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The Veterinary clinics of North America. Equine practice.
Publisher:
W.B. Saunders,
Frequency: Three no. a year
Country: United States
Language: English
Start Year:1985 -
ISSN:
0749-0739 (Print)
1558-4224 (Electronic)
0749-0739 (Linking)
1558-4224 (Electronic)
0749-0739 (Linking)
Impact Factor
1.1
2022
| NLM ID: | 8511904 |
| (DNLM): | SR0053812(s) |
| (OCoLC): | 11078671 |
| LCCN: | sn 84006968 |
| Classification: | W1 VE929F |
Equine wellness care in ambulatory practice. Clients want dependable veterinary care and to understand how the services will benefit and meet their horse’s needs. Wellness visits provide ambulatory practitioners with great opportunities to strengthen the doctor-client-patient bond; effective communication with clients during wellness visits, where new literature or facts can be presented, can offer opportunities for demonstrating the value of having the veterinarian maintain a primary role in disease control. The criteria for selecting vaccines, interpreting FECs, and diagnosing dental pathology require the continued need for veterinar...
Equine ambulatory practice: challenges and opportunities. Current economic conditions make the practice of equine medicine challenging, to say the least. The downward trend in the US economy has had a huge impact on horse owners and equine veterinarians alike. Horses are expensive to keep; as such, economics are the driving factor in the problem of the unwanted horse. Under these conditions, efficient equine ambulatory practices are well-suited to weather the economic storm. As contributors to this issue of Veterinary Clinics of North America note, one can practice high-quality medicine and surgery without the overhead and expense of a large clinic. ...
Ambulatory medicine in equine practice. The scope of medical problems encountered by the equine ambulatory practitioner is immense; there is a wealth of information available to ambulatory practitioners pertaining to specific medical topics. It is certainly possible to practice high-quality equine medicine in a field setting. However, hospital referral should be offered to clients for conditions not conducive to successful treatment in the field. Prompt referral of difficult cases is a sign that the practitioner wants the best treatment for the patient and is often gladly accepted by the client. When surgical or hospital referral is...
The approach to the equine dermatology case in practice. A logical and thorough clinical investigation should provide the best basis for the diagnosis of skin diseases. Where no diagnosis can be reached despite a full range of investigations, the clinician can justifiably attempt symptomatic treatment, but it is always better to focus treatment on a specific condition based on properly accumulated and tested clinical evidence. Unfortunately, in equine dermatology there are few text descriptions of the majority of the conditions encountered in practice. While a few diseases are well recognized, there is still little consensus on the best treatments f...
Ophthalmology in equine ambulatory practice. Equine practitioners examine patient eyes on a daily basis. Indications range from inspection of normal anatomy to treatment of traumatized eyes to workups of sight threatening inflammatory or neoplastic ocular conditions. Assessment of equine eyes requires practitioners to take time to create a good "exam room" in the field and administer appropriate restraint, sedation and/or regional anesthesia to facilitate thorough examination. Accurate diagnosis and treatment of equine eye problems requires skill in ocular surface staining and cytology, and basic proficiency in standing surgery. Expertis...
Wound care in horses. Care of equine wounds in the field can be a challenging endeavor. Many times, wound care is complicated by chronicity or by prior inappropriate care in addition to the great degree of tissue trauma that occurred when the horse was wounded. Recognizing involvement of synovial structures, loss of skin, and damage to bone are critical in the initial examination of wounds and will guide future care. Education of clients is also important in that preparing them for possible outcomes during healing may help improve compliance and proper treatment of wound. Owners and trainers often perform much of t...
Neuro-ophthalmology in horses. A complete neuro-ophthalmologic assessment is relatively simple, requires minimal instrumentation and should be performed as part of every complete ophthalmic and neurologic examination. This article has summarized the tests that comprise and the species-specific details of the complete neuro-ophthalmologic of the equine patient. Selected causes of sudden blindness in the horse were summarized and some common neuro-ophthalmic conditions with significant ophthalmic consequences, such as facial nerve paralysis, were discussed. Split-lid tarsorrhaphies, which are indicated but rarely used in case...
Lesions of the equine neck resulting in lameness or poor performance. Lesions of the neck are an uncommon primary cause of pain resulting in either lameness or poor performance but should be considered if local analgesic techniques of the limbs fail to abolish lameness or if there are clinical signs directly referable to the neck such as pain, abnormal neck posture, stiffness, or patchy sweating. Accurate diagnosis requires careful clinical examination, exclusion of other causes of lameness or poor performance, and accurate interpretation of diagnostic imaging findings.
