Outcome Of Horses Research Articles

Clinical features and outcomes of horses presenting with presumed equine immune mediated keratitis to two veterinary hospitals in the United Kingdom and Finland: 94 cases (2009-2021).

There is limited literature regarding equine immune mediated keratitis (IMMK) in Europe. North America-based publications describe minimal blepharospasm, rare corneal ulceration and no uveitis; clinical impression suggests these are seen in Europe. Assess the prevalence of blepharospasm, corneal ulceration and uveitis and their impact on outcome in horses diagnosed with IMMK in Europe (UK and Finland). Retrospective case series. Clinical records of 94 horses with IMMK were evaluated. The UK and Finland populations were comparable; therefore, descriptive statistics were performed on combined data on subtypes of IMMK and clinical features. Odds ratios (OR) and confidence intervals (CI) were calculated for impact of blepharospasm, ulceration or presence of uveitis on the outcome of enucleation and treatment duration. IMMK subtype was classified as 10/94 (10.6%) epithelial, 50/94 (53.2%) anterior stromal, 14/94 (14.9%) mid-stromal, 4/94 (4.25%) endothelial and 16/94 (17.0%) unrecorded. After excluding three horses with incidental corneal ulceration, blepharospasm was documented in 34/91 (37.4%), corneal ulceration in 26/91 (28.6%), and signs of uveitis in 23/91 (25.3%) horses. Increased odds of enucleation were significantly associated with the presence of blepharospasm (OR 5.5, 95% CI 1.6-19.4, p = 0.008) and signs of uveitis (OR 8.9, 95% CI 2.6-30.8, p < 0.001), but not corneal ulceration. The presence of blepharospasm, corneal ulceration or uveitis did not significantly alter the odds of ongoing medication. Data were collected over a wide timeframe; the diagnosis was mainly made without histopathology; a broad definition of uveitis was used and there was a bias towards complicated cases being retained for follow-up. The clinical features of IMMK were similar between two European countries but differed to USA descriptions. Blepharospasm, corneal ulceration and signs of uveitis can occur with IMMK; presence of blepharospasm and uveitis increase the odds of enucleation.

Penetrating wood foreign bodies (stob) of the coronary band in horses: 15 cases.

To retrospectively report the historical and clinical findings, diagnostics, treatment, and outcome of horses with penetrating wood foreign bodies (PWFBs) of the coronary band. 15 client-owned horses. Horses had varying degrees of lameness and soft tissue swelling of the coronary band and pastern region. A defect in the coronary band was identified, but the actual wood foreign body was not always readily visualized. Medical records of horses diagnosed with PWFBs of the coronary band between 2004 and 2023 were reviewed. Information retrieved from the medical records included history, signalment, diagnostics, treatment, and outcome. Thirteen of 15 horses that sustained a PWFB to the coronary band were participating in foxhunting. Penetrating wood foreign bodies occurred more frequently near the central axis or toe region (11/15) and more commonly in the forelimbs (11/15). Removal of PWFBs can be performed with the horse standing and sedated with regional anesthesia. Complete removal of the PWFB required partial removal of the adjacent hoof wall. Penetrating wood foreign bodies occurred in the coronary band and lodged distally in the hoof wall of horses. Foxhunting may be a risk factor for this type of injury. Penetrating wood foreign bodies occurred most commonly in the front feet, near the central axis of the coronary band. Complete removal of the PWFB required removing a section of the adjacent hoof wall. The prognosis for return to the previous level of activity following treatment was favorable.

Whole dried black soldier fly (Hermetia illucens) larvae are acceptable, palatable, and do not negatively affect health when fed to healthy, adult horses at low inclusion rates

