The post-operative period in horses refers to the timeframe following surgical procedures during which the animal undergoes recovery and rehabilitation. This period involves careful monitoring and management to ensure proper healing and to minimize complications. Key aspects of the post-operative period include pain management, wound care, and the prevention of infections. Horses may require restricted movement, dietary adjustments, and regular veterinary evaluations to assess recovery progress. This page compiles peer-reviewed research studies and scholarly articles that explore the management strategies, physiological responses, and outcomes associated with the post-operative period in equine patients.
Wickstead FA, Milner PI, Bardell DA.Wound infusion catheters (WICs) have been used in humans and some veterinary species for post-operative local anesthetic administration following a variety of surgical procedures, aiming to reduce post-operative analgesia requirements and improve patient comfort. Benefit in reduction in pain, post-operative analgesia requirements and length of hospital stay are well documented in humans, but use of WICs may not have been widely adopted in veterinary species due to the concern of increased complications, such as dehiscence or surgical site infection (SSI), creating a barrier to their use. This ...
Barton CK, Hector RC, Hendrickson DA, Kawcak CE, Nelson BB, Goodrich LR.To compare 3 perioperative feeding regimens and their effect on anesthetic complications, manure output, and colic proportion in healthy horses. Methods: 45 horses presenting for elective orthopedic procedures were randomly assigned to 1 of 3 groups: not fasted (NF; continuous access to hay perioperatively), fasted muzzled (FM; 10-hour preoperative fast with slow refeeding postoperatively and muzzle placement), or fasted not muzzled (FNM; same as FM without muzzle placement). Anesthetic protocol was standardized. Outcomes compared between groups included anesthesia time, arterial oxygenation, ...
Gandini M, Cerullo A, Giusto G.Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. H...
Tallon RE, Allen SE, Bladon BM, McGovern KF.To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. Methods: Retrospective cohort study over an 11-year period (2008-2019). Methods: UK-based private referral center. Methods: Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. Methods: Ninety-seven horses received a single intraoperative dose of dexamethasone ...
Salciccia A, de la Rebière de Pouyade G, Caudron I, Ponthier J, Serteyn D, Sandersen C, Deleuze S, Grulke S.Although rarely fatal, complications of ventral midline laparotomy incision in equine patients increase hospitalization cost and duration and may jeopardize return to athletic function. Therefore, many techniques have been developed to reduce their occurrence and expedite their resolution when they occur. Our technique of celiotomy incision closure includes the use of tension sutures (vertical U mattress) of polyglactin 910 on the linea alba, which is then apposed by polyglactin 910 interrupted sutures or a simple continuous pattern suture with a stop midway before routine closure of the super...
Verhaar N, Grages AM, Sauer FJ, Geiger T, Reineking W, Hewicker-Trautwein M, Geburek F, Kästner SBR.To assess the histological injury and intestinal microperfusion measured by laser Doppler flowmetry and spectrophotometry (LDFS) of the small intestine orad to a strangulation during colic surgery. Methods: Horses with naturally occurring small intestinal strangulations undergoing colic surgery were included. Methods: In this prospective clinical trial, intestinal tissue oxygen saturation (tSO2) and tissue blood flow (tBF) were measured by LDFS orad to the strangulation following release of the strangulation (n = 18). The number of horses with postoperative reflux (POR) and the cases that surv...
Williams ZJ, Pezzanite LM, Hendrickson DA.Skin grafting is a simple technique that can be performed by equine practitioners to improve cosmetic outcomes in wounds with large skin defects that would not heal functionally or cosmetically with standard wound therapy interventions. Successful skin grafting is not difficult but relies upon appropriate preparation of the wound bed and effective immobilisation of the grafted area after skin graft placement. Prior to grafting, the wound bed should be treated with a moist wound healing dressing to prepare the granulation tissue bed to receive the graft. For best results, skin grafts should be ...
Bellitto NA, Oliver FB, Pollock PJ.To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba. Methods: Laboratory study. Methods: Adult light horse cadavers (n = 24). Methods: A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern. Closure time was recorded for each suture type. The bladder was air-insufflated at 40 L/min, and the pressure at body w...
