About

Megan Burke is an Associate Clinical Professor at the College of Veterinary Medicine at NC State University. Originally from San Francisco, California, she graduated from the UC Davis School of Veterinary Medicine in 2010. Following her graduation, she completed a Large Animal Surgery Internship at the University of Pennsylvania’s New Bolton Center, where she also completed a Comparative Orthopedics Fellowship at PENN Vet CORL. She then pursued a three-year residency in Large Animal Surgery, achieving board certification in 2016. In 2015, she joined NC State College of Veterinary Medicine as a Clinical Instructor in Equine Emergency and has been serving as an Assistant Clinical Professor of Equine Emergency since 2018. She also completed a collaborative Fellowship in Large Animal Emergency and Critical Care at The Ohio State University, earning board certification in 2021. Her research interests focus on reducing morbidity and mortality in critically ill equids, particularly those undergoing surgery for colic.

Research topics

• Biology
• Medicine
• Internal medicine
• Pedagogy
• Chemistry
• Pharmacology
• Intensive care medicine
• Medical education
• Surgery
• Psychology
• Biotechnology
• Veterinary medicine
• Immunology

Selected publications

• Application of a framework to mitigate the risk of surgical site infection after exploratory celiotomy in horses: A retrospective study

  Veterinary Surgery · 2026-03-03

  articleOpen access

  OBJECTIVE: To describe the methodology used to identify the contributors to a perceived sudden increase in exploratory celiotomy surgical site infections (SSI) and complications at the North Carolina State University Veterinary Teaching Hospital (NCSU VTH) between 2019 and 2020 and evaluate the effect of the designed intervention up to 4 years after its implementation. STUDY DESIGN: Case-control retrospective study over a five-year period. ANIMALS: A total of 448 horses that underwent exploratory celiotomy for the treatment of acute abdominal pain were included. METHODS: Medical records of horses that underwent exploratory celiotomy between 2019-2024 were reviewed from software systems used at the NCSU VTH. A surgical audit was conducted to assess adherence to best practices and identify factors contributing to increased SSI incidence. This led to the development of an evidence-based intervention to address procedural deficiencies and incorporate preventative perioperative strategies. The approach, resultant protocols, and reduction of SSI incidence are described. Data were analyzed using Fisher's exact test and univariate logistic regression. Statistical significance was set to p < .05. RESULTS: A significant increase in %SSI was observed from 7.7% in 2019 to 29% in 2020 (p = .0067). Following new protocol implementation, %SSI decreased to 2.3%. CONCLUSION: A surgical audit enabled the development of an evidence-based intervention that significantly reduced SSI incidence after exploratory celiotomy surgery. CLINICAL SIGNIFICANCE: Surgical audits serve as critical quality-of-care measure, allowing hospitals to identify procedural deficiencies. There is currently no literature that describes structured processes to manage this kind of problem in veterinary medicine. Surgical audit implementation may help other hospitals faced with similar challenges.

  PublisherDOI

• Urolithin A Supplementation Increases Acute Exercise Mediated Natural Killer Cell Cytotoxicity

  Medicine & Science in Sports & Exercise · 2025-09-16

  article

  Acute exercise increases the number of natural killer (NK) cells in the blood, resulting in increased cancer cell killing in vitro in healthy adults but less in adults with cancer. This immune dysfunction is partially mediated through impaired immune bioenergetics, particularly mitochondrial function. Urolithin A is a potent mitochondrial enhancer with the potential to enhance immune cell bioenergetics. PURPOSE: Determine whether Urolithin A, a potent mitochondrial enhancer, increases acute exercise-induced cancer cell killing by NK cells. METHODS: Fourteen healthy adults (6F/8M: aged 24 ± 4 years) completed a parallel design, double-blind, randomised, placebo-controlled trial. Supplementation was either 14 days of 500 mg/day Urolithin A [UroA, N = 7 (3F/4M)] or 500 mg/day of a cellulose placebo [CON, N = 7 (3F/4M)]. Participants completed a 30-minute bout of cycling at 75% VO2peak before (T0) and after (T1) supplementation. We assessed the acute-exercise mediated increased (Pre to Post acute-exercise) NK cell killing of K562 cancer cell lines by flow cytometry and lymphocyte mitochondrial function by Seahorse. RESULTS: In all conditions, acute exercise increased the number of blood CD3-/CD56+ NK cells (T0: 1.5 ± 0.5 to 5.2 ± 0.7 x 108 cells/L and T1: 1.7 ± 0.6 to 5.9 ± 0.7 x 108 cells/L; both p < 0.001) resulting in 19.1 ± 5.3% more K562 cell death (p < 0.001) at an effector:target of 100:1. The difference between T0 & T1 Pre to Post K562 cell death increased by 5.0% (95% CI: 3.3, 6.4) for UroA (MeanDiff±SD 19 ± 4.0% v 24 ± 4.0%; p < 0.001) while CON did not change (16.6 ± 5.3% v 15.4 ± 4.7%; p = 0.210). Similarly, the difference between T0 & T1 Pre to Post K562 killing per NK cell increased by 10.5% (95% CI: 2.7, 18.2) for UroA (0.5 ± 9.2% v 11.0 ± 4.5%; p = 0.012) while CON did not change (-2.2 ± 8.3% v -3.8 ± 2.8%; p = 0.706). The difference between T0 & T1 Pre to Post lymphocyte mitochondrial maximal respiration increased by 27.2% (95% CI: 5.0, 49.4) for UroA (6.1 ± 32.4% v 33.3 ± 10.2%; p = 0.021) while CON did not change (3.6 ± 16.1% v 6.0 ± 26.8%; p = 0.847). CONCLUSION: Fourteen days of Urolithin A supplementation enhances NK cell cytotoxicity against K562 cancer cells after acute exercise in part through improved mitochondrial function. Further work is required to determine if Urolithin A supplementation overcomes cancer-related immune dysfunction.