Black soldier fly larvae (BSFL) have the potential to be incorporated into equine feed as a sustainable and nutritionally dense insect-derived source of protein and fat. The purpose of this study was to investigate the suitability of whole dried BSFL as a novel protein source in equine diets based on acceptability, palatability, and various health parameters. Seventeen horses (15.2 ± 7.0 years; 596 ± 122 kg body weight (BW) (mean±SD)) and three ponies (19.7 ± 0.6 years; 364 ± 53 kg) were separately fed a BSFL-based supplement (TRT) and a roasted soybean-based supplement (CON) (0.75 g crude protein per kg BW0.75) for 28-days using a cross-over study design. Feed intake was recorded throughout the feeding periods to assess the acceptability of the novel ingredient. Body weight, body condition score (BCS), plasma biochemistry, and complete blood counts were assessed at the beginning and end of each treatment period as markers of health status. After the cross-over study, two-bowl tests were used to assess the palatability of the BSFL supplement, with or without the presence of other concentrates. Minimal differences were observed between treatment groups for biochemical analytes and complete blood counts, and BW and BCS did not change throughout the study period. Both supplements were willingly consumed by the horses over the 28-day feeding periods, though feed intake was 8% greater in the CON compared to the TRT group (P<0.01). For the palatability tests, horses first approached (P=0.03) and first consumed (P=0.03) the CON more frequently than the TRT supplement when the supplements were supplied with other concentrates. When the supplements were offered in the absence of other concentrates, there was no difference in which bucket was approached first, but horses tended to first consume the CON rather than the TRT supplement. Overall, these data indicate that dietary consumption of BSFL for 28 days at a low-inclusion rate results in no negative health outcomes in horses; however, longer-term studies are warranted to further examine physiological effects of consuming BSFL and at higher inclusion rates. Though horses did favour the CON supplement based on palatability parameters, horses willingly consumed the BSFL supplement, indicating that BSFL at low inclusion rates may be considered a palatable ingredient in equine diets.

Phacoemulsification Combined with Pars Plana Vitrectomy: Outcome in Horses with Acquired Cataracts Associated with Uveitis.

Cataracts resulting from equine recurrent uveitis (ERU) or other forms of uveitis are usually associated with rapid progression. ERU is the most common ocular disease cause of blindness and cause of cataracts in horses. The necessity for the posterior capsulorhexis (PC) during phacoemulsification (PE) is controversial. This study aimed to evaluate vision and complications after PE combined with pars plana vitrectomy (PPV) in horses with uveitis-associated cataracts and compare the PE technique with and without posterior capsulorhexis. Thirty-two eyes of 28 horses with uveitis-associated cataracts aged 14 months to 19.6 years were treated with PE-PPV under identical conditions. Twenty-three eyes of 21 horses were affected by an ERU-associated (ERU group), and nine eyes of 7 horses were affected by cataracts related to uveitis with pathogenesis different to ERU (non-ERU group). PE-PPV was performed in 12 eyes of 10 horses (PC group) and 20 eyes of 18 horses without posterior capsulorhexis (NPC group). Follow-up examination was performed at a mean of 1.7 ± 1.8 years postoperatively (range: 1 month-6.4 years). In the period up to 1 month postoperatively, 17/20 (85%) NPC-eyes and 8/12 (67%) PC-eyes (total: 25/32 [78%]) were visual. From 1-6 months postoperatively, 16/20 (80%) NPC-eyes and 7/12 (58.3%) PC-eyes (total: 23/32 [72%]), and from 6-12 months, 7/11 (63.6%) NPC-eyes and 3/8 (37.5%) PC-eyes (total: 10/19 [52.6%]) were visual. From 12-18 months postoperatively, 3/7 (42.9%) NPC-eyes and 2/9 (22.2%) PC-eyes (total: 5/16 [31.3%]), and from 18-24 months, 3/8 (37.5%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 4/16 [25%]) were visual. After 24 months postoperatively, 2/7 (28.6%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 3/15 [20%]) were visual. Despite the higher number of visual eyes in the NPC group at each time point, differences were not significant. No obvious differences regarding postsurgical vision were observed between the ERU- and non-ERU groups at each time point. In the overall population, a significant decrease in the number of eyes with postoperative active uveitis was observed during the follow-up examinations (p < 0.001). A significant increase in the number of eyes that were blind due to retinal detachment was observed in the overall patient population as the examination period progressed (p < 0.001). Retinal detachment was the sole long-term cause of blindness. In horses diagnosed with uveitis-associated cataracts and treated with PE-PPV, no persistent active uveitis was observed in the present study during follow-up examinations. However, the proportion of eyes that were blind due to retinal detachment increased. Whilst PE-PPV may prevent postsurgical persistent active uveitis and remove lens opacity, the prognosis for a visual outcome is guarded. A superior outcome in postsurgical vision was observed in the NPC group. However, caution is required when interpreting these results due to several factors that affect the independent comparison of the surgical groups.

Application of the HRE-S to 140 horses with trigeminal-mediated headshaking and the association of clinical signs with diagnosis, therapy, and outcome.

