Tales from the cupboard

In case you don’t remember me since it my posts seem to be rather spread out, I’m Taryn and I am doing Equine Cardiology research in Edinburgh Scotland.  My project focuses on using left atrial size as a diagnostic and prognostic tool for determining the severity of mitral valve disease.  Last week had to be one of the most frustrating weeks I have had yet!  I spent the entire week sludging through old paper records for horses in a tiny 6×6 filing closet with no windows.  It really made me learn to appreciate the fresh air.   The problem I had run into was that I had about 50 horses that were logged into the imaging book as receiving cardio scans, but didn’t have write ups in the case notebook.  For each of these horses I had to go through the old paper files in the cabinet because of course they were prior to computer filing (meaning 2008 and earlier here ).

I was riffling through old files because I needed to find 18 horses for each of my test groups.   My study is focusing on horses with mitral valve regurgitation and grouping them based on severity of the mitral valve murmur (graded 1-6/6).   The only other defect allowed was horses that had tricuspid valve regurgitation along with the mitral valve.  Any horses with aortic insufficiency, ventricular septal defects, atrial septal defects and atrial fibrillation were all excluded from the study as all of those could influence left atrial size.  Horses with av-block are being left in the study.  The next goal was to go through all the horses to separate them based on breed, only large performance horses (ie: thoroughbreds, thoroughbred crosses, Irish sport horses, and warmblood breeds)  are being used in the study.  Essentially I am excluding drafts and ponies.   Once again not every horses breed was logged on the computer, so back into my filing closet I went.

I was completely shocked at how long it took for me to simply organize my spreadsheets and groups for the study.  I had figured it would be quick and easy so naturally by the end of the week I was well frustrated with the fact that I hadn’t actually started measuring yet!  Once I had identified the grade of each horses murmur and their breed I was then able to group them.  I made the groups based on the grade of their murmur: normal, grade 1-2/6, grade 3/6, grade 4/6, grade 5-6/6 and heart failure.  My goal was to have 18 horses in each group, which I was able to do up until grade 4/6.   I currently only have 3 horses for my grade 5-6/6 and heart failure horses.  It is hard to find horses with that severe of murmur for the study because once they become that severe they usually go into atrial fibrillation due to extreme dilation of the left atrium. The horses were then randomized based on their case number and I am doing my measuring blinded to their condition.

By Friday afternoon I was finally able to start measuring!!  The valuable lesson I learned in this is to keep good, complete records (for all you vets reading this), and if you think you are going to want to use cases for retrospective studies make sure to come up with a convenient storage system!  I have been measuring both days this week so far and it is very rewarding to finally be able to start.  I have a busy summer ahead of me because I have 80 horses and have only gotten through 6 so far.  I am finding it is a huge learning curve to get proficient at measuring and using a technique that makes my measurements repeatable.  I think I am on the right track now and hopefully with have more exciting news next time!

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