Toxins and adverse drug reactions affecting the equine nervous system. This article provides an overview of the more common toxins and adverse drug reactions, along with more rare toxins and reactions (Table 1), that result in neurologic dysfunction in horses. A wide variety of symptoms, treatments, and outcomes are seen with toxic neurologic disease in horses. An in-depth history and thorough physical examination are needed to determine if a toxin or adverse drug reaction is responsible for the clinical signs. Once a toxin or adverse drug reaction is identified, the specific antidote, if available, and supportive care should be administered promptly.
Evaluation and management of the recumbent adult horse. Evaluation and management of recumbent horses are challenging. Familiarity with disorders that can result in recumbency will facilitate more rapid diagnosis and more appropriate formulation of a prognosis. With rapid and appropriate diagnosis, appropriate treatment can be pursued and, with good nursing care, can result in a favorable outcome.
Guttural pouch diseases causing neurologic dysfunction in the horse. The close relationship between guttural pouches, cranial nerves, and sympathetic structures make neurologic abnormalities due to diseases of the guttural pouches (especially mycosis) possible. Recognition of epistaxis or mucopurulent nasal discharge, together with signs of dysfunction of the cranial nerves in contact with the guttural pouches, are important key points in order to consider a comprehensive evaluation of these structures and further definitive diagnosis. Diseases of the guttural pouches can also cause signs such as dysphagia, abnormal soft palate positioning, laryngeal paralysis,...
Differentiation of ataxic and orthopedic gait abnormalities in the horse. The differentiation of ataxia and orthopedic disease can be facilitated by the use of several additional tests, not commonly part of either neurologic or orthopedic examination protocols. However, a full neurologic and orthopedic examination and suitable diagnostic imaging will of course also be necessary in such cases. The common association of orthopedic and neurologic disease makes it even more necessary to correctly attribute movement or posture abnormalities to potentially treatable structures.
Advanced imaging of the nervous system in the horse. Neuroimaging underwent a dramatic revolution during the past few decades due to the development of new technologies that produce exquisite images of patient morphology and function, new technologies that store and distribute information more efficiently, and research that has improved understanding of pathogenesis and effective clinical use of new imaging methods. Advanced equine neuroimaging is a specialized field with unique challenges associated with patient size, availability of equipment, using equipment designed for humans, small sample size for various diseases, and issues associated wi...
Miscellaneous neurologic or neuromuscular disorders in horses. NMD is an important cause of morbidity in horses. Signs of dysfunction could be variable depending on the specific area affected. NM disease can go unrecognized if a thorough evaluation is not performed in diseased horses. Electrodiagnostic testing is an area that has the potential to document and improve our understanding of NM disease yet is uncommonly performed. Keeping an open and observant mind will enhance our ability to search and find answers.
Cell-based therapies for equine joint disease. Joint disease is a major cause of wastage in performance horses. Arthritis can be challenging to treat because articular cartilage has little or no capacity for repair, therapeutic options are limited and are largely targeted at ameliorating clinical signs of joint disease. Cell-based therapies have potential to overcome the intrinsic constraints to articular cartilage repair. This article focuses on cell-based therapies for treatment of equine joint disease. Results from experimental model and human clinical studies are presented along with available data from equine studies.
Collection and propagation methods for mesenchymal stromal cells. Mesenchymal stromal cells (MSC) are derived from adult mesenchymal tissues and have the ability to undergo differentiation into bone, cartilage, and fat, and have therefore attracted great interest in regenerative medicine. Many isolation and culture methods have been described, making comparison between laboratories and quality-control protocols difficult. A uniform protocol to characterize equine MSC has recently been proposed, aiming to introduce consistency across the equine stem cell research field. This article reviews the published techniques for collection and propagation of equine MSC...
Mesenchymal stem cells: characteristics, sources, and mechanisms of action. This article provides an overview of mesenchymal stem cell (MSC) biology. In the first section, the characteristics that are routinely used to define MSCs-adherence, proliferation, multi-lineage potential, and "cluster of differentiation" marker profiles-are discussed. In the second section, the major tissues and body fluids that are used as sources for equine MSCs are presented, along with the comparative biologic activities of MSCs from specific locations. Finally, the current understanding of the mechanisms by which MSCs influence repair and regeneration are discussed, with an emphasis on t...
