Equine Practitioners Research Articles

An Investigation into Equine Nutrition Knowledge and Educational Needs of Equine Veterinarians.

This study investigated equine nutrition knowledge and educational needs of licensed veterinarians in the United States who were exclusively or predominately equine practitioners. It found veterinarians regard their peers as an important resource of nutritional knowledge, ranking ahead of all other sources except a PhD equine nutritionist. Interestingly, only 21% of veterinarians felt good about their knowledge level in equine nutrition after graduating from veterinary school. Although veterinarians in this study reported equine nutrition to be an area of weakness, 75% had not pursued continuing education in the field of nutrition within the last year. Additionally, they devoted only 65 minutes per year on average to improving their knowledge of equine nutrition, yet the majority (82.2%) had been providing nutritional advice to clients. This study revealed that time spent practicing veterinary medicine increases (p < .001) a veterinarian's self-perceived knowledge level of equine nutrition, shifting from just below average after graduation from veterinary school to just above average at the time of this study. The majority (70%) of veterinarians in this study believe nutrition is very important in their practice philosophy, and 71% showed interest in taking online continuing education courses; thus, curriculum should be developed and offered in areas of need as identified by this study. These areas include insulin resistance, equine gastric ulcer syndrome, equine metabolic syndrome, performance horses, equine pituitary pars intermedia dysfunction, equine polysaccharide storage myopathy, and arthritis/joint pain, along with how to assess nutritional status during general wellness examinations.

Marijuana toxicosis in 2 donkeys.

Marijuana toxicosis is typically seen by companion animal veterinarians. However, with increased marijuana availability, there is a greater potential for toxicosis in other species. Herein we describe a case of suspected marijuana toxicosis in a female and a male American Mammoth donkey, aged 8 y and 20 y, respectively, fed cannabis buds. Both cases were presented because of depression and lethargy. However, the jenny had ataxia, mild colic, tachycardia, tachypnea, and decreased tongue tone. Plasma samples from the jenny on presentation and 3 d following hospitalization were submitted to the Kansas State Veterinary Diagnostic Laboratory to be screened for cannabinoids using high-pressure liquid chromatography coupled with tandem mass spectroscopy (HPLC-MS/MS). A single serum sample from the jack was taken on presentation and submitted to the Animal Health Diagnostic Center at Cornell University for Δ9-tetrahydrocannabinol (THC) and cannabidiol analysis using HPLC-MS/MS. THC was detected in all samples. Clinical signs were noted 24-36 h after ingestion, which included mild-to-moderate neurologic deficits, mild colic, tachycardia, tachypnea, and decreased tongue tone. Both donkeys recovered uneventfully within 24 h of peak effects. Utilizing a cannabinoid screening assay in collaboration with a veterinary diagnostic laboratory may be useful when an equine practitioner suspects marijuana toxicosis in a patient.

Collection and administration of blood products in horses: Transfusion indications, materials, methods, complications, donor selection, and blood testing.

Blood transfusion is a lifesaving treatment for horses with acute hemorrhage and other causes of anemia. Transfusions improve oxygen delivery to the tissues via increased blood volume and hemoglobin concentration. Certain aspects of equine blood transfusion are challenging, especially in the field situation, and practitioners may be unfamiliar or feel overwhelmed with the process. An understanding of the indications, materials, methods, and techniques as well as donor selection and possible complications will help practitioners successfully implement blood transfusion in clinical practice. Blood transfusion involves several steps including appropriate donor selection, cross-matching, blood collection, and administration, as well as monitoring and handling of transfusion reactions. Guidance for each of these steps are detailed in this review. Blood transfusion is an effective and often lifesaving treatment for managing diseases of blood loss, hemolysis, and decreased RBC production. Equine practitioners require a thorough understanding of the indications for blood transfusion, the immunological principles behind compatibility testing and transfusion reactions, and the technical skills to aseptically collect and administer blood products KEY POINTS: Equine practitioners require a thorough understanding of the indications for blood transfusion, the immunological principles behind compatibility testing and transfusion reactions, and the technical skills to aseptically collect and administer blood products. Because there are over 400,000 possible equine RBC phenotypes, no universal donor exists, and some blood type incompatibilities are likely between any donor and recipient. Therefore, prior to any blood transfusion, donor and recipient blood should be cross-matched Inadequate delivery of oxygen (Do2 ) to the tissues, resulting from low hemoglobin (Hb) concentration, is the most important indication for blood transfusion Neonatal isoerythrolysis most commonly occurs following an anamnestic response in late gestation; it rarely occurs following a primary exposure because the immune response is not strong enough to produce clinically significant alloantibody titers.