Ratliff BL, Bauck AG, Roe HA, Freeman DE.To describe a 3-wire method with endoscopic guidance for extensive nasal septum resection. Methods: Retrospective study. Methods: Thirteen horses with nasal septum diseases. Methods: In anesthetized horses in left lateral recumbency, endoscopic guidance was used to place obstetrical wires for the ventral and caudal incisions in the nasal septum and a trephine opening was used to place the dorsal wire. The rostral aspect of the septum was incised with a scalpel, followed by incisions with the preplaced wires, and the nasal passages were packed with gauze. Horses were recovered with a temporary ...
François I, Lepage OM, Schramme MC, Salciccia A, Detilleux J, Grulke S.To report findings, outcome and determine variables associated with survival in horses with acquired inguinal hernia (AIH). Methods: Retrospective study. Methods: A total of 98 cases in 97 horses. Methods: 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). Results: Manual reduction was attempted in a third of the...
Hopfgartner T, Brown JA, Adams MN, Werre SR.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. Methods: Retrospective study. Methods: A total of 229 equids. Methods: The medical records of equids (229) presented for sinusitis treated via trephination that had CT, radiography and/or sinoscopy at time ...
Comino F, Pollock PJ, Fulton I, Hewitt-Dedman C, Handel I, Gorvy DA.To achieve an excellent functional and cosmetic result, primary closure is preferred over leaving wounds to heal by secondary intention. However, traumatic wounds are often under excessive tension during wound closure and incorrect suture technique can compromise microcirculation, leading to skin necrosis and impaired wound healing. Objective: To describe an inexpensive and effective tension relief technique that helps the successful primary closure of a variety of equine wounds at high risk of dehiscence. Methods: Retrospective case series. Methods: All wounds that were managed with the Tensi...
Hoblick S, Denagamage TN, Morton AJ, McCarrel TM.Post-anaesthetic fever is a known complication of general anaesthesia, however, its incidence in horses undergoing elective magnetic resonance imaging (MRI) is unknown. Objective: To determine the incidence of post-anaesthetic fever in horses undergoing elective orthopaedic MRI and determine whether prophylactic antimicrobial therapy would be associated with a reduction in the incidence of post-anaesthetic fever. We hypothesised that prophylactic antimicrobials would be associated with a reduction in the incidence of post-anaesthetic fever. Methods: Retrospective cross-sectional study. Methods...
Straticò P, Hattab J, Guerri G, Carluccio A, Bandera L, Celani G, Marruchella G, Varasano V, Petrizzi L.Owner complaints of estrus-related behavior in mares are a common cause of referral for laparoscopic ovariectomy. Granulosa cell tumors are a common neoplastic condition affecting the equine ovary, causing behavioral changes at rest and reduced performance. The reported success rate of ovariectomy in treating behavioral disorders is 64-86%. The aim of this study was to retrospectively evaluate the long-term follow-up of laparoscopic ovariectomy in mares in our case series, focusing on the owner's perspective of the behavior of the mares after surgery. In addition, the histopathological feature...
Scala E, van Galen G, Skärlina EM, Durie I.Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi-drug-resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caused by extended-spectrum beta-lactamase-producing bacteria belonging to the Enterobacter cloacae complex. [Correction added on 9 August 2023, after first online publication: The preceding sentence was corrected.] An 11-year-old Swedish warmblood gelding was diagnosed with a cystolith and a cystotomy through a...
Bonomelli N, Höglund OV, Bonilla AG.To report the use and feasibility of a self-locking resorbable loop device for cryptorchidectomy. Methods: Clinical prospective study. Methods: Twenty horses. Methods: Horses suspected to have an abdominal testicle/s after admission work-up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical ti...