  PublisherDOI

• Hemoperfusion with a polymer-based column alters inflammatory responses in lipopolysaccharide-treated horses in vivo

  American Journal of Veterinary Research · 2025-08-19 · 1 citations

  articleOpen access

  Objective: To determine the effect of hemoperfusion with a polymer-based column on systemic cytokine concentrations and neutrophil dysfunction in lipopolysaccharide-treated horses in vivo. Methods: 6 university-owned horses received 60 ng/kg lipopolysaccharide, IV, as a bolus and then 60 ng/kg, IV, as a constant rate infusion over 1 hour. Endotoxemia was confirmed by clinical signs and neutropenia. In a crossover model that was completed from January 2024 through July 2024, hemoperfusion was performed for 4 hours with either a sham or polymer column. Blood was collected at 5 time points over a 72-hour period for flow cytometry analysis and 14 time points for cytokine multiplex analysis. Results: There were significant differences between column treatment and sham treatment, including increased early and late neutrophil apoptosis and improved reactive oxygen species production in response to stimulation at the postfiltration time point. Additionally, 2 of 5 column-treated horses had improved CBC parameters compared to 0 of 5 sham-treated horses. Systemic cytokines were not significantly different between column and sham treatment. Conclusions: The results of this study provide proof of concept for hemoperfusion with a polymer-based column as a potential treatment to mitigate deleterious lipopolysaccharide-induced immune responses in adult horses. Clinical Relevance: Further investigation and optimization of hemoperfusion as an adjunctive treatment for sepsis in the horse is warranted. Because there are known differences in lipopolysaccharide infusion and clinical sepsis, further investigation in horses with clinical sepsis is needed.

  PublisherDOI

• Pulmonary Embolism, Thrombectomy, and Catheter-Directed Lysis in Pregnant Woman With Fontan Palliation

  JACC Case Reports · 2025-06-01

  articleOpen access

  BACKGROUND: Patients with Fontan circulation are at increased risk for thrombosis, particularly during pregnancy. CASE SUMMARY: A 26-year-old woman at 10 weeks gestation with a lateral tunnel Fontan experienced acute onset of dyspnea and dizziness. Cardiac CT demonstrated an occlusive pulmonary embolism within the Fontan circulation. The patient underwent pulmonary thrombectomy and catheter-directed thrombolysis without complications. A surveillance cardiac CT 3 months after her discharge demonstrated complete resolution of the thrombus, and the patient is at baseline functional capacity. DISCUSSION: Patients with Fontan circulation and pregnancy have a heightened risk for both thromboembolism and bleeding; anticoagulation strategies are thus not standardized and are tailored to each individual's case. TAKE-HOME MESSAGES: To our knowledge, this is the first reported case of pulmonary embolism during the antepartum period in a patient with Fontan palliation who was subsequently treated with pulmonary thrombectomy and catheter-directed thrombolysis. Multimodality imaging evaluation was critical for rapid diagnosis and interventional planning.

  PublisherDOI

• Diseases of the Abdomen

  2025-12-19

  other1st authorCorresponding

  Colic is the most common equine emergency, with approximately 4–10 colic events per 100 horses per year. Approximately 75% of events are mild and resolve with 1 or more treatments in the field. The remaining 25% can be classified as “critical,” meaning that they require referral, surgery, or humane euthanasia. The focus of this section will be on triage of horses with colic. Emphasis will be placed on use of available diagnostics to determine whether a horse can be treated on the farm, or if referral should be considered.

