DR.

MEGAN BURKE (Orcid ID : 0000-0002-2491-5745)

Accepted Article
Article type : General Article

EVJ-GA-17-046.R3

Evaluation of digital cryotherapy using a commercially available sleeve style ice

boot in healthy horses and horses receiving intravenous endotoxin

M. J. Burke*1, J. E. Tomlinson2, A. T. Blikslager1, A. L. Johnson3 and B. L. Dallap-Schaer3

1Department of Clinical Sciences, North Carolina State University, Raleigh, North

Carolina, USA; 2Baker Institute, Cornell University College of Veterinary Medicine, Ithaca,

New York, USA and 3Department of Clinical Studies, University of Pennsylvania, School

of Veterinary Medicine, Kennett Square, Pennsylvania, USA.

*Corresponding author email: mjburke3@ncsu.edu

Keywords: horse;

This article has been accepted for publication and undergone full peer review but has
not been through the copyediting, typesetting, pagination and proofreading process,
which may lead to differences between this version and the Version of Record. Please
cite this article as doi: 10.1111/evj.12842

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 Summary
Accepted Article
Background: Continuous digital cryotherapy experimentally prevents development and

reduces severity of sepsis-associated laminitis. A sleeve style ice boot where ice is in

direct contact with the skin, and water drains from the boot is being used clinically for

distal limb cryotherapy. The degree of cooling achieved by this boot is unknown.

Objectives: Evaluate skin and lamellar cooling after application of the ice sleeve in

healthy horses, and the same horses during an endotoxaemia model.

Study design: Prospective study, crossover design.

Methods: In 8 healthy horses thermocouples were inserted into dorsal lamellae of both

front feet, and under skin on both metacarpi. One forelimb received cryotherapy using

sleeve style ice boot, with contralateral limb as control. Temperature was recorded on

data logging devices at 5-minute intervals during each cryotherapy session. Day 1:

temperature data was collected for healthy horses. Day 2: data was collected for the

same horses during intravenous administration of endotoxin.

Results: In healthy and endotoxaemic horses, the sleeve style ice boot significantly

decreased mean skin (7.2°C and 5.8°C respectively) and lamellar (10.8°C and 9.6°C

respectively) temperatures compared to control limbs (p<0.001). Skin and lamellar

temperatures in endotoxaemic horses undergoing cryotherapy were significantly colder

than in healthy horses (p = 0.01).

Main limitations: Order of treatment not randomised.

Conclusions: The boot caused significant decreases in lamellar temperatures compared

to untreated control limbs in all horses. Endotoxaemic horses had significantly colder

lamellae and skin than healthy horses. This study is the first to show that a sleeve style

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 boot, where ice does not cover the hoof, can cause significant decreases in lamellar
Accepted Article temperatures through cooling of blood as it travels to the foot.

Introduction

In horses, systemic sepsis is associated with the development of a severe form of

laminitis, termed sepsis-associated laminitis [1]. Horses that have clinical signs of

endotoxaemia are at high risk of developing sepsis-associated laminitis. The

oligofructose overload (OF) model has been used to study the pathogenesis of sepsis-

associated laminitis [2-8]. These studies have also shown that continuous digital

cryotherapy prevents the development and reduces the severity of sepsis-associated

laminitis [9-13]. There is also some clinical evidence that continuous digital cryotherapy

prevents or mitigates the severity of naturally occurring sepsis-associated laminitis. In

one retrospective study, early initiation of continuous digital cryotherapy reduced the

risk of sepsis-associated laminitis in horses with colitis, compared to horses that did not

receive cryotherapy [14]. Although these studies have increased our understanding of

the mechanisms of sepsis-associated laminitis, the precise degree of cooling required to

prevent naturally occurring laminitis has not been determined. The current consensus

for laminitis prevention and treatment recommends maintaining a hoof wall

temperature below 10°C [12].

The Jack’s boota, a sleeve style ice boot consisting of a foam cuff surrounding the

pastern, and a sleeve that holds ice extending up to the carpus or tarsus, has gained

popularity in various equine referral hospitals for continuous digital cryotherapy (Fig

1A). The ice-water slurries used in most experimental models of laminitis require the

horse to be maintained in stocks while cryotherapy is applied, making them impractical

for clinical use [9,10,12,13,15]. In contrast, horses can walk and lay down while wearing

this sleeve style ice boot. Additionally, they require less maintenance and are more

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 resistant to damage than the 5 L fluid bags used by Reesink and colleagues to decrease
Accepted Article hoof wall temperatures [16]. With this boot, ice is in contact with the skin to the level of

the pastern but does not cover the hoof. Water drains out of the cuff at the bottom of the

boot, and therefore, ice is always in direct contact with the skin. This boot is

commercially available, durable, inexpensive, and easy to use. The major drawback of

using these boots in clinical patients is that their degree of lamellar cooling is unknown.