Reed RA, Krikorian AM, Reynolds RM, Holmes BT, Branning MM, Lemons MB, Barletta M, Quandt JE, Burns CC, Dantino SC, Sakai DM.Equine pain scoring may be affected by the residual effect of anesthetic drugs. Unassigned: To compare pain scores in the hours immediately following anesthetic recovery to baseline pre-anesthetic scores in equine patients undergoing surgical and non-surgical procedures. Unassigned: Clinical observational study. Unassigned: Fifty adult horses undergoing anesthesia for surgical or non-surgical procedures were enrolled. Horses underwent pain scoring using the Composite Pain Score (CPS) and Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) prior to anesthesia (T0) and foll...
Di Cesare F, Negro V, Ravasio G, Villa R, Draghi S, Cagnardi P.Gabapentin is an anticonvulsant drug, which presents an established clinical efficacy in human patients for the management of refractory partial seizures, secondarily generalized tonic-clonic seizures, and for the control of chronic neuropathic pain. Gabapentin was synthesized as a structural analogue of the inhibitory neurotransmitter GABA, with GABA-mimetic effects, able to cross the blood-brain barrier. In veterinary medicine, is extra-label used in combination with other treatments to control seizures when other drugs are no longer effective or become toxic or for neuropathic pain treatmen...
Lamkin I, Pugliese B, Nystrom J, Fubini SL, Knickelbein KE.To describe the successful restoration of superior eyelid function in a horse following traumatic avulsion using an advancement flap blepharoplasty and subdermal hyaluronic acid filler. Methods: A 21-year-old American Paint Horse stallion who was attacked by a fellow stallion resulting in numerous traumatic injuries including avulsion of approximately 75% of the left superior eyelid. Methods: With standing sedation and locoregional anesthesia, the superior eyelid wound was debrided and an advancement flap blepharoplasty (H-plasty) and temporary tarsorrhaphy were performed. Routine healing of t...
Hoerdemann M, Yarbrough T.To describe the technique, postoperative complications, and outcome after autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia. Methods: Retrospective case series. Methods: Eleven horses with ulcerative keratitis and keratomalacia. Methods: Horses included had undergone fascia lata grafting with conjunctival flap overlay due to impending or recent corneal perforation. Preceding therapy, lesion characteristics, postoperative complications, and short- and long-term outcomes were recorded. Results: Postoperative complications include...
Young N, Barker W, Minshall G, Wright I.To describe an arthroscopically guided technique for lag screw placement across subchondral bone cyst (SBC) in the medial femoral condyle (MFC) and to compare postoperative racing performance with corticosteroid injection and cyst debridement. Methods: Retrospective cohort study. Methods: One hundred twenty-three horses with 134 MFC SBCs undergoing treatment at a single referral hospital in the UK between January, 2009, and December, 2020. Methods: Sex, age, limb affected, radiographic cyst dimensions, preoperative and postoperative lameness, surgical technique (lag screw placement, cyst debr...
Pál Z, Bodó G.Allograft arthroplasty is a promising cartilage-resurfacing technique. A 14-year-old horse was diagnosed with a medial femoral condyle subchondral bone cyst. Allografts were harvested from a young donor animal and implanted to fill the cyst cavity. A visual assessment of the surgical site was possible during follow-up arthroscopy. In addition to a desirable gliding surface and a good adaptation of the grafts, fibrillation of the cranial ligament of the medial meniscus was noted and debrided. The recipient horse became sound four months after follow-up surgery with a high level of owner satisfa...
Brabon A, Labens R, Ramachandran A, Dart AJ, Dowling BA.Four adult horses with histories of moderate abdominal pain and inappetence were diagnosed with delayed gastric emptying and gastric impaction attributed to pyloroduodenal obstruction (three cases) or duodenitis (one case). A stapled side-to-side gastrojejunostomy was performed on all horses. Two horses returned to work and survived ≥3 years. One horse was euthanased 6 months post-surgery due to recurrent abdominal pain, and one was found dead 5 months postsurgery after an unattended foaling.