The regulation of veterinary regenerative medicine and the potential impact of such regulation on clinicians and firms commercializing these treatments. This article provides an overview of the US Food and Drug Administration's current and potential regulation of veterinary regenerative medicine and the various products used in the practice. This article also discusses several of the potential enforcement risks associated with the commercialization of such therapies and products and offers the reader strategies for mitigating those risks. Finally, the article concludes with a review of an important and ongoing court battle that focuses on the marketing and promotion of cellular-based therapies for humans that could have a significant impact on...
Cell-based therapies: current issues and future directions. This article focuses on current issues facing cell-based therapies in equine practice and future studies validating the use of stem cells and related biologic therapies for the treatment of musculoskeletal conditions in the horse. Issues raised include the characterization and use of tissue- and anatomic location-specific mesenchymal stem cell (MSC) sources, the putative advantages and feasibility of allogeneic embryonic stem cell and MSC products, the technical advantages and performance of cell-based biologic agents that do not require extensive ex vivo manipulation, the regulation of MSC ho...
Anti-inflammatory and immunomodulatory activities of stem cells. The recent interest in equine stem cell biology and the rapid increase in experimental data highlight the growing attention that this topic has been receiving over the past few years. Within the field of stem cell biology, the relevance of immunobiology is of particular intrigue. It appears that optimal and effective stem cell therapy for equine patients will require a thorough analysis of the immune properties of stem cells as well as their response to immune mediators. The main goal of this review is to discuss the biology of adult mesenchymal stem cells in the context of immunology.
Cell-based therapies for tendon and ligament injuries. Tendon and ligament injuries have proved difficult to treat effectively. Cell-based therapies offer the potential to harness the complex protein synthetic machinery of the cell to induce a regenerative response rather than fibrous scarring. This article reviews the current state of play with respect to the clinically used cell preparations for the treatment of tendon and ligaments overstrain injuries.
Autologous biologic treatment for equine musculoskeletal injuries: platelet-rich plasma and IL-1 receptor antagonist protein. Autologous biologic therapies such as platelet-rich plasma and autologous conditioned serum are in widespread clinical use to treat musculoskeletal pathology in horses. These substances exert a therapeutic effect through the provision of either anabolic or anti-catabolic factors, or a combination of both. This article discusses the history, experimental and clinical literature, and currently accepted preparation and usage strategies for both platelet-rich plasma and autologous conditioned serum.
Stem cell-based therapies for bone repair. This article provides an overview of the cellular and molecular events involved in bone repair and the current approaches to using stem cells as an adjunct to this process. The article emphasizes the key role of osteoprogenitor cells in the formation of bone and where the clinical applications of current research may lend themselves to large animal orthopaedics. The processes involved in osteogenic differentiation are presented and strategies for bone formation, including induction by osteogenic factors, bioscaffolds, and gene therapy, are reviewed.
Embryonic stem cells and iPS cells: sources and characteristics. The field of regenerative medicine research is rapidly expanding. One area of interest to equine researchers is the possibility of isolating or generating pluripotent cells, capable of producing differentiated cell types derived from all 3 primary germ layers. Reports of equine embryonic stem-like (ES) cell isolation can be found in the literature. Other groups are working to produce equine-induced pluripotent stem (iPS) cells. This article summarizes the essential features needed to characterize a cell type as pluripotent, specific challenges in using the horse as a model organism for pluripo...
Commercial cell-based therapies for musculoskeletal injuries in horses. Several cell-based therapeutic options to treat musculoskeletal injuries in horses are commercially available. The current literature supports the use of cell-based therapies to treat equine musculoskeletal injuries. Researchers continue to search for more effective cell-based therapies to provide practitioners with optimal treatment tools for musculoskeletal injuries in horses. Cell-based therapies require specialized facilities and technical competencies that might not be available or economically justifiable in many private practices. This review provides a summary of current commercially a...
Evidence-based medicine and stem cell therapy: how do we know such technologies are safe and efficacious? Evidence-based medicine (EBM) refers to the conscientious, explicit, and judicious use of current best evidence from research for the care of an individual patient. Central to the adoption of EBM is both producing and identifying the best possible evidence for a particular intervention or therapy. This article identifies and reviews the approaches to producing and identifying the best possible evidence that is necessary for the full acceptance of stem cell therapies in the horse and reviews the approaches that will allow future clinical studies in stem cell therapies to provide the best eviden...