The objectives of this study were to evaluate skin and lamellar cooling achieved

using the sleeve style ice boot in healthy horses, and in the same horses using an

endotoxaemia model. Intravenous administration of endotoxin was chosen for the

endotoxaemia model because it causes consistent, predictable and reversible clinical

signs with a low risk of permanent complications [17-20]. By evaluating cooling in

healthy horses, and endotoxaemic horses, we hoped to gain information applicable to

clinical cases.

We hypothesised that this boot would decrease skin and lamellar temperature to

≤10°C in healthy and endotoxaemic horses. We also hypothesised that skin and lamellar

temperatures in the cryotherapy limbs of endotoxaemic horses would be significantly

colder than those in healthy horses.

Materials and Methods

Horses

Eight healthy Thoroughbred horses with a mean age of 3.5 years (range 3 – 5 years), and

weight of 487 kg (range 450 – 509 kg) were enrolled. There were 3 geldings, and 5

fillies. Horses were determined to be healthy based on physical examination and

haematologic analysis (complete blood count, fibrinogen). Horses had no clinical or

radiographic history of laminitis. Horses were moved from pasture to temperature

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 controlled 12 by 12 feet stalls 12 hours prior to the start of data collection and were fed
Accepted Article free choice mixed hay (timothy and alfalfa), and one pound of 12% sweet feed twice

daily. Water was available ad lib.

Study design

This was a prospective study with a cross-over design. The forelimb to receive

cryotherapy was assigned randomly by coin toss, with the contralateral limb used as

control. The order of treatment (healthy vs. endotoxaemic) was not randomised, and all

horses received endotoxin on the second day of data collection. All data collection

occurred during the summer.

Thermocouple Placement

The protocol for thermocouple placement used in this study has been previously

validated [15]. Horses were sedated with xylazineb and butorphanolc. Sites for

thermocouple insertion (dorsal midline 1.5 cm proximal to the coronary band, and

dorsolateral mid-metacarpus) were clipped of hair. Insertion sites, and the palmar

aspect of both fetlocks were cleaned with 4% chlorhexidine gluconated. An abaxial

sesamoid nerve block was performed in each forelimb using 2 ml of 2% lidocainee per

injection site. One to two milliliters of lidocaine was also infused subcutaneously at each

thermocouple insertion site. Horses were placed in stocks and insertion sites were

aseptically prepared using 4% chlorhexidine gluconate, followed by 70% ethanolf.

Sterile, tissue implantable, 18-gauge Teflon coated thermocouplesg were

aseptically placed as follows: a 16-gauge needleh was inserted through the desensitised

skin 1.5 cm proximal to the coronary band, and advanced distally into the dorsal

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 lamellae until the hub of the needle contacted the skin of the coronary band.
Accepted Article Thermocouples were advanced through the needle until resistance was met. The needle

was withdrawn over the thermocouple, leaving it in place. Thermocouples were

similarly placed under the skin on the dorsolateral aspect of the metacarpus, avoiding

the extensor tendons. Thermocouples were secured to the skin with cyanoacrylatei.

White tapei was used to keep the thermocouple wires close to the forelimbs.

Dorsopalmar and lateromedial radiographs were obtained to confirm appropriate

placement of thermocouples (Fig 1B).

Ice Boot Placement and Maintenance

The ice boot was placed on the limb designated by coin toss to receive

cryotherapy. The boot was filled with crushed ice to the level of the carpus. Ice was

added to the boot as needed to maintain levels at the carpus. As the ice melted, water

ran passively out the cuff at the bottom of the boot and into a drain located on the floor

of the stocks. The temperature of the ice within the boot was not monitored during the

study.

Data Collection

Skin and lamellar temperature readings were obtained and simultaneously

recorded on data logging devicesj at 5-minute intervals over 2 consecutive days. On day

1 data was collected for 195 minutes: a 15 minute baseline period prior to application of

cryotherapy, followed by a 180 minute cryotherapy period. Rectal temperatures, pulse

and respiratory rates were obtained at 60-minute intervals throughout data collection.