Horses with trigeminal-mediated headshaking (TMHS) exhibit different headshaking patterns (HSPs), electric shock-like jerking, signs of nasal irritation, and painful facial expressions. The History Rest and Exercise Score (HRE-S) was developed to objectively clarify the severity of the condition in affected horses. This score considers the history and severity of clinical signs at rest and exercise. This study aimed to assess the frequency of different clinical signs and their individual associations with diagnosis, treatment, and outcome in horses diagnosed with TMHS.The clinical records of horses presented with headshaking (HS) at the Clinic for Horses, University of Veterinary Medicine Hannover, between 2006 and 2021 were assessed retrospectively for clinical signs, diagnosis, and treatment. A total of 140 horses were included in the study. Video recordings were evaluated using the HRE-S and compared to the score described by Talbot. Following discharge, owners were interviewed via telephone about the outcome. Correlations between the presence and severity of clinical signs, diagnosis, and outcome were evaluated. The following clinical signs were significantly correlated with a higher HRE-S and grade by Talbot: HS at walk (independently of HSP) (52.9%, 74/140), increased total number of demonstrated HSP (independent of the dominant HSP) (more than one HSP per horse in 91.4%, 128/140), signs of nasal irritation (75.9%, 104/137), painful facial expression (67.8%, 80/118), and electric shock-like jerking (77.5%, 107/138). Diagnosis and outcome do not correlate with the presence of the above-mentioned clinical signs. The HRE-S was confirmed as a valid tool to evaluate disease severity in a cohort of 140 horses with HS. Additionally, clinical signs identified as indicators for higher disease severity may have a stronger negative effect on patient welfare, but they do not correlate with diagnosis or outcome.

Osteoarthritis of the coxofemoral joint in 24 horses: Evaluation of radiography, ultrasonography, intra-articular anaesthesia, treatment and outcome.

Few case reports describe equine coxofemoral joint osteoarthritis (CFJOA). To evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment. Retrospective case series. History, clinical signs, ultrasonographic, radiographic and intra-articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra- and inter-observer reliability was determined using weighted Cohen's kappa (Cκ) and the correlation between radiographic and ultrasound findings via Spearman correlation coefficient. The study included 24 horses (median age 14 years). Most of them (20/24) were chronically lame. Frequent clinical signs included unilateral gluteal muscle atrophy (18/21), lengthening of the stride of the affected limb (13/19) and locomotion on three tracks (13/20). Both imaging modalities enabled evaluation of periarticular osteophytes (correlation coefficient r = 0.64; p = 0.003). Additionally, radiography allowed detection of irregular joint spaces, subchondral bone opacity changes and femoral head flattening/tapering. Inter-observer (Cκ = 0.846) and intra-observer (Cκ = 0.853 and Cκ = 0.842) agreement was excellent. If treated, mostly intra-articular corticosteroids were administered (16/18). Nine horses were euthanised immediately or during follow-up examination. Post-mortem, the Ligamentum capitis ossis femoris was commonly found ruptured. All surviving horses remained lame. Retrospective analysis of clinical records and subjective outcome assessment based on owner follow-up with potential recall bias. Due to overall disease severity, associations between different grades of clinical findings, radiographic abnormalities and outcome could not be evaluated. Typical clinical signs may indicate CFJOA. Standardised evaluation of ventrodorsal radiographs allows a comprehensive diagnosis. Postmortem findings suggest joint instability as a possible causative factor that may contribute to the poor prognosis and resistance to medical therapy of the disorder.

Designing an early selection morphological traits index for reproductive efficiency in Pura Raza Española mares.

