breakthrough in the treatment of chronic kidney disease. An international, interdisciplinary research collaboration, including scientists from the Research Institute of Wildlife Ecology, has now provided an initial overview of which animal mechanisms could be useful for the development of new therapeutic approaches to this globally spreading disease.

Solutions sought for chronic kidney disease

Physical adaptations that are of interest to biomimetics include the outstanding longevity of naked mole rats, for example, or the ability to survive extreme conditions like hibernation. “Biomimetics attempts to copy strategies that have already been tried and perfected by nature over thousands of years,” explains Johanna Painer from the Department of Integrative Biology and Evolution. Painer, in an international collaboration with experts from various different fields, researches which of these elements from the animal kingdom could be applied to human health. “We are comparing examples from human and veterinary medicine as well as from the field of biology to more quickly learn about the development of certain problems and then minimise them in the future,” the researcher says.

One of these problems for which solutions may be found in the animal kingdom is chronic kidney disease. This disease, which is becoming increasingly prevalent worldwide, is associated with many complications, such as cardiovascular disease, osteoporosis, muscle wasting and premature ageing. But kidney disease is also a problem in the animal kingdom. Domestic felines and wild cats are quite frequently affected by chronic kidney disease. “A possible cause is the high meat consumption and the resulting changes of the bacteria in the intestine,” says Painer. Other animals, like the common vampire bat or hibernators like the bear, have developed mechanisms that project them against the disease.

Future studies should investigate the mechanisms which, on the one hand, cause the disease in animals and, on the other hand, are responsible for certain protective effects. “Studies of felids may provide information on links between red meat consumption, gut microbiota and kidney disease. Studies of hibernating bears could help identify new strategies to treat and prevent complications such as muscle wasting, pressure ulcers, thrombosis and osteoporosis during longer periods of bedriddenness,” concludes Painer. New possibilities of organ preservation may also be found.

The advantage offered by biomimetics lies in its interdisciplinary nature. The collaboration between nephrologists — these are specialists in kidney disease and high blood pressure — and experts from other fields, such as veterinary medicine, zoology, molecular biology, anthropology and ecology, could introduce a novel approach for improving human health and help to find new treatment strategies for chronic kidney disease. “Collaboration between various disciplines creates a synergetic effect that may result in the discovery of many novel therapeutic approaches. We should make increased use of such collaboration in the future,” says Painer.

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World’s oldest lizard fossil discovered

An international team of paleontologists, which includes the University of Bristol, have identified the world’s oldest lizard, providing key insight into the evolution of modern lizards and snakes.

The 240-million-year-old fossil, Megachirella wachtleri, is the most ancient ancestor of all modern lizards and snakes, known as squamates, the new study, published today in the journal Nature, shows.

The fossil, along with data from both living and extinct reptiles — which involved anatomical data drawn from CT scans and DNA — suggests the origin of squamates is even older, taking place in the late Permian period, more than 250 million years ago.

Tiago Simões, lead author and PhD student from the University of Alberta in Canada, said: “The specimen is 75 million years older than what we thought were the oldest fossil lizards in the entire world and provides valuable information for understanding the evolution of both living and extinct squamates.”

Currently, there are 10,000 species of lizards and snakes around the world — twice as many different species as mammals. Despite this modern diversity, scientists did not know much about the early stages of their evolution.

Tiago Simões added: “It is extraordinary when you realize you are answering long-standing questions about the origin of one of the largest groups of vertebrates on Earth.”

Co-author, Dr Michael Caldwell, also from the University of Alberta, added: “Fossils are our only accurate window into the ancient past. Our new understanding of Megachirella is but a point in ancient time, but it tells us things about the evolution of lizards that we simply cannot learn from any of the 9000 or so species of lizards and snakes alive today.”

Originally found in the early 2000s in the Dolomites Mountains of Northern Italy, researchers considered it an enigmatic lizard-like reptile but could not reach conclusive placement, and it remained nearly unnoticed by the international community.

In order to better understand both the anatomy of Megachirella and the earliest evolution of lizards and snakes the authors assembled the largest reptile dataset ever created.

The authors combined it with several new anatomical information from Megachirella obtained from high-resolution CT scans.

All this new information was analysed using state of the art methods to assess relationships across species, revealing that the once enigmatic reptile was actually the oldest known squamate.

Co-author Dr Randall Nydam of the Midwestern University in Arizona, said: “At first I did not think Megachirella was a true lizard, but the empirical evidence uncovered in this study is substantial and can lead to no other conclusion.”

Co-author Dr Massimo Bernardi from MUSE — Science Museum, Italy and University of Bristol’s School of Earth Sciences, added: “This is the story of the re-discovery of a specimen and highlights the importance of preserving naturalistic specimens in well maintained, publicly accessible collections.

“New observations, that could arise from the use of new techniques — as for the mCT data we have obtained here, could provide a completely new understanding even of long-known specimens.”

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