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 On day 2, thermocouples were placed in both forelimbs as for day 1. After
Accepted Article thermocouple placement, an intravenous catheterh was placed into one jugular vein. A

single source of pharmaceutical grade, lyophilised powdered lipopolysaccharide (LPS)

from Escheria coli was used as the source of endotoxink. Per manufacturer’s instructions,

the powdered endotoxin was reconstituted with 1 ml of balanced polyionic fluid using

sterile technique to create a 5 mg/ml solution. Once reconstituted, LPS was stored at 4°C

until use. Immediately after thermocouple placement an appropriate volume of

endotoxin was extracted from the vial and diluted in a one litre bag of sterile saline.

Endotoxin was administered for a total of 240 minutes, at the rate of 125 ng/kg/h [21]

using a programmable fluid pump and the previously placed intravenous catheter. Once

the endotoxin CRI was begun, temperature data collection occurred as follows: A 60-

minute pre-cryotherapy interval, followed by a 180-minute cryotherapy interval. Rectal

temperature, heart rate and respiratory rate were recorded every 15 minutes for 240

minutes, beginning at the start of endotoxin administration. Clinical signs consistent

with endotoxaemia were recorded as they developed. A second complete blood count

was obtained at the end of the endotoxin infusion.

Thermocouple Removal and Monitoring

Thermocouples were removed immediately after completion of data collection.

Insertion sites were covered with clean gauze, and standing wraps were placed

overnight. Horses were examined by study veterinarians 12 hours after thermocouple

removal. A complete physical examination including thorough evaluation of the

forelimbs was performed to ensure the limbs were in good condition with no heat,

swelling or sensitivity to palpation prior to performing the second day of data collection.

Following the second day of data collection, horses were evaluated by study

veterinarians for clinical signs of endotoxaemia at 6-hour intervals. Horses displaying

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 signs consistent with endotoxaemia were administered flunixin megluminel
Accepted Article intravenously at 1.1 mg/kg every 12 hours until complete resolution of signs. Horses

remained in stalls in the climate-controlled barn for 24 hours after resolution of clinical

signs, at which point they were returned to pasture housing.

Data Analysis

A sample size of n=8 horses was chosen for this study based on previous work

by Van Eps and others evaluating continuous digital cryotherapy, where 6-10 horses

were used [5,8-11]. Data was checked for normality of distribution and analysed by 2-

way ANOVA, using commercial software (SigmaStat®)m. Data was found to be normally

distributed for all comparisons tested. The effect of limb (right vs. left) on temperature

was evaluated first, and found to be non-significant. Limb was therefore excluded from

further analyses. The effects of time, treatment and time/treatment interactions were

evaluated using two-way ANOVAs on repeated measures. Post hoc analyses were

performed when appropriate using the Holm-Sidak test. All results are reported as mean

± s.d.. Significance was set at p≤0.05 for all tests.

Results

Healthy Horses

In healthy horses, the sleeve style ice boot caused a significant decrease in

lamellar temperature, compared to control limbs beginning 45 minutes after placement

(p<0.001). After 180 minutes of cryotherapy, mean lamellar temperature in treated legs

had decreased by 23.6°C. The mean minimum lamellar temperature achieved was

10.8°C for legs undergoing cryotherapy, compared to 28.8°C for control legs (Fig 2A).

The sleeve style ice boot also caused a significant decrease in skin temperature of

treated legs compared to control legs, beginning 5 minutes after boot placement

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 (p<0.001). After 180 minutes of cryotherapy, mean skin temperature decreased by
Accepted Article 19.3°C, with a mean minimum temperature of 7.2°C for treated legs, compared to 25.8°C

for control legs (Fig 2B).

Endotoxaemia Model Horses

All horses showed clinical signs consistent with endotoxaemia [22]. Clinical

signs included colic (n = 8), muscle fasciculations (n = 7), depression (n = 5), decreased

appetite (n = 4), scleral injection (n = 4), hyperaesthesia of face and head (n = 3),

prolonged CRT (n = 2), yawning (n = 2) and cool extremities (n = 2). Mean time from the

start of the LPS infusion to development of the first clinical sign was 42 minutes (range

40 – 45 minutes). Four horses developed colic signs severe enough to warrant sedation

with a single dose of xylazine (0.5 mg/kg, i.v.). Compared to baseline, endotoxaemic

horses had a significantly higher (p<0.01) mean heart rate, respiratory rate and rectal

temperature after the 240 minute intravenous infusion of LPS. Conversely, mean white

blood cell counts were significantly lower after receiving 240 minutes of LPS compared

with pre-LPS values (p<0.01) (Table 1).