Pala S, Hänninen NE, Mohammadi A, Ebrahimi M, Te Moller NCR, Brommer H, René van Weeren P, Mäkelä JTA, Korhonen RK, Afara IO, Töyräs J....The aim of this study is to assess whether articular cartilage changes in an equine model of post-traumatic osteoarthritis (PTOA), induced by surgical creation of standard (blunt) grooves, and very subtle sharp grooves, could be detected with ex vivo T relaxation time mapping utilizing three-dimensional (3D) readout sequence with zero echo time. Grooves were made on the articular surfaces of the middle carpal and radiocarpal joints of nine mature Shetland ponies and osteochondral samples were harvested at 39 weeks after being euthanized under respective ethical permissions. T relaxation times ...
Aitken MR.The following article provides an overview of the last 5 years of research and innovation within the field of equine colic surgery, focusing on new techniques, new or recently described lesions, prevention of lesion recurrence or postoperative complications, and updates in prognoses. Early surgical intervention is an important factor in horse survival.
Freeman DE, Bauck AG.Repeat celiotomy can be lifesaving in horses with a surgically treatable postoperative obstruction, although guidelines for its use are lacking, except for uncontrollable postoperative pain. Overdiagnosis of ileus as the cause of postoperative obstruction could delay a second surgery so the disease progresses beyond a manageable level of severity. Although many horses respond favorably to repeat celiotomy, complications can be severe and life threatening, such as incisional infection and adhesions. Repeat celiotomy does not seem to exacerbate postoperative ileus, despite additional surgical ma...
Mair T, Sherlock C.Most recurrent episodes of non-specific colic are self-limiting, and the results of clinical examinations are unremarkable. Differentiating these cases from serious diseases can be difficult, but repeated evaluations are warranted. Horses presenting with very frequent bouts of colic are more likely to have serious diseases and a higher mortality rate compared to horses presenting with less frequent bouts of transient colic. Horses with recurrent bouts of prolonged colic are more likely to have motility issues or partial intestinal obstruction. Non-gastrointestinal diseases can also cause recur...
Ruff J, Zetterstrom S, Boone L, Hofmeister E, Smith C, Epstein K, Blikslager A, Fogle C, Burke M.The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Unassigned: A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Unassigned: Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variab...
Bauck AG.The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function ...
Breen LJ, Coleridge MOD, O'Brien T.A 6-month-old thoroughbred colt foal was referred to a private equine referral hospital for evaluation of an acute onset, left hind limb lameness. On arrival the foal was 4/5 lame on the left hind at walk and there was diffuse swelling of the left hind pastern and fetlock region. The physical exam was otherwise unremarkable. Digital radiographs of the left hind pastern identified a Salter-Harris type-2 physeal fracture of the proximal phalanx. The fracture was initially treated conservatively using a cast, but the immobilization was not sufficient at achieving adequate reduction. As a result, ...
Küls N, Trujanovic R, Otero PE, Larenza-Menzies MP.Colic surgery is one of the most painful procedures carried out in horses. Common strategies to alleviate immediate postsurgical abdominal pain include the administration of potent systemic analgesics; however, these may cause unwanted adverse effects such as cardiovascular depression, ileus, and ataxia. The administration of local anesthetics at the incision site in form of an ultrasound-guided subcostal transversus abdominis plane (TAP) block may therefore be preferred to provide adequate analgesia without significant side effects. To date, no technique for a TAP block in horses undergoing m...
Korthagen NM, Brommer H, Hermsen G, Plomp SGM, Melsom G, Coeleveld K, Mastbergen SC, Weinans H, van Buul W, van Weeren PR.Cartilage repair remains a major challenge and treatment of (osteo)chondral defects generally results in poor quality fibrous repair tissue. Our approach aims to address some of the major biomechanical issues encountered in scaffold-based cartilage repair, such as insufficient stiffness of the scaffolds, step formation at the interface with the native tissue and inadequate integration with the original tissue. Two osteochondral defects were created on the medial femoral trochlear ridge in each stifle of six Shetland ponies. The defects were filled with a bi-layered implant consisting of a poly...