  PublisherDOI

• Hemadsorption extracorporeal therapy removes cytokines ex vivo in horses

  American Journal of Veterinary Research · 2024 · 5 citations

  • Medicine
  • Pharmacology
  • Chemistry

  OBJECTIVE: Plasma cytokine adsorption has shown benefit as an adjunctive therapy in human sepsis but has yet to be investigated in horses. We hypothesized that ex vivo filtration of equine plasma with a novel cytokine adsorption device would significantly reduce concentrations of lipopolysaccharide-stimulated cytokines. We also hypothesized that the device would adsorb medications commonly used to treat sepsis. ANIMALS: 8 horses owned by North Carolina State University. METHODS: Four liters of heparinized whole blood was collected from healthy adult horses (n = 8) and stimulated with lipopolysaccharide (100 ng/mL) for 6 hours (37 °C.) from June 4, 2023, to December 15, 2023. Plasma was filtered through a cytokine adsorption device or sham circuit. Samples were collected at 11 time points for multiplex cytokine analysis. Chemistry analysis was performed before and after filtration. To investigate the impact of the device on medication concentrations, equine plasma containing potassium penicillin, gentamicin, and flunixin meglumine was filtered through the cytokine adsorption device or sham for 6 hours. Drug concentrations before and after filtration were determined by ultra-high-performance liquid chromatography. Prefiltration versus postfiltration sample concentrations were analyzed by Student paired t test using GraphPad Prism 9.0 (P < .05). RESULTS: Filtration of lipopolysaccharide-stimulated equine plasma (n = 8) for 6 hours resulted in significant mean reductions in the cytokines IL-10, IL-5, IL-8, tumor necrosis factor-α (TNF-α), and IL-1β, as well as albumin. Drug concentrations of potassium penicillin, gentamicin, and flunixin meglumine were also significantly reduced by filtration. CLINICAL RELEVANCE: This work provides proof of concept for further investigation of extracorporeal cytokine adsorption as a potential adjunct treatment for equine sepsis.

  PublisherOA PDFDOI

• Feasibility of hemoperfusion using extracorporeal therapy in the horse

  Frontiers in Veterinary Science · 2024 · 5 citations

  • Medicine
  • Intensive care medicine
  • Surgery

  Objective: Develop, implement, and monitor for adverse effects of, a novel hemoperfusion therapy in adult horses. Methods: A prospective, observational feasibility study using three healthy adult horses from the North Carolina State University teaching herd. Health status was determined by physical exam, complete blood count, coagulation panel, and serum biochemistry. Each horse was instrumented with a 14 Fr × 25 cm double-lumen temporary hemodialysis catheter and underwent a 240 min polymer-based hemoperfusion session. Horses were administered unfractionated heparin to maintain anti-coagulation during the session. Given the novelty of this therapy in horses, each horse was treated as a learning opportunity that informed an iterative process of protocol development and modification. Measurements and main results: Our long-term goal is to investigate potential clinical applications of hemoperfusion in horses, including cytokine reduction in horses with severe SIRS/sepsis. Horses were monitored for changes in clinical exam, biochemistry and hematology parameters. Additionally, cytokines were quantified to determine whether extracorporeal hemadsorption therapy alone caused an inflammatory response. Our results show that hemoperfusion therapy was associated with decreased platelet counts and serum albumin concentration. There was no significant change in plasma cytokine concentrations with hemoperfusion therapy. In one horse, the cytokine concentrations decreased, as previously reported with hemoperfusion therapy in humans. Hypothesis: We hypothesized that hemoperfusion therapy could be performed in healthy adult horses without significant adverse effects. Conclusion: Polymer-based hemoperfusion is a feasible extracorporeal therapy (ECT) modality for adult horses. Additional studies are needed to further establish clinical protocols, as well as establish efficacy of polymer-based hemoperfusion for treatment of various conditions in horses, including intoxications, immune-mediated conditions, and sepsis.