In endotoxaemic horses, the sleeve style ice boot caused a significant decrease in

lamellar temperatures for treated limbs compared to controls beginning 15 minutes

after placement (p<0.001). After 180 minutes of cryotherapy, a mean decrease in

lamellar temperature of 24.8°C was achieved, with a mean minimum lamellar

temperature of 9.6°C for treated legs, and 24.0°C for control legs (Fig 2C). The boots also

caused a significant decrease in skin temperatures of treated legs beginning 15 minutes

after initiation of cryotherapy (p<0.001). After 180 minutes of cryotherapy, a mean

decrease in skin temperature of 25.3°C was achieved, with a mean minimum skin

temperature of 5.8°C for treated legs, and 24.3°C for control legs (Fig 2D).

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 Healthy Vs. Endotoxaemic Horses
Accepted Article
When treated limbs of healthy horses were compared to treated limbs of

endotoxaemic horses, a significant interaction between endotoxaemia and lamellar

temperature was seen. From 75 – 135 minutes after initiation of cryotherapy,

endotoxaemic horses had significantly lower lamellar temperatures in their cryotherapy

treated limbs than healthy horses (p = 0.01) (Fig 3A). When skin temperatures were

compared between the cryotherapy treated legs of endotoxaemic and normal horses, a

significant interaction between endotoxin, temperature and time was noted throughout

the cryotherapy interval. Due to variability in the data, the specific time points where

significance occurred could not be identified (Fig 3B).

Discussion

The sleeve style ice boot evaluated in this study achieved a mean lamellar

temperature of 10.2°C after 3 hours of continuous application, meeting the current

published guidelines for continuous digital cryotherapy [12]. The lamellar temperature

produced by this boot was comparable to temperatures seen after 2 hours of

cryotherapy using 5 L fluid bags (11.41 ± 1.6°C), or wader boots filled with an ice/water

slurry (11.9 ± 1.0°C) [9,10,16]. Previous studies where wader boots were applied

beyond 2 hours showed additional cooling of the hoof wall to temperatures as low as 5.0

± 0.3°C [9-12,23]. Application of cryotherapy with the sleeve style boot beyond 3 hours

was not evaluated in the current study but may be an area for further investigation.

An important factor to consider when comparing results of this study to other

cryotherapy studies is probe placement. In most studies probes are placed on the hoof

wall, or within the wall adjacent to lamellar tissue. In the current study, probes were

placed within the lamellae themselves. Temperatures recorded by probes adjacent to

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 lamellar tissues are generally 2-3°C higher than those recorded by probes placed on the
Accepted Article hoof wall [12]. Therefore, the average minimum temperature of 10.2°C recorded by the

lamellar probes in this study translates to a hoof wall temperature between 7-8°C, only

slightly higher than the average of 5.0 ± 0.3°C seen with prolonged application of the

wader boot.

Work in humans and rats has shown that a decrease in temperature of 10°C can

reduce tissue metabolic demands by 50% [24-26]. Recent studies have shown that

increases in tissue metabolic demand and changes in glucose metabolism in the lamellar

interstitium contribute to the development of sepsis-associated laminitis [4]. The mean

decrease in lamellar temperature of 24.6°C seen with application of the sleeve style boot

should be associated with a substantial reduction in tissue metabolism, however that

was not directly studied. Evaluation of this sleeve style boot in horses where sepsis-

associated laminitis has been induced using the OF model is warranted to evaluate the

boot’s efficacy for laminitis prevention.

The sleeve style ice boot studied here has a unique design: water continuously

drains passively out of the foam cuff at the bottom of the boot. With other forms of

cryotherapy, water does not drain and the limbs are predominantly immersed in an ice-

water slurry. Water has a temperature >0°C, compared to ice from most commercial

freezers which have temperatures ranging from -20°C to -30°C. With other forms of

cryotherapy the presence of a water/ice interface may protect the skin from cold

thermal injury by acting as an insulator against the ice itself. Interestingly, several

horses in our hospital have developed presumptive cold thermal injuries on the skin of

the dorsal metacarpus after prolonged cryotherapy with the sleeve style ice boot. This

may be related to prolonged direct contact between the skin and ice. Additionally,

different freezers may produce ice with different temperatures, and it is possible that ice

from colder freezers may result in increased risk of cold thermal injury. In light of this,

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 evaluation of the long-term safety of the sleeve style ice boot for continuous digital
Accepted Article cryotherapy may be warranted prior to prolonged clinical use.

