{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:30:00Z","timestamp":1778459400718,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T00:00:00Z","timestamp":1754784000000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Vet Emergen Crit Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the clinical presentation of horses with synchronous diaphragmatic flutter (SDF) and identify clinical and laboratory variables associated with survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study from January 2004 to September 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Five large animal referral hospitals in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Animals<\/jats:title><jats:p>Thirty\u2010seven horses of various breeds and ages presenting with clinical signs of SDF, excluding animals participating in an endurance competition. All horses were &gt;1\u00a0year of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Variables recorded and analyzed included signalment, clinical and laboratory data, treatments, and outcome. SDF was seen with gastrointestinal disease in 35% (13\/37) of horses. The survival for horses with SDF was 78.4% (29\/37). Nonsurvivors had a higher heart rate (78\u00a0\u00b1\u00a015\/min) than survivors (58\u00a0\u00b1\u00a017\/min; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). Nonsurviving horses were more likely than surviving horses to have had nasogastric reflux (odds ratio: 16.8; 95% confidence interval: 1.9\u2013222.8). Compared with survivors, nonsurvivors had a lower sodium concentration (131\u00a0\u00b1\u00a07\u00a0mmol\/L [131\u00a0\u00b1\u00a07\u00a0mEq\/L]) and bicarbonate concentration (22.7\u00a0\u00b1\u00a02.8\u00a0mmol\/L [22.7\u00a0\u00b1\u00a02.8\u00a0mEq\/L]). Nonsurvivors had higher lactate concentration (7.1\u00a0\u00b1\u00a03.9\u00a0mmol\/L [64\u00a0\u00b1\u00a035.1\u00a0mg\/dL]), glucose concentration (20 [13.3\u201329] mmol\/L; 378 [239\u2013522] mg\/dL), and gamma\u2010glutamyltransferase activity (51 [27\u2013687] U\/L). In horses that had ionized calcium concentration measured, 13 of 18 (72%) had a concentration &lt;1.3\u00a0mmol\/L (5.2\u00a0mg\/dL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SDF in horses is seen concurrently with gastrointestinal and other diseases, and not all horses present with hypocalcemia. The survival for nonendurance horses with SDF was\u00a078%. Nonsurvival was associated with increased heart rate, the presence of nasogastric reflux, and a variety of laboratory abnormalities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vec.70009","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T05:24:26Z","timestamp":1754889866000},"page":"392-397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrospective Evaluation of Synchronous Diaphragmatic Flutter in Horses: 37 Cases (2004\u20132022)"],"prefix":"10.1111","volume":"35","author":[{"given":"Joanna","family":"Faircloth","sequence":"first","affiliation":[{"name":"Loomis Basin Equine Medical Center  Penryn California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3279-6205","authenticated-orcid":false,"given":"Langdon","family":"Fielding","sequence":"additional","affiliation":[{"name":"Loomis Basin Equine Medical Center  Penryn California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kira","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Large Animal Medicine University of Georgia College of Veterinary Medicine  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Crabtree","sequence":"additional","affiliation":[{"name":"Department of Large Animal Medicine University of Georgia College of Veterinary Medicine  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathleen","family":"Mochal","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences College of Veterinary Medicine Mississippi State University  Mississippi State Mississippi USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Gary","family":"Magdesian","sequence":"additional","affiliation":[{"name":"Department of Medicine and Epidemiology, School of Veterinary Medicine University of California, Davis  Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin","family":"Major","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences Texas A&amp;M University School of Veterinary Medicine  College Station Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/0002-9343(54)90324-1","article-title":"Interrelations Between Hiccup and the Electrocardiogram","volume":"16","author":"Lepeschkin E.","year":"1954","journal-title":"American Journal of Medicine"},{"key":"e_1_2_9_3_1","first-page":"112","volume-title":"A Guide to the Management of Emergencies at Equine Competitions","author":"Taylor P.","year":"1996"},{"issue":"01","key":"e_1_2_9_4_1","article-title":"Potassium\u2010Free Electrolytes and Calcium Supplementation in an Endurance Race","volume":"5","author":"Hess T. 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