de Oliveira MGC, de Paula VV, Mouta AN, Lima IO, de Macêdo LB, Nunes TL, Trindade PHE, Luna SPL.This study aimed to validate a scale for assessing acute pain in donkeys. Forty-four adult donkeys underwent castration after sedation with intravenous (IV) xylazine, induction with guaifenesin and thiopental IV, local anesthetic block, and maintenance with isoflurane. The scale was constructed from a pilot study with four animals combined with algetic behaviors described for equines. After content validation, the scale was evaluated in 40 other donkeys by three blinded and one reference evaluator, by means of edited videos referring to the preoperative and postoperative periods: before anesth...
Durward-Akhurst SA, Mair TS, Boston R, Dunkel B.Appropriate durations of perioperative antimicrobial therapy following exploratory coeliotomy in horses are controversial, and with the rising prevalence of multiresistant bacteria there is a strong incentive to use antimicrobials for the shortest time possible. Following exploratory coeliotomies, incisional infections are an important cause of morbidity in horses and could be influenced by the duration of systemic antimicrobial therapy. The aim of this study was to investigate whether 72 hours of perioperative antimicrobial therapy is as effective as 120 hours at preventing the development of...
van den Top JG, de Heer N, Klein WR, Ensink JM.The most common penile and preputial neoplasm in the horse is the squamous cell carcinoma (SCC), but no large surveys of treatment and effects of the grade of the tumour, based on the degree of differentiation, on outcome of affected horses are available. Objective: Analysis of treatment of male horses affected with SCC of the external genitalia and long-term results of treatment. Methods: Seventy-seven cases of SCC were evaluated. Data recorded included treatment, outcome, post operative histopathology and retrospective tumour grading. Results: Treatments included: cryosurgery, excision, part...
Valverde A, Black B, Cribb NC, Hathway A, Daw A.To compare the effects of sedative doses of acepromazine, xylazine or xylazine/ketamine administered to horses after isoflurane anesthesia on the quality of recovery and anesthesia recovery times. To determine if recovery scores improve after repeated consecutive anesthetic episodes. Methods: Prospective, randomized, crossover study. Methods: Fifteen adult research horses, 6.5±3.4 years old and weighing 499±40 kg. Methods: Horses undergoing three anesthetic episodes with isoflurane for magnetic resonance of the forelimbs were administered acepromazine (0.02 mg kg(-1) i.v.) or xylazine (0.3 m...
Di Cesare F, Negro V, Ravasio G, Villa R, Draghi S, Cagnardi P.Gabapentin is an anticonvulsant drug, which presents an established clinical efficacy in human patients for the management of refractory partial seizures, secondarily generalized tonic-clonic seizures, and for the control of chronic neuropathic pain. Gabapentin was synthesized as a structural analogue of the inhibitory neurotransmitter GABA, with GABA-mimetic effects, able to cross the blood-brain barrier. In veterinary medicine, is extra-label used in combination with other treatments to control seizures when other drugs are no longer effective or become toxic or for neuropathic pain treatmen...
Fjordbakk CT, Johansen GM, Løvås AC, Oppegård KL, Storset AK.No recommendations have been made regarding the relative timing of blood collection for autologous conditioned serum (ACS) preparation and surgical procedures. Objective: 1) To identify effects of surgical stress on cytokine levels in ACS, 2) identify haematological markers for prediction of cytokine production in ACS and 3) investigate the necessity for specialised ACS containers when preparing a cytokine-rich serum. Methods: Experimental in vitro study. Methods: Blood was drawn from 15 stallions admitted for elective castration preoperatively and 22-24 h post operatively and incubated in A...
Van Hoogmoed LM, Nieto JE, Snyder JR, Harmon FA.To report prokinetic strategies used to manage horses after gastrointestinal surgery. Methods: Electronic questionnaire. Methods: Diplomates of the American College of Veterinary Surgeons (ACVS) who perform equine intestinal surgery. Methods: A survey (21 questions) designed to determine use of prokinetic agents was sent electronically to 112 ACVS Diplomates known to perform equine intestinal surgery. Several clinical scenarios were also described to determine which, if any, prokinetic agent respondents would select. Results: Responses were obtained from 58 (52%) surgeons from 44 clinics. Sele...