  PublisherOA PDFDOI

• Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy

  Frontiers in Veterinary Science · 2023-04-27 · 4 citations

  articleOpen accessSenior authorCorresponding

  Objective The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Animals A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Materials and methods Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variables and pre-operative PCV, surgery duration, pre-operative reflux, and type of surgery were evaluated as independent variables. Type of surgery was divided into manual decompression ( n = 88) and jejunal enterotomy ( n = 33). Results There were no significant differences in development of minor complications, development of major complications, presence of post-operative reflux, amount of post-operative reflux, and survival to discharge between horses that were treated with manual decompression and those treated with distal jejunal enterotomy. Pre-operative PCV and surgery duration were significant predictors of survival to discharge. Conclusions and clinical relevance This study showed that there are no significant differences in post-operative complications and survival to discharge in horses undergoing distal jejunal enterotomy versus manual decompression for correction of ileal impaction. Pre-operative PCV and duration of surgery were found to be the only predictive factors of survival to discharge. Based on these findings, distal jejunal enterotomy should be considered earlier in horses with moderate to severe ileal impactions identified at surgery.

  PublisherOA PDFDOI

• Severe unilateral nephrolithiasis and recurrent colic in a horse

  Veterinary Record Case Reports · 2023-01-12

  articleOpen access

  Abstract Urolithiasis is an uncommon disorder reported in horses. Calculi located in the kidneys and ureters are often underdiagnosed. Associated clinical signs include weight loss, anorexia, haematuria, dysuria, colic and polyuria/polydipsia. A 26‐year‐old Thoroughbred gelding was referred for evaluation of an acute colic episode of 5‐hour duration. Haematologic analysis revealed increased serum creatine kinase and creatinine concentrations. Abdominocentesis yielded serosanguineous, mildly cloudy fluid with a lactate of 9.6 mmol/L (&lt;2 mmol/L). Exploratory laparotomy was recommended. Surgical intervention was declined, and the horse was humanely euthanased. Limited postmortem evaluation was performed. A 3.633 kg nephrolith measuring 23.6 × 16.2 × 8.9 cm was completely effacing the left kidney. Crystallography and infrared spectroscopy (attenuated total reflection and Fourier transform infrared) revealed a 100% calcium carbonate nephrolith. Carbonate calcium calculi are the most common subtype in horses. Nephrolithiasis should be considered as a differential diagnosis for colic and haematologic evidence of azotaemia in horses.

  PublisherOA PDFDOI

• Development and Formative Evaluation of a Low-Fidelity Equine Castration Model for Veterinary Education

  Frontiers in Veterinary Science · 2021 · 6 citations

  • Medicine
  • Veterinary medicine
  • Medical education

  Entrustable Professional Activities (EPAs) are units of activity that early-stage professionals perform in the workplace that necessitate simultaneous integration of multiple competencies. EPA #6 requires students to perform a common surgical procedure on a stable patient, including pre-operative and post-operative management. Castration is one of the most common surgeries performed by equine primary care practitioners and is considered an "entry-level competency" for veterinary graduates entering equine private practice, however, to our knowledge there are no equine castration models available for veterinary student education. Therefore, we developed an inexpensive, low-fidelity model of equine field castration and evaluated it using a mixed-methods approach. Two different groups of students, with or without model experience, completed surveys before and after live horse castration. Students who used the model also completed model specific surveys. Videos of the students completing the model were evaluated by at least two different equine veterinary faculty using a 15-point rubric, and inter-rater reliability of the rubric was determined. After completing the model, students reflected on strengths and weaknesses of their performance. From our student survey results, we determined that student attitudes toward the model were mostly positive. Interestingly, there were several student attitudes toward the model that became significantly more favorable after live horse castration. Prior to live horse castration, there was no significant difference in confidence in model vs. no-model groups. Following live horse castration, students who used the model had higher confidence in procedure preparation and hand-ties than students who did not use the model, but they had lower scores for confidence during patient recovery. When reflecting on model castration, students most commonly cited preparation and surgical description as strengths, and ligature placement and hand-ties as weaknesses. Experts provided several suggestions to improve the model, including incorporation of emasculators and the need for better model stabilization. Our findings suggest that both students and veterinary educators feel that this low-fidelity model has educational value. Rubric performance metrics were favorable, but additional steps are needed to improve grading consistency among educators. Future research will determine whether student performance on the model is predictive of competence score during live-horse castration.

  PublisherDOI

Frequent coauthors

• Anthony T. Blikslager

  North Carolina State University

  7 shared

• M. Aïssou

  Université Djilali Bounaama Khemis Miliana

  6 shared

• P. Tilleul

  6 shared

• Marc Beaussier

  Institute Mutualiste Montsouris

  6 shared

• Joseph G. Craig

  Henry Ford Hospital

  4 shared

• Mark Wright

  4 shared

• Nigel Hacking

  NIHR Southampton Biomedical Research Centre

  4 shared

• John Hutton

  4 shared

Education

• Ph.D., Veterinary Science

  North Carolina State University

  2015

• M.S., Veterinary Science

  North Carolina State University

  2011

• B.S., Animal Science

  North Carolina State University

  2009