Advances in the treatment of osteoarthritis in horses

AbstractOsteoarthritis is a common and debilitating disease affecting horses across breeds and disciplines. Although the cornerstone of therapy among equine practitioners remains systemic and local anti-inflammatory medications, this approach only addresses the symptoms of osteoarthritis, rather than modifying the progression of the disease itself. There has been great interest in various biologic and cell-based therapies, such as autologous conditioned serum, platelet-rich plasma, and mesenchymal stem cells, as potentially being disease-modifying osteoarthritis drugs.In vitroand experimental results for these novel modalities are promising. However, although the use of these therapies is now widespread, scientific evidence supporting their efficacy in clinical cases is limited to date. Gene therapy for delivery of anti-inflammatory cytokines or growth factors has also been investigated experimentally with good results but has not entered widespread clinical practice. Standardized definitions of disease and large randomized controlled trials, organized across institutions, are needed improve evidence-based recommendations for osteoarthritis treatment. This review provides a brief overview of what is known about the pathophysiology of osteoarthritis and addresses the current literature for medical treatment of osteoarthritis in the horse.

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

Current joint therapy usage in equine practice: Changes in the last 10years.

Osteoarthritis is a common clinical condition in the performance horse. In the last 10years, there has been substantial growth in understanding of the disease and in the development of novel therapies. To document changes in clinical use of joint therapies over the past 10years. We also aimed to understand how newly developed therapies have been added to routine clinical practice. Survey of veterinary professionals. We administered an electronic survey to members of the American Association of the Equine Practitioners. Questions from a similar survey in 2009 were repeated and new questions were added. The responses were tabulated, analysed and compared to those of the previous survey. A total of 407 completed surveys were returned. There were no significant differences between the current and previous surveys with respect to demographic parameters. Triamcinolone acetonide (TA) remained the most common corticosteroid used to treat high-motion joints. Methylprednisolone acetate (MPA) remained the most common corticosteroid to treat low-motion joints. The use of MPA for high-motion joints was significantly more common in 2009 than in 2019 (odds ratio [OR]: 2.38, 95% confidence interval [CI]: 1.66-3.42, P=.001). Biological therapies became more popular, and the likelihood of respondents reporting having used autologous conditioned serum was substantially higher in 2019 than in 2009 (OR: 4.24, 95% CI: 3.16-5.68, P<.001). Concomitant use of antibiotics with intra-articular medications became more common as well. This is a report of survey data and not directly measured treatments. There is a decrease in the use of MPA to treat high-motion joints. The use of biological therapies in joints has become more prevalent. There are clear differences in the use of joint therapies over time. While some differences agree with the scientific evidence, others are not fully concordant or are in direct conflict with the scientific literature.

The Combination of hCG and GnRH Analog to Hasten Ovulation in Mares Does not Change Luteal Function and Pregnancy Outcome in Embryo Recipient Mares