Torfs S, Delesalle C, Dewulf J, Devisscher L, Deprez P.Postoperative ileus (POI) is a frequent and often fatal complication of colic surgery. Reliably effective treatments are not available. Objective: To determine risk factors and protective factors associated with POI, and to assess the effect of lidocaine IV on short-term survival. Methods: One hundred and twenty-six horses that underwent small intestinal colic surgery and that survived for at least 24 hours postoperatively. Methods: Retrospective cross-sectional study. The association of 31 pre-, intra-, and postoperative variables with POI and the association of lidocaine treatment with short...
Trindade PHE, Taffarel MO, Luna SPL.This prospective and longitudinal study aimed to identify spontaneous post-orchiectomy pain behaviors in horses regardless of the effects of anesthesia, analgesia, and recording time of day. Twenty-four horses divided into four groups were submitted to: inhalation anesthesia only (GA), or combined with previous analgesia (GAA), or orchiectomy under pre (GCA), or postoperative (GC) analgesia. The data obtained from the subtraction of frequency and/or duration of 34 behaviors recorded during seven 60-min time-points in the 24 h after the anesthesia from those recorded in the mirrored time-points...
Salem SE, Proudman CJ, Archer DC.Changes in management of the surgical colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and t...
Little D, Brown SA, Campbell NB, Moeser AJ, Davis JL, Blikslager AT.To determine the effect of meloxicam and flunixin meglumine on recovery of ischemia-injured equine jejunum. Methods: 18 horses. Methods: Horses received butorphanol tartrate; were treated IV with saline (0.9% NaCl) solution (SS; 12 mL; n = 6), flunixin meglumine (1.1 mg/kg; 6), or meloxicam (0.6 mg/kg; 6) 1 hour before ischemia was induced for 2 hours in a portion of jejunum; and were allowed to recover for 18 hours. Flunixin and SS treatments were repeated after 12 hours; all 3 treatments were administered immediately prior to euthanasia. Selected clinical variables, postoperative pain scores...
Klöppel H, Leece EA.To compare alfaxalone with ketamine for total intravenous anaesthesia in ponies undergoing castration. Methods: Prospective, randomised, blinded clinical study. Methods: Forty-two, 12-month-old Welsh Mountain ponies. Methods: Ponies were assigned randomly to receive ketamine or alfaxalone. After administration of romifidine 100 μg kg(-1) and butorphanol 50 μg kg(-1) intravenously (IV), sedation and response to tactile stimulation were scored. If sedation was insufficient, romifidine 30 μg kg(-1) was administered IV. Anaesthesia was induced with ketamine 2.2 mg kg(-1) or alfaxalone 1 mg kg(-...
Smith MR, Wright IM.Until recently, the pathogenesis of noninfected tenosynovitis of the digital flexor tendon sheath (DFTS) has been considered obscure. With the advent of tenoscopy some inciting causes have been described, but to date few cases with a precise diagnosis have been reported. Objective: Tenoscopic surgery enables accurate diagnosis and facilitates treatment of noninfected tenosynovitis of the DFTS. Methods: The case records of all horses with noninfected tenosynovitis of the DFTS admitted to a referral clinic over a 7-year period were evaluated retrospectively. Follow-up information was obtained by...
Valverde A, Gunkelt C, Doherty TJ, Giguère S, Pollak AS.Lidocaine constant rate infusions (CRIs) are common as an intraoperative adjunct to general anaesthesia, but their influence on quality of recovery has not been thoroughly determined. Objective: To determine the effects of an intraoperative i.v. CRI of lidocaine on the quality of recovery from isoflurane or sevoflurane anaesthesia in horses undergoing various surgical procedures, using a modified recovery score system. Objective: The administration of intraoperative lidocaine CRI decreases the quality of recovery in horses. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 microg/kg bwt/min...