The low rate of reproductive efficiency in horses may be linked to the equine industry's practice of maintaining breeding stock that stands out for its athletic or morphological performance but exhibits poor reproductive efficiency. In this study, the age at first foaling, age at last foaling, interval between first and second foaling, average interval between foaling, foaling number and reproductive efficiency, and their relationship with the morphological records in 19,758 Pura Raza Española (PRE) mares were analyzed. After a partial least squares analysis height at withers, lateral hock angle, dorsal-sternal diameter, perimeter of anterior cannon bone, angle of shoulder, thoracic perimeter, hip-stifle distance, and angle of croup were the most important traits related with reproductive traits in PRE mares. A multivariate animal model with both morphological and reproductive traits was applied, including age, geographical area, coat color, and average stud size in the decade of the mare's first foaling. The results indicate that reproductive selection is feasible, and is enhanced by the use of morphological traits, given the moderate to high magnitudes of heritability values in both types of traits, which oscillated between 0.1 (interval between first and second foaling) and 0.95 (height at withers). The resulting genetic parameters were used to develop a series of selection indexes based on morphological or morphological and reproductive combination traits to improve reproductive efficiency traits in PRE mares and thus compute the expected genetic response (EGR) for the different strategies. The increase in EGR, when comparing EGR using only reproductive traits as selection criteria vs. using a combined index of both morphological and reproductive traits, oscillated between 4.0% for the age at first foaling to 46.8% for the interval between first and second foaling. In addition, two precocity indexes showed positive EGR when the age at last foaling and the interval between first and second foaling, both with and without morphological traits, were used as selection criteria. Therefore, this analysis reveals that the preselection of reproductive traits based on morphological traits is possible in PRE mares. Ultimately, this knowledge will help breeders achieve genetic progress in reproductive traits, leading to healthier and more successful breeding outcomes in horses.

Equine dental sinusitis—A statistical analysis of the effect of antibiotics on dental sinusitis following dental extraction

SummaryBackgroundAntibiotic resistance is an increasing global threat to human and veterinary practices. The relevance and efficacy of antibiotic therapy in the treatment of various diseases has been poorly documented in the literature. One such disease is equine sinusitis secondary to dental disease where dental extraction is most often combined with broad‐spectrum antibiotic treatment. It, however, remains undocumented if antibiotic treatment reduces the risk of complication in horses where the diseased tooth is removed by extraction.ObjectivesThe aim of this study was to analyse the effects of perioperative antibiotics in horses with dental sinusitis treated by dental extraction with or without concurrent antibiotic treatment.Study designRetrospective cohort study.MethodsClinical records from horses presenting with nasal discharge between September 2016 and May 2022 were reviewed. Horses with sinusitis secondary to dental disease were identified, and data from clinical records were collected supplemented by online questionnaires. The final statistical model was built using logistic regression.ResultsA total of 59 horses with dental sinusitis were included in the study. Following dental extraction, 62.5% (15/24) of horses that did receive perioperative antibiotics and 60% (21/35) of horses that did not receive perioperative antibiotics were successfully treated without the need for further treatment. The final model showed no significant difference on the probability of success (p = 0.85) between treatment with and without antibiotics.Main limitationsThe retrospective nature of this study may increase the risk of biases in relation to data collection and follow‐up information and the limited number of individuals available for the analysis.ConclusionsThese findings indicate that the use of perioperative antibiotics does not influence the likelihood of complications or the probability of a successful outcome in horses with dental sinusitis undergoing dental extraction.

Low progesterone concentration in early pregnancy is detrimental to conceptus development and pregnancy outcome in horses

High progesterone concentrations in the early luteal phase support pregnancy, whereas subphysiological progesterone concentrations delay embryonic development at least until placentation. In this study, fetal growth and development of pregnancy was investigated in pregnancies with prostaglandin F2α-induced low progesterone concentrations (PGF) in the early luteal phase and control pregnancies (CON) in the same mares (n = 12). Mares were inseminated and in PGF pregnancies received the prostaglandin F2α analogue cloprostenol (62.5 µg) on days 0–3 after ovulation to induce subphysiological progesterone concentrations; CON pregnancies remained untreated. Mares were assigned to PGF or CON treatments in alternating order and received the opposite treatment in the following year. Blood was collected and conceptus size determined repeatedly by transrectal (≤day 101) and transabdominal (>day 101) ultrasonography. After birth, foals were weighed, measured and submitted to a clinical examination. Treatment PGF resulted in fewer pregnancies than CON treatment. All foals born from CON pregnancies were healthy and mature, whereas 4/7 PGF pregnancies were either lost (one embryonic death, one abortion) or resulted in the birth of compromised foals (P = 0.018). Size of the conceptus (e.g., diameter day 49: PGF 6.6 ± 0.7, CON 7.7 ± 0.7 cm, P = 0.006) and embryo proper (e.g., crown rump length day 54; PGF 4.4 ± 0.8, CON 5.8 ± 0.6 cm, P = 0.015) differed between treatments. These size differences decreased over time and at birth PGF foals did not differ significantly from CON foals. In conclusion, reduced progesterone concentration in the early luteal phase leads to delayed conceptus growth beyond placentation and increased pregnancy loss.