Equine practitioners often prescribe the combined use of hCG and GnRH to hasten ovulation due to presumed synergistic effects. Therefore, this study aimed to test whether the combination of hCG and deslorelin acetate to hasten ovulation in mares would show any effect in inducing ovulation more efficiently than when either drug is used by itself, and to verify whether this association would affect progesterone concentrations; corpus luteum (CL) diameter and blood flow; and pregnancy outcome in recipient mares after embryo transfer (ET). Seventeen mares had the ovulation hastened (≥35 mm follicle) as follow: Control, 1 mL of 0.9% NaCl solution; GnRH, 1 mg of deslorelin acetate; hCG, 1,500 IU of hCG; hCG+GnRH, 1mg of deslorelin acetate and 1,500 IU of hCG. CL diameter and blood flow, and serum progesterone concentrations were assessed between the day of ovulation induction and sixteen days after ovulation. In addition, data of 194 ET were retrospectively analyzed. Pregnancy rates at five days after ET and pregnancy loss up to 60 days of recipient mares with natural ovulation (Control, n=37), or with ovulation hastened with hCG (n=25), or deslorelin acetate (n=46), or the combination of these hormones (n=86), as described above, were assessed. The control group had a higher progesterone concentration on the day of ovulation than the GnRH group (P < .05). However, there were no differences in CL diameter and blood flow at any time point, as well as in progesterone concentration over time (P > .05). Pregnancy rates and pregnancy loss didn't differ between recipient mares treated or not with hormones. In conclusion, the combination of hCG and deslorelin acetate to hasten ovulation was not able to change luteal development, progesterone concentration, or pregnancy outcome in recipient mares after ET.

93 Effect of replacing part of concentrates with pelleted alfalfa on squamous gastric ulcers in exercised trotters.

Horses at heavy work have a high prevalence of Equine Squamous Gastric Disease (ESGD). Exposure of the squamous mucosa to HCl causes damages, which can be more severe with acids produced by bacterial fermentation of starch and soluble sugars at pH ≤ 4. Among low-starch feedstuffs commonly fed to horses, alfalfa ( Medicago sativa ) has the strongest buffering capacity, and promising data on its healing impact have been observed in preliminary trials. In this field study, the effect of alfalfa was investigated on ESGD prevention and healing in trained horses. In 4 training centers, 80 exercised trotters (“very heavy work” based on NRC 2007) and housed in individual boxes were followed for 42 d. Gastroscopies were performed on D0, D21, D42 by an equine practitioner in a blind assessment. ESGD severity was scored using the EGUS Council 0–4 scoring system. On D0, horses were divided into 2 homogeneous groups on each center based on ESGD initial score, age and sex. Horses in control group (CON; n = 40) kept their previous ration (hay ad lib and 6.6 ± 1.8kg pellets; 4.5 ± 1.5g starch/kg BW/d). In the alfalfa group (ALF; n = 40), 50% (vol/vol) of pelleted concentrates were replaced by pelleted dehydrated alfalfa (hay ad lib and 6.3 ± 1.6kg pellets; 2.3 ± 0.7g starch/kg BW/d). Rations were almost isoenergy and isoprotein per center. Training continued without difference between groups. Horses were categorized in “no or mild ulcerations” (NMU – grades 0, 1, 2) and “severe ulcerations” (SU – grades 3, 4). Among the NMU horses at D0 (n = 49), preventive effect of the diet was determined by comparing number of NMU and SU horses at D21 and D42 using a Chi-2 test. Curative effect was evaluated by comparing number of NMU and SU horses at D21 and D42 among the SU horses at D0 (n = 31). No significant effect of the diet was measured on ESGD prevention or healing. In our study, ALF rations remained higher in starch compared with previous studies. In addition, in the 2 trials that showed a beneficial effect of alfalfa, horses were not intensively trained and alfalfa was fed as fodder. Feeding alfalfa pellets may have limited the preventive effect associated with saliva and formation of a protective layer on top of the gastric chyme.

Evaluation of Diagnostic, Prognostic Indicators and Surgical Outcome in 20 Cases Treated for Equine Intestinal Colic