Garcia-Seco E, Wilson DA, Kramer J, Keegan KG, Branson KR, Johnson PJ, Tyler JW.To determine the prevalence of pedunculated lipomas and identify risk factors affecting postoperative complications and survival in horses at a veterinary teaching hospital undergoing surgery for colic caused by pedunculated lipomas. Methods: Retrospective study. Methods: 102 horses with a diagnosis of pedunculated lipoma. Methods: Age, breed, weight, and sex of horses with pedunculated lipomas were compared with the total equine hospital population and the population of horses admitted for abdominal surgery during the same period. Follow-up information was obtained by reevaluation or contact ...
Naylor RJ, Taylor AH, Knowles EJ, Wilford S, Linnenkohl W, Mair TS, Johns IC.Ex vivo evidence suggests that cyclo-oxygenase (COX) 2-preferential inhibitor nonsteroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, have a less detrimental effect on intestinal healing than flunixin meglumine (FM). Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal (SSI) lesions is unknown. Objective: To compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM. Methods: Randomised prospective study. Methods: Cases presenting to the Royal Veterinary College Equine Referral H...
Jacobson E, Dart AJ, Mondori T, Horadogoda N, Jeffcott LB, Little CB, Smith MM.It is not known how extensively a localised flexor tendon injury affects the entire tendon. This study examined the extent of and relationship between histopathologic and gene expression changes in equine superficial digital flexor tendon after a surgical injury. One forelimb tendon was hemi-transected in six horses, and in three other horses, one tendon underwent a sham operation. After euthanasia at six weeks, transected and control (sham and non-operated contralateral) tendons were regionally sampled (medial and lateral halves each divided into six 3 cm regions) for histologic (scoring and ...
Morton AJ, Blikslager AT.Although short-term survival rates following small intestinal resection reportedly range from 48-88%, there is little information on predicting which horse may or may not survive small intestinal (SI) resection and anastomosis. The aim of this study was to identify factors that contribute to nonsurvival in horses following small intestinal resection. Medical records of horses which recovered from anaesthesia following SI resection were reviewed. Clinical and surgical variables were evaluated for their association with short-term survival using logistic regression and were reported as odds rati...
Curtiss AL, Stefanovski D, Richardson DW.To determine the prevalence of surgical site infection (SSI) after internal fixation and to identify risk factors for SSI and nonsurvival. Methods: Retrospective study. Methods: One hundred fifty-five horses with long bone fractures or arthrodesis treated by internal fixation at 1 hospital between 2008-2016. Methods: Signalment, diagnosis, surgical repair, surgeon, surgical time, antimicrobial use, SSI onset, bacterial identification, and adjunct treatments were recorded. Perioperative variables were analyzed to identify risk factors associated with outcomes. Results: Surgical-site infection w...
Schwaber MJ, Navon-Venezia S, Masarwa S, Tirosh-Levy S, Adler A, Chmelnitsky I, Carmeli Y, Klement E, Steinman A.Methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization has become a serious emerging condition in equine hospitals. Following the detection of MRSA in asymptomatic hospitalized horses and in two horses with post-operative wound infections, an investigation was conducted. Twelve of 84 horses (14.3%) and 16 of 139 personnel (11.5%) were MRSA carriers. The profile of the dominant MRSA strain common to horses and staff was multi-drug-resistant, spa-type t535, SCCmec type V, pvl-negative. MLST of a representative isolate yielded sequence type (ST) 5. The risk of MRSA carriage ...
Radcliffe RM, Divers TJ, Fletcher DJ, Mohammed H, Kraus MS.To evaluate changes in plasma cardiac troponin I (cTnI) and L-lactate (LLt) as prognostic indicators in horses undergoing emergency abdominal surgery. Methods: Prospective observational study. Methods: Veterinary teaching hospital. Methods: Thirty-four horses undergoing emergency abdominal surgery. Methods: Serial blood sampling during various times during hospitalization (hospital admission, and 12, 24, 48, and 72 h postoperatively) evaluating cTnI and LLt concentrations. Results: All horses required surgery for correction of a strangulating (n = 29) or nonstrangulating obstruction (n = 5) of...