Clinical findings, surgical techniques, prognostic factors for short-term survival and long-term outcome in horses with acquired inguinal hernias: Ninety-eight cases (2005-2020).

To report findings, outcome and determine variables associated with survival in horses with acquired inguinal hernia (AIH). Retrospective study. A total of 98 cases in 97 horses. The medical records (2005-2020) of horses diagnosed with AIH were reviewed. Retrieved data included signalment, history, clinical variables, surgical aspects, postoperative complications, and short- and long-term outcomes. Logistic regression analyses were used to determine factors associated with short-term survival (p < .05). Manual reduction was attempted in a third of the cases (32/98, 33%) and emergency surgery to reduce the hernia was performed in 64 of 98 (65%) cases. Concurrent small intestinal (SI) volvulus was identified in 26 (26/98, 27%) cases. Castration was the most common technique used to prevent recurrence (64/94, 68%). Overall AIH recurrence rate was 11% (11/98). A total of 59 (59/98, 60%) cases survived to hospital discharge and 49 of 52 (94%) cases were still alive after 12 months. Cases admitted within 10 h of colic signs had increased odds of survival (72%) compared to those admitted after 10 h (26%; p < .001). Draft breeds (p = .021), high heart rate on admission (p = .001) and concurrent SI volvulus (p = .048) were associated with reduced survival to hospital discharge. Horses with AIH had a higher risk of concurrent SI volvulus and lower survival than reported. Draft breeds, high heart rate on admission and concurrent SI volvulus were associated with reduced short-term survival. The results of this study should help in prognostication for horses with AIH.

Comparison of equine paranasal sinus trephination complications and outcome following standing computed tomography, radiography and sinoscopy guided approaches for the treatment of sinusitis.

The recent availability of standing computed tomography (CT) for equine paranasal sinus disease has enhanced diagnosis and enabled more targeted surgery compared to radiography and sinoscopy. To date, there have been no studies which have critically evaluated the benefit of preoperative CT versus radiography and sinoscopy on complications and outcome in horses undergoing sinus trephination. Retrospective study. A total of 229 equids. The medical records of equids (229) presented for sinusitis treated via trephination that had CT, radiography and/or sinoscopy at time of surgery between 2009 and 2022 were reviewed. Outcome and complications were evaluated for six different pre- and intraoperative imaging modalities. The six groups did not differ in demographics or disease category, though equids with less weight (p = .0179) and shorter disease duration (p = .0075) were more likely to have radiography and sinoscopy based surgical planning. Short-term postoperative complications occurred in 30.1% and were higher in groups using preoperative CT imaging (p = .01), with hemorrhage being the most common surgical complication. Following initial trephination surgery, 57.0% (127/223) of cases resolved and there was no difference between the imaging groups. Final resolution after follow-up medical or surgical treatment increased to 94.6% (211/223) and was not different between the imaging groups or between primary or secondary sinusitis. Additional nasal fenestrations to improve sinonasal drainage, maxillary septal bulla fenestrations and trephinations to treat nasal conchal bullae were made in the CT groups. CT provided additional diagnostic information and enabled different surgical approaches but did not improve resolution in this study population.

Relationship between the Cycle Threshold Value (Ct) of a Salmonella spp. qPCR Performed on Feces and Clinical Signs and Outcome in Horses.

The objective of this retrospective study was to evaluate the clinical significance of fecal quantitative real-time polymerase chain reaction (qPCR) Salmonella results when taking the cycle threshold values (Ct) into account. The study included 120 Salmonella qPCR-positive fecal samples obtained from 88 hospitalized horses over a 2-year period. The mean Ct of the qPCR test was evaluated in regard to (1) clinical outcome and (2) systemic inflammatory response syndrome (SIRS) status (no SIRS, moderate SIRS, or severe SIRS) of the sampled horses. An ROC analysis was performed to establish the optimal cut-off Ct values associated with severe SIRS. The mean ± SD Ct value was significantly lower in samples (1) from horses with a fatal issue (27.87 ± 5.15 cycles) than in surviving horses (31.75 ± 3.60 cycles), and (2) from horses with severe SIRS (27.87 ± 2.78 cycles) than from horses with no (32.51 ± 3.59 cycles) or moderate (31.54 ± 3.02 cycles) SIRS. In the ROC analysis, the optimal cut-off value of Ct associated with a severe SIRS was 30.40 cycles, with an AUC value of 0.84 [95% confidence interval 0.76-0.91] and an OR of 0.64 [0.51-0.79]. Results suggest that including the Ct value in the interpretation of fecal qPCR results could improve the diagnostic value of this test for clinical salmonellosis in horses.