Background: Colic is one of the most common and challenging problem encountered by equine practitioners. In practise majority of horses suffering from colic can be treated with medical management but around 10% of horses with colic require surgical intervention in an effort to save the life of animal. In India, equine abdominal surgery is not popular because there is lack of infrastructure, manpower and expertise therefore, there is a need to conduct clinical studies to document outcome of equine colic cases managed surgically. The present report describes diagnostic, prognostic indicators and post-operative outcome of exploratory celiotomy performed to manage various cases of colic surgical outcome of colic surgery in Indian horse breeds.Methods: The present study was conducted on 20 horses having intestinal colic (n=20). The affected patients were selected for exploratory celiotomy on an emergency basis having moderate to severe persistent abdominal pain, lack of response to medicinal treatment with absence of intestinal borborygmi. Preoperative physical assessment, biochemical analysis and peritoneal fluid analysis were done in all the clinical cases. The preoperative physical assessment and various blood parameter estimation helped in decision making.Conclusion: The result of intestinal colic cases showed that mean heart rate and respiration rate (mean±SE) were significantly higher in non-survivors as compared to survivors. Blood lactate level was significantly higher in non survivors than survivors. Large colon affectation (n=8) were the primary cause of the colic, followed by small colon (n=6), cecum (n=3) and small intestine (n=3). Postoperative complications were peritonitis and ileus (n=6), subcutaneous seroma (n=7), pyrexia (n=4), diarrhoea (n=6). Short term survivability in intestinal colic patients was 55% and long term survivability was 50%.

How to interpret an electrocardiogram

Electrocardiography is the ultimate tool for diagnosing suspected cardiac arrhythmia, and the required equipment is readily available to an equine practitioner. Careful interpretation is essential to determine whether an arrhythmia is significant, either as a cause of poor performance or as a risk for collapse and sudden death. A good quality electrocardiogram recording is essential, usually an exercising electrocardiogram and a recording over 24 hours. Electrocardiographical interpretation is aided by modern electrocardiogram analysis software, and technology enables access to a second opinion when required. Vagally-mediated arrhythmias are common in horses at rest, but should be overridden by exercise. Atrial fibrillation or frequent ectopic beats during exercise warrants further cardiac evaluation.

EquineReview

Introduction: Peritonitis in horses, equine bleeding and the pathogenesis of gamma glutamyl-transferase activity in Thoroughbred horses are discussed in this month's selection of three recent papers for equine practitioners.

Ultrasound examination of the equine acute abdomen

Background: Abdominal pain is one of the most common causes of emergency in equine practice. The origin of these clinical signs is wide ranging; therefore, the treatment and prognosis can vary significantly. The use of imaging modalities, especially ultrasonography, for the diagnosis of abdominal diseases in horses has become widely available and currently plays a crucial role in the diagnostic work‐up of colic.Aim of the article: This article describes the use of ultrasound for assessing the equine abdomen and guides the equine practitioner on the diagnostic features of the most common diseases that can cause colic in horses.

Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment.

Simple SummaryNeck pain and dysfunction in the horse is becoming an increasingly important topic among riders, trainers and veterinarians. Some horses may present for a subtle performance decline, while others may show dramatic, dangerous behavior. It is important to recognize how to carefully evaluate the horse in an effort to understand the different types of pain that may be contributing to the different behaviors. The musculoskeletal and nervous systems may both play a role in the development of clinical signs. Recognizing that there are many diagnostic options as well as several treatments choices is important. This synopsis covers the disease processes that may contribute to the development of neck pain and dysfunction in the horse, as well as several possible diagnostic and treatment options.Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.

EquineReview

Introduction: The topics of facial nerve paralysis, synovitis following blackthorn injury, sepsis of the calcaneal bursae, and the extent to which xylazine and acepromazine affect the assessment of forelimb lameness are discussed in this month's selection of recent papers for equine practitioners.

Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses.

Simple SummaryIt is difficult to measure pain in horses. As animals are not able to verbalize what they feel, we are left with trying to interpret the different signs that they display when they are in pain. Many of these signs are vague (e.g., not eating their food), but some are more readily identified if the animal moves away or lifts their leg when pressure is applied to a sensitive area. Pressure algometry is a tool used to detect responses to applied mechanical stimuli within painful and nonpainful tissues. Pressure algometry has been used in many different studies, but there is no consensus on how to synthesize this information to better diagnose and treat pain in horses. The purpose of this study was to summarize the results of these studies. Based on that review, we conclude that there is good evidence that pressure algometry is a reliable and objective method to measure pain responses. This information will help to improve the diagnosis and treatment of pain in horses.The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until an avoidance response is noted, which is defined as the mechanical nociceptive threshold (MNT). Numerous studies have used pressure algometry in different applications to measure MNTs in horses. There is an acute need to establish normative values within different body regions and to develop standardized methods of testing MNTs to better guide practitioners in the diagnosis and treatment of pain. The aim of this systematic review was to summarize the evidence for the use of pressure algometry in horses. There is good evidence that pressure algometry is a repeatable, semi-objective method that can be used in a wide array of clinical and research applications to assess MNTs in horses.