Little D, Tomlinson JE, Blikslager AT.Post operative ileus (POI) remains an important cause of post operative morbidity and mortality in the horse. However, clinical progression of naturally occurring cases of POI in both horse and man does not entirely support the 'neurogenic' hypothesis as the sole mechanism of POI; and the hypothesis that inflammation plays a major role at 12-24 h after surgery requires validation. Objective: An inflammatory infiltrate in the muscularis externa and myenteric plexus of equine jejunum is present 18 h following a period of ischaemia. Methods: Samples of normal jejunum, jejunum from the proximal re...
Roberts VL, Perkins JD, Skärlina E, Gorvy DA, Tremaine WH, Williams A, McKane SA, White I, Knottenbelt DC.Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow-up time were limitations. Objective: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer-term follow-up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and c...
Dixon PM, Dacre I, Dacre K, Tremaine WH, McCann J, Barakzai S.Extraction of cheek teeth (CT) by the conventional repulsion technique requires general anaesthesia and carries a high rate of post operative complications. Consequently, an alternative method of extraction, i.e. orally in standing horses, was evaluated. Objective: The need for and risks of general anaesthesia could be avoided and post extraction sequelae reduced by performing extractions orally in standing horses. Methods: One hundred mainly younger horses (median age 8, range 2-18 years) with firmly attached CT that required extraction because of apical infections, displacements, diastemata,...
Malone E, Ensink J, Turner T, Wilson J, Andrews F, Keegan K, Lumsden J.To determine if intravenous lidocaine is useful and safe as a treatment for equine ileus. Methods: Prospective double-blinded placebo-controlled trial. Methods: Horses (n = 32) with a diagnosis of postoperative ileus (POI) or enteritis and that had refluxed >20 L or had been refluxing for >24 hours. Methods: Refluxing horses were administered lidocaine (1.3 mg/kg intravenously [IV] as a bolus followed by a 0.05 mg/kg/min infusion) or saline (0.9% NaCl) solution placebo for 24 hours. Variables evaluated included volume and duration of reflux, time to 1st fecal passage, signs of pain, anal...
Busk P, Jacobsen S, Martinussen T.To compare postoperative inflammatory responses in horses administered perioperative procaine penicillin and those not administered penicillin using acute phase protein serum amyloid A (SAA) as a marker of inflammation. Methods: Randomized clinical trial. Methods: Stallions (n=50) castrated under field conditions. Methods: SAA concentrations were determined on days 0, 3, and 8. Six horses were subsequently excluded because of elevated SAA concentrations on day 0. Of the remaining 50 horses, 26 were administered nonsteroidal anti-inflammatory drug (NSAID) therapy and 24 were administered NSAID ...
Pehkonen J, Karma L, Raekallio M.No studies have focused on dental pain signs associated with periapical infection in cheek teeth (CT) of horses. Moreover, the ability of owners to recognize signs of dental pain in horses has not been reported. We hypothesized that periapical infection will usually induce pain that manifests in the behavior of the horse. Removing the infected tooth will reduce the expression of such behaviors. Owners of 47 horses whose CT had been removed because of periapical infection participated in this study. They filled an internet-based questionnaire including 23 questions about eating behavior, bit be...
Feeney E, Peal BT, Inglis JE, Su J, Nixon AJ, Bonassar LJ, Reesink HL.The objective of this study was to examine temporal variations in synovial fluid composition and lubrication following articular fracture. Post-traumatic osteoarthritis (PTOA) was induced by creating an osteochondral fracture in the middle carpal joint of four horses while the contralateral limb served as a sham-operated control. Horses were exercised on a high-speed treadmill, and synovial fluid was collected pre-operatively and at serial timepoints until 75 days post-operatively. Lubricin and hyaluronic acid (HA) concentrations were measured using sandwich ELISAs, and the molecular weight di...