Conservative management of equine tarsal collateral ligament injuries may allow return to normal performance.

To describe type and distribution of tarsal collateral ligament (CL) injuries and to assess the long-term outcome in horses treated conservatively. 78 horses (median age, 7 years [IQR, 4 to 9.75 years]) of different breeds and disciplines. Retrospective analysis (2000 through 2020) of horses with tarsal CL lesions diagnosed on ultrasound. The resting time, ability to return to work, and performance level after the injury were compared between horses having a single ligament (group S) or multiple ligaments (group M) affected and according to the case severity. Most of the horses (57/78) presented a single CL injury, while 21 had multiple CLs affected simultaneously, for a total of 108 CLs injured and 111 lesions. In both groups, the short lateral CL (SLCL) was the most commonly affected (44/108), followed by the long medial CL (LMCL; 27/108). Enthesopathies (72.1%) were more frequent than desmopathies alone (27.9%) and involved mostly the proximal insertion of the SLCL and the distal attachment of the LMCL. Conservative treatment (n = 62) consisted mainly of stall rest. The median resting time (120 days [IQR, 60 to 180 days]) did not significantly differ between the 2 groups (group S vs M) or according to the severity. Most horses (50/62) were able to return to work within 6 months. Horses that did not return (12/62) were more likely to have severe lesions (P = .01). Thirty-eight horses were able to perform at a level equal to or higher than before the injury. This study highlights the importance of thorough ultrasound assessment of tarsal CL injuries and demonstrates that conservative management is a viable option to allow these horses to return to previous performance level.

Larval cyathostominosis: Clinicopathological data and treatment outcomes of 38 hospitalised horses (2009–2020)

SummaryBackgroundThere is limited evidence regarding the treatment and outcomes of larval cyathostominosis.ObjectivesTo describe the presentation, treatment and outcomes of horses with larval cyathostominosis in two equine hospitals.Study designRetrospective, multicentred cohort study.MethodsClinical records were reviewed (2009–2020). Inclusion criteria included a diagnosis of larval cyathostominosis (determined by faecal assessment and/or post‐mortem examination). Data were assessed for normality. Descriptive analysis was performed for frequency results and central tendencies. Statistical analysis between survivors and nonsurvivors was determined by Chi‐square/Fisher's exact test for categorical variables, and Student's t‐test/Mann–Whitney for continuous variables.ResultsOf 38 cases, 21 (55%) were nonsurvivors (3/38 dead on arrival). Nonsurvivors died by 2.9 days ± 2.4. Tachycardia (mean 61 beats/min ± 14), leucocytosis (mean 17.1 × 109/L ± 9.1), neutrophilia (mean 14.1 × 109/L ± 8.5), hypoalbuminaemia (mean 21.6 g/L ± 6.0), hyperfibrinogenaemia (mean 7.4 g/L ± 2.6) and elevated serum amyloid A (SAA) (median 315.0 mg/L, interquartile range [IQR] 117.0–1460.0) were consistent findings. Faecal shedding of Salmonella spp. occurred in four cases. The mean last recorded albumin was 18.6 g/L ± 4.5 and total protein (TP) 52.3 g/L ± 13.6. Crystalloids were administered in 25/35, synthetic colloids in 5/35 and plasma in 17/35 cases. Anthelmintic treatment was administered in 25/35 cases, of which 22 also received corticosteroids. Recumbency prior to admission (p = 0.037) and administration of isotonic fluid therapy (p = 0.027) were associated with nonsurvival. From peripheral blood analysis, lower TP (p = 0.006) and higher SAA (p = 0.050) concentrations at admission as well as lower last recorded TP (p = 0.002) and lower last recorded albumin concentrations (p = 0.028) were associated with nonsurvival.Main limitationsResults may not be applicable to other populations.ConclusionsReferred cases of larval cyathostominosis have a low survival rate. Several variables are associated with reduced survival: history of recumbency, isotonic fluid therapy, elevated SAA at admission, low TP at admission, low last recorded TP and low last recorded albumin.

A seasonal idiopathic hepatitis syndrome in horses presented to a Midwestern veterinary teaching hospital.