EquineReview

Introduction: Facial nerve paralysis, synovitis following blackthorn injury and sepsis of the calcaneal bursae are discussed in this month's selection of three recent papers for equine practitioners.

A Survey of Clinical Usage of Non-steroidal Intra-Articular Therapeutics by Equine Practitioners.

There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein solution, cellular therapies, and polyacrylamide hydrogel) was distributed internationally to equine practitioners. A total of 353 surveys were completed. NSIATs were used by 87.5% of the participants. Corticosteroids and hyaluronic acid remain the intra-articular therapeutic of choice among practitioners, followed by autologous conditioned serum, platelet-rich plasma and autologous conditioned protein. Polyacrylamide hydrogel was the least used. Practitioners were more likely to use NSIATs if their caseload was > 50% equine (P < 0.001), they treated more than 10 horses intra-articularly per month (P < 0.001), and horses treated were considered English sport horses (P = 0.02). Years in practice and practice location did not influence the use of NSIATs. One of the most common reasons why NSIATs were chosen was to treat acute articular pathologies. As survey limitations, answers to questions regarding clinical response and complication rates were based on subjective estimation and practitioners recall, not clinical records. In conclusion, corticosteroids remain the most widely used intra-articular therapeutic. Among the NSIATs, blood-based products are more commonly used by practitioners, followed by cellular and synthetic products. Equine practitioners frequently use NSIATs, choosing to treat acute joint pathology more than previously reported.

Plantar fasciitis in 19 endurance horses: Diagnosis, treatment and follow‐up

SummaryLesions of the peritendinous–periligamentous soft tissues of the tarsus (plantar fasciitis) commonly result in a curb‐like appearance and are considered overrepresented in Standardbred racehorses; however, plantar fasciitis is also quite common in endurance horses. Nineteen endurance horses of different ages (median: 7 years; range: 3–13) and athletic activity level comprising a total number of 25 plantar fasciitis cases were described in this study. In nine cases, injury developed during a training session, and in 16 cases, it developed during competition. In 18 cases, there was swelling, heat and pain on palpation, and in six cases, only swelling was detected. Eight cases were not lame at the time of examination, while in 17 cases, lameness ranged from grades 1–3 on the American Association of Equine Practitioners modified grading scale. The degree of swelling was significantly related to the lameness grade. Ultrasonography revealed differing amounts of thickening of the plantar fascia plantar to the superficial digital flexor tendon and peritendinous–periligamentous oedema of heterogeneous appearance. Horses were treated conservatively with several combinations of rest, controlled exercise, ice‐therapy, corticosteroids, local application of working counterirritants and therapeutic shoeing. Seventeen of 25 cases (68%) did not develop re‐injury after treatment and rehabilitation, whilst eight of 25 (32%) developed one or more re‐injury/injuries. Overall, 21 of 25 cases (84%) returned to the previous or a higher level of competition; in one case (4%), the injury was the cause of retirement from athletic activity. Plantar fasciitis can be considered a sport‐related injury in endurance horses of all ages and athletic activity level. Re‐injury rate is low; however, adequate rest and rehabilitation protocols are important. Plantar fasciitis rarely leads to retirement from athletic activity, but it can result in 2–5 months out of training and competition.

Building Bridges between Theory and Practice: How Citizen Science Can Bring Equine Researchers and Practitioners Together.