Previous evaluation of this sleeve style boot showed that it was not effective at

altering hoof wall temperature [15]. The mechanism of action of this boot is therefore

likely due to cooling of arterial blood as it moves through the palmar digital arteries

towards the foot. Interestingly, the average minimum skin and lamellar temperatures

were significantly lower for horses in the endotoxaemia model, than for healthy horses.

The reason for this difference is not known, but may be due to altered perfusion of the

foot in horses with clinical endotoxaemia. It should be noted however, that by the end of

the cryotherapy interval, skin and lamellae temperatures were similar between groups.

Therefore, the significance of these differences in a clinical setting requires further

investigation.

In this study, the sleeve style ice boots were only placed on the forelimbs. In

experimental models, histologic changes consistent with laminitis have been noted in

the hindlimbs, even in the absence of clinical signs of lameness [10]. Therefore,

application of the boots to all 4 limbs is recommended in horses at risk of sepsis-

associated laminitis. In our experience, application of the boots to the hindlimbs is

technically easy, and well tolerated. Although there is no data available regarding the

lamellar temperatures achieved by these boots when applied to the hindlimbs, it is

reasonable to assume that cooling profiles would be similar to those seen in the

forelimbs.

One limitation of this study was its relatively small sample size, which can result

in Type 2 error (failure to detect an effect when an effect is present). Therefore, our

study may actually have underestimated the significance of differences in hoof and

lamellar temperatures between healthy horses and those in the endotoxaemia model. A

second limitation was that all horses underwent the endotoxaemia model on day 2 of

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 the study. Resolution of clinical signs of endotoxaemia can vary after cessation of an
Accepted Article endotoxin CRI [18], therefore, the order of treatment (healthy vs. endotoxaemia model)

was not randomised. This protocol was chosen to ensure that data collection was

completed within the available time frame for the study.

During the endotoxaemia model, 4 of 8 horses showed clinical signs of colic

severe enough to warrant sedation with a single dose of xylazine (0.5 mg/kg). Xylazine

causes peripheral vasoconstriction for 10-15 minutes after i.v. administration [27-29].

Horses administered xylazine may have experienced a temporary change in their skin or

lamellar temperatures compared to other study horses due to this vasoconstriction.

Cryotherapy using the sleeve style boot works by cooling the blood before it enters the

foot. Vasoconstriction caused by xylazine would be expected to reduce blood flow to the

foot in these horses, decreasing effectiveness of lamellar cooling for up to 15 minutes.

Therefore, it is possible that the use of xylazine in 50% of the study horses may have

resulted in underestimation of the true cooling potential of these sleeve style boots.

To our knowledge, this is the first study that has shown that an ice boot that

does not cover the hoof can cause significant cooling of lamellae by cooling the blood as

it flows to the foot. This study also demonstrated that this sleeve style ice boot lowered

lamellar temperatures to 10.2°C after 3 hours of application, which is within the range

currently recommended for clinical application of continuous cryotherapy. In addition,

when healthy horses, and horses undergoing an endotoxaemia model were compared, a

significant difference in skin and lamellar temperatures was seen during application of

cryotherapy. The reasons for this difference were not directly investigated in this study,

but could suggest that endotoxaemia has a direct effect on perfusion to the skin and foot.

This potential effect, combined with the unique nature of this boot where ice is in direct

contact with the skin, may result in a risk of cold injury after prolonged application.

Further work is warranted to evaluate the safety of this boot for prolonged use, as well

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 as its efficacy for prevention of both experimentally induced and naturally occurring
Accepted Article sepsis-associated laminitis.

Authors’ declaration of interests

No competing interests have been declared.

Ethical animal research

All aspects of this study were approved by the Institutional Animal Care and Use

Committee (IACUC) of the University of Pennsylvania prior to beginning the project.

Sources of funding

Raymond A. Firestone Research Fund: Internal funding source for junior faculty

members and House officers at University of Pennsylvania, New Bolton Center, Kennett

Square, Pennsylvania.

Authorship

M. Burke was a primary co-contributor to study design, study execution and preparation

of the manuscript and was involved in data analysis and interpretation. J. Tomlinson was

a primary co-contributor to study design and execution. A. Blikslager was a co-

contributor to data analysis and interpretation. A. Johnson was involved in study design.

B. Dallap-Schaer was involved in study design and execution. All authors were involved

in manuscript approval.