To report history, clinical examination findings, clinicopathologic findings, diagnostic test results, treatment, and outcome in horses with a novel idiopathic hepatitis syndrome. 13 client-owned horses. Medical records of horses that were presented with fever and increased blood liver enzyme activity over a 16-month period were reviewed (December 1, 2020, to April 1, 2022). Collected data included signalment, history, clinical and clinicopathologic findings, diagnostic test results, treatment, clinical progression, and short-term outcome. Affected horses were presented between December and April of each of the 2 seasons investigated. The majority of horses developed cyclic fevers over the course of 3 weeks, during which time histologic evidence of hepatitis was observed. Histologic lesions included hepatic necrosis, neutrophilic to lymphohistiocytic inflammation, biliary epithelial injury, and portal fibrosis. Systemic inflammation was evidenced by increased serum amyloid A concentration and leukon changes. No horse developed signs of hepatic insufficiency, and all horses clinically recovered. Return of serum activity of GGT to within the reference range occurred within 16 weeks in most horses. Histologic lesions remained evident up to 27 weeks after initial presentation in 1 horse. Although an etiologic agent has not been identified, an apparently seasonal equine hepatitis syndrome was characterized by fever, systemic inflammation, increased liver enzyme activity, and histologic evidence of hepatitis. An infectious cause is suspected on the basis of histology and outcome.

Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols.

Most horses affected by headshaking (HS) are diagnosed with idiopathic trigeminal-mediated headshaking (i-TMHS) when no underlying disease is found. Diagnosis is made by the exclusion of differentials considering history, clinical signs, and diagnostic investigations. Therefore, in horses presented with headshaking, many diagnostic procedures and therapies are conducted. Retrospectively, the digital patient records of 240 horses with HS were analysed regarding the impact of diagnostic procedures on diagnosis, therapy, and outcome. Horses were extensively examined using a standardised protocol including clinical (ophthalmologic, orthopaedic, neurologic, dental) examination, blood analysis, and imaging techniques (endoscopy, radiographs, computed tomography (CT), and magnetic resonance imaging). Many findings were revealed but were of clinical relevance in only 6% of the horses. These horses were, therefore, diagnosed with secondary headshaking (s-HS). In addition, all of these horses demonstrated a positive outcome. The CT of the head revealed 9/10 of the clinically relevant findings. Other diagnostic procedures had no major additional impact. Conclusively, the diagnostic investigation of horses with HS should aim at differentiating i-TMHS from s-HS. The clinical relevance of findings should be verified through diagnostic anaesthesia or targeted therapy depending on risks, invasiveness, and expected benefits. To reduce the multitude of examinations, diagnostic investigations should focus on the CT of the head in those horses with suspicion of i-TMHS based on typical history, clinical signs, and physical examination.

Therapeutics prior to mesenchymal stromal cell therapy improves outcome in equine orthopedic injuries.

Mesenchymal stromal (stem) cells (MSCs) have been studied to treat many common orthopedic injuries in horses. However, there is limited information available on when and how to use this treatment effectively. The aim of this retrospective study is to report case features, treatment protocols, and clinical outcomes in horses treated with MSCs. 65 horses presenting with tendinous, ligamentous, and articular injuries, and treated with MSCs prepared by a single laboratory between 2016 and 2019. Outcome information was available for 26 horses. Signalment, clinical signs, diagnostic methods, treatment protocol features (prior and concurrent therapies, cell origin, dose, application site and number), and effective outcomes were analyzed. The analysis was focused on comparing the effect of different MSC treatment protocols (eg, autologous vs allogeneic) on outcome rather than the effectiveness of MSC treatment. MSC treatment resulted in 59.1% (clinical lameness) to 76.9% (imaging structure) improvement in horses with diverse ages, breeds, sex, and lesions. The use of other therapeutic methods before MSC application (eg, anti-inflammatories, shockwave, laser, icing, resting, bandage and stack wrap, intra-articular injections, and/or surgical debridement) was shown to be statistically more effective compared to MSCs used as the primary therapeutic procedure (P < .05). Autologous versus allogeneic treatment outcomes were not significantly different. A prospective MSC treatment study with standardization and controls to evaluate the different features of MSC treatment protocols is needed. The various case presentations and treatment protocols evaluated can be used to inform practitioners who are currently using MSCs in clinical practice.

Equine heel bulb lacerations: 62 cases (2004-2018).