Simple SummaryHorse owners and caregivers are ideally placed to inform equine researchers about the training, management and behaviour of their horses, and online surveys are a simple and easy way to collect this information. However, as potential survey respondents may need some incentive to engage in detailed surveys, we investigated the popularity of four potential no-cost tools to compensate survey participants for their time. While our inquiry found at least one of these tools would be of benefit to most participants, it also revealed the need to improve horse riders’ and handlers’ access to scientific findings.Over the last decade, equitation scientists have increasingly relied on online survey tools to gather information on horse training, management, behaviour and other equine-related subjects. With a detailed knowledge of their animals, horse owners and riders are ideally placed to contribute to research but are sometimes reluctant to engage with and devote time to surveys. The current article reveals, through consultation with stakeholder groups, the potential of a range of motivational items to boost horse-owner participation. A short, three-question inquiry was developed to rank respondents’ (n = 747) preferred survey tools and other items designed to engage the equestrian community with the donation of data. Respondents were asked to assign themselves to one of four categories: academics/researchers, professionals, practitioners and enthusiasts. The inquiry offered respondents the choice of three hypothetical tools: a standardised tool to measure behaviour over time; a logbook tool to record training and behaviour on a regular basis; and a chart to compare an individual horse’s behaviour with that of the general horse population. While analysis revealed that stakeholders considered at least one of the tools to be useful, it also exposed significant differences among the perceived usefulness of the various tools themselves. Using free-text responses, participants described the challenges faced when gathering information on horse training, management and behaviour. Qualitative analysis of these data revealed the need to improve the current dissemination of scientific findings to bridge various knowledge gaps. The Equine Behavior Assessment and Research Questionnaire (E-BARQ) is a longitudinal instrument that investigates horse training and management practices and permits an analysis of their relationship with behaviour. The current stakeholder consultation contributed to the final version of the E-BARQ questionnaire, identified incentivising items that can be offered to putative E-BARQ respondents, guided the eventual selection of a Share-&-Compare feedback chart, and reinforced the need for open-access dissemination of findings.

Diagnostic and Treatment Practices of Equine Endometritis-A Questionnaire.

Endometritis is a major cause for impaired fertility in mares. The objectives of this study were to collect information on diagnostic and treatment practices performed by veterinarians and to investigate possible effects of professional experience, caseload, and geographical location on the practitioners' management of endometritis cases. For this purpose, equine practitioners (n = 680) were asked to fill out an online survey (34 questions). The online survey yielded 117 responses by veterinarians practicing in all parts of Germany. Most respondents came from Lower Saxony and managed <20 mares per year. For the diagnosis of chronic infectious endometritis, uterine sampling for microbiological examination was performed manually with a swab by the majority of practitioners whereas only few used the speculum technique. The incidence of antibiotic resistant pathogens was reported to be <5% by almost all respondents. Most practitioners relied on systemic antibiotic treatment with trimethoprim-sulfadiazine. Only occasionally veterinarians used intrauterine antibiotic therapy. Uterine lavages were performed routinely by almost half of the respondents in case of positive uterine cultures, mostly with 0.9% saline solution. Irritant solutions (e.g., iodine, chlorhexidine, kerosene) were used less often. Collection of an endometrial culture after completion of the treatment was common practice. While only a very limited association of the geographical location of practitioner (e.g., on selection of mares for endometrial culture, p < 0.05) was observed, the number of managed mares affected the answers notably (e.g., for use of irritating intrauterine treatment, p < 0.05). The management of persistent breeding induced endometritis (PBIE) was influenced by the number of managed mares (e.g., for use of oxytocin, p < 0.05) and 29.6% of respondents administered antibiotics as part of their PBIE management. In summary, treatment strategies in the field vary considerably and include also non-evidence-based methods, but most German practitioners apply the recommended suitable treatments. Following the guidelines for antibiotic usage, most veterinarians administer antibiotics dependent on endometrial culture results but do not use cytology, low-volume lavage, or biopsy routinely. Antibiotic resistant uterine pathogens are reported to be isolated infrequently and equine practitioners prefer systemic to local antibiotic treatment of endometritis.