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 Figure legends
Accepted Article
Fig 1A and 1B: (a) Jack’s Boot. (b) Lateromedial radiograph of left forelimb, showing

appropriate placement of thermocouple (arrow) into dorsal lamellae.

Fig 2A-D: Comparison of lamellar and skin temperatures for cryotherapy vs. control

limbs in healthy horses (A&B), and in the same horses during an endotoxaemia model

(C&D). (A&B) Mean lamellae and skin temperatures (± s.d.) for cryotherapy vs. control

limbs in healthy horses are compared. (A) Limbs receiving cryotherapy had significantly

colder lamellae beginning 45 minutes after the start of cryotherapy. The mean decrease

in lamellar temperature for treated limbs was 23.6°C. The mean minimum lamellar

temperature for cryotherapy and control limbs was 10.8 ± 2.8°C and 28.8 ± 4.7°C

respectively. (B) Limbs receiving cryotherapy had significantly colder skin beginning 5

minutes after the start of cryotherapy. The mean decrease in skin temperature for

treated limbs was 19.3°C. The mean minimum skin temperature for cryotherapy and

control limbs was 7.2 ± 4.5°C and 25.8 ± 4.5°C respectively. (C&D) Mean lamellae and

skin temperatures (± s.d.) for cryotherapy vs. control limbs in endotoxaemic horses are

compared. (C) Limbs receiving cryotherapy had significantly colder lamellae beginning

15 minutes after the start of cryotherapy. The mean decrease in lamellar temperature

for treated limbs was 24.8°C. The mean minimum lamellar temperature for cryotherapy

and control limbs was 9.6 ± 2.8°C and 24.0 ± 2.3°C respectively. (D) Limbs receiving

cryotherapy had significantly colder skin beginning 15 minutes after the start of

cryotherapy. The mean decrease in skin temperatures for treated limbs was 25.3°C. The

mean minimum skin temperature for cryotherapy and control limbs was 5.8 ± 1.8°C and

24.3 ± 2.2°C respectively.

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 Fig 3A and 3B: Comparison of lamellar and skin temperatures in cryotherapy limbs of
Accepted Article healthy vs. endotoxaemic horses. Mean lamellae and skin temperatures (± s.d.) of

cryotherapy treated limbs are compared between healthy and endotoxaemic horses. (A)

Lamellar temperatures in endotoxaemic horses were significantly lower than those of

healthy horses between 75 and 135 minutes after application of cryotherapy. (B) There

was a significant interaction between endotoxin, cryotherapy and skin temperature

throughout the cryotherapy interval. However, due to variability within the data it was

not possible to identify the specific time points where significance occurred.

Manufacturers’ addresses

aJack’s Inc, Washington, Ohio, USA.

bVedco Inc, St Louis, Missouri, USA.

cPfizer Animal Health, New York, NY, USA.

dPurdue Pharma L.P., Stamford, Connecticut, USA.

eHospira, Lake Forest, Illinois, USA.

fCumberland Swan, Smyrna, Tennessee, USA.

gPhysitemp, Clifton, New Jersey, USA.

hBecton Dickinson, Franklin Lakes, New Jersey, USA.

i3M, St Paul, Minnesota, USA.

jOakton Instruments, Vernon Hills, Illinois, USA.

kSigma-Aldrich, St Louis, MO, USA

lMerck, Kenilworth, New Jersey, USA.

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 mSystat Software, San Jose, California, USA.
Accepted Article
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 Tables
Accepted Article
Table 1: Mean (± s.d.) heart rate, respiratory rate and rectal temperature for eight

healthy and endotoxaemic horses.

Mean RR (± s.d.) Mean Total WBC Count (±

Mean HR (± s.d.) Mean Rectal T (± s.d.)
Group s.d.)
(breaths per
(beats per min) (°C)
min) (x 109/L)

Healthy 42.8 (± 2.8) 12.0 (± 1.8) 38.0 (± 0.40) 9.06 (± 0.90)

Endotoxaemic 70.3* (± 14.4) 20.5* (± 7.0) 39.2* (± 1.00) 3.16* (± 1.07)

HR = heart rate, RR = respiratory rate, T = temperature, WBC = white blood cell

NOTE: Values for healthy horses were obtained at the end of the cryotherapy interval.

Values for endotoxaemic horses were obtained at the end of the cryotherapy interval,

which also corresponded to the end of the endotoxin infusion. (*) = value significantly

different (p<0.01) compared to value for the same horses before initiation of the

endotoxaemia model.

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Accepted Article
Accepted Article