To characterize clinical findings and outcomes for horses with heel bulb lacerations. Medical records of a teaching hospital were reviewed to identify horses treated for heel bulb lacerations between February 2004 and October 2018. Long-term outcome was assessed by telephone communication with owners. Results were analyzed to determine association with clinical outcome. 31 mares and 31 geldings of various ages, breeds, and uses were evaluated. Thirty-six horses had a wound of 0 to 2 days' duration, and 17 horses had a wound of > 2 days' duration. Horses with a wound duration of < 2 days had a significantly greater likelihood of a higher outcome score (P = .025; OR = 7.08; 95% CI = 1.28% to 39.08%). Synovial communication with the wound was confirmed in 21 of 62 (33.9%) horses. One synovial structure was involved in 17 horses, and > 1 synovial structure was involved in 4 horses. Fifty-nine horses survived to discharge, and follow-up information was available for 18 (30.5%) horses. Of the horses available for follow-up, 78% returned to the previous level of work (14/18). Degree of lameness at presentation, degree of wound contamination, treatment prior to presentation, treatment with foot casting, and involvement of synovial structures were not found to be significantly associated with clinical outcome. Results suggest that horses with heel bulb lacerations have a good prognosis for survival and a favorable prognosis for return to work. Clinical application of additional findings needs further investigation before clinical relevance can be ascertained.

Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic.

ObjectiveTo evaluate previously published predictive survival models in a population of horses undergoing colic surgery in the midwestern United States.Study designRetrospective cohort study; single referral hospital.AnimalsA total of 260 horses met the inclusion criteria.MethodsMedical records of horses undergoing surgical treatment for colic were reviewed. Previously published models were applied to cohort data to predict outcome. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for prediction of short‐term survival were calculated.ResultsSingle‐variable and multivariable models performed similarly for prediction of survival, with a mean 79% sensitivity (range: 44%–94%), 48% specificity (range: 22%–83%), 63% PPV (range: 56%–72%), 73% NPV (range: 60%–83%), and 64% accuracy (range: 59%–72%). Blood lactate ≤6 mmol/l and the colic severity score (CSS) were highly sensitive for prediction of survival; however, both had poor specificity.ConclusionSingle‐variable and multivariable predictive models did not perform as well for prediction of survival in the study cohort compared to original reports, suggesting that population‐specific factors contribute to patient survival.Clinical significancePredictive models of survival developed in one population may be less reliable when used to predict outcome in horses undergoing colic surgery from an independent population. Additional model testing and refinement using data from multiple surgical centers could be considered to improve prediction of outcome for horses undergoing laparotomy for treatment of colic.

Long-Term Outcome of Horses Undergoing Unilateral Mandibular Condylectomy and Meniscectomy for Temporomandibular Joint Disease.

BackgroundThere are no reports describing the long-term outcome of sport horses undergoing unilateral mandibular condylectomy with meniscectomy (UMC) for treatment for severe temporomandibular joint (TMJ) disease (TMD). Whether horses undergoing UMC require a specialized diet, can return to riding with a bit, or return to intended function after surgery is unknown.ObjectiveTo determine the long-term outcome of horses undergoing UMC for treatment of severe TMD.Study DesignA multi-institutional, retrospective study.MethodsMedical records obtained from seven equine referral hospitals of horses with severe TMD that underwent UMC were reviewed. Details regarding the presenting complaints, results of clinical examination, findings of diagnostic imaging, surgical technique, and outcome (including long-term follow-up with an owner questionnaire) were recorded.ResultsEleven horses fit the inclusion criteria. Three had severe idiopathic osteoarthritis, and eight had confirmed septic osteoarthritis of the TMJ. The most common post-operative complications were drainage and peri-incisional swelling (n = 5). One horse developed a hematoma at the surgical site because the facial artery was inadvertently transected during the approach, causing the condylectomy to be postponed. All horses were discharged alive from the hospital, and 10 returned to their previous or intended use. All had complete resolution of clinical signs of TMD. One mare was retired from athletic use due to her genetic value as a broodmare. One horse was euthanized 2 years after UMC due to progressively worsening of clinical signs of temporohyoid osteoarthropathy (THO), which were not present before surgery. When available, owner satisfaction of the results of the procedure was excellent.Main LimitationsSample size; multiple institutions; owner bias.ConclusionsUnilateral mandibular condylectomy should not be considered a salvage procedure. Horses treated for severe TMD by UMC can return to their previous or intended level of athletic performance and do not require a specialized diet.