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The Confidential Enquiry into Perioperative Equine Fatalities: phase 4 (CEPEF4) – a worldwide observational, prospective, multicentre cohort study in 2025. To report on the Confidential Enquiry into Perioperative Equine Fatalities 4 (CEPEF4). Methods: Confidential, observational, prospective, multicentre, cohort study. Methods: 47,396 horses/ponies undergoing general anaesthesia (GA). Methods: Characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs (p < 0.05). Results: Data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as NO...
Exposure of horses to biotoxins, phytoestrogens, and pesticides from different feed materials and supplementary feeds. The occurrence of biotoxins and chemical residues in marketed horse feeds has direct influences on horse health but has not been studied yet. Objective: The study investigated the exposure and health implications of contaminants in various horse feedstuffs available on the European market. Methods: A total of 108 feed samples representing diverse product categories such as hay, processed roughage products, grains, and various supplementary feeds were collected from different European countries and analyzed for contaminants, including mycotoxins, phytoestrogens, pesticides, and veterinary drug ...
Clinical evaluation of freeze-dried secretome (lyosecretome) for osteoarthritis: a controlled trial in dogs and preliminary safety assessment in horses. Most in vivo studies on MSC-secretome for osteoarthritis (OA) have relied on animal models, using products lacking pharmaceutical quality, not formulated for clinical use, and insufficiently characterized, limiting knowledge of its effectiveness. This study reports veterinary clinical trials on dogs and horses with spontaneous OA: in dogs (26 subjects), the trial is randomized, double-blinded, and controlled; in horses, 5 clinical cases were treated for safety assessment. Treatment consisted of hyaluronic acid with either lyosecretome - a freeze-dried, injectable MSC-secretome obtained through...
Group housing increases alertness and social interaction compared to traditional single stabling in two-year-old sport horse stallions during pretraining. Horses in training are often stabled individually, but this is increasingly questioned. We have investigated the effects of different stabling systems in Warmblood stallions during a 12-week pretraining programme. Stallions were 24 months old and housed either in a group stable (Group 24, n = 9) or in individual boxes (Box 24, n = 10), or they were 30 months of age and housed in individual boxes (Box 30, n = 10). Cortisol, heart rate, heart rate variability (HRV), body development, injuries and selected behaviour patterns were analysed (1) at transfer from pasture to stable and (2) the...
Molecular detection of the Escherichia coli heme-utilization gene A virulence factor in E. coli isolated from the feces of horses in Sumbawa island, Indonesia. The transmission of () containing virulent genes from animals to humans and the environment poses significant public health challenges. This study aimed to detect the virulence factor of the () in isolated from the feces of apparently healthy horses in the island of Sumbawa, Indonesia. The study utilized 52 fecal samples from a total horse population of 283, calculated using the disease detection formula. Fresh feces were collected immediately after excretion and placed in buffered peptone water for subsequent analysis. The samples were then isolated on eosin methylene blue media and identi...
Equine botulism. Botulism is a severe and often fatal disease in equine patients worldwide. Clostridium botulinum is a ubiquitous soil organism which produces a potent neurotoxin resulting in neuromuscular blockade and flaccid paralysis in affected animals. Definitive diagnosis is often impractical or impossible, leading to diagnosis and treatment based on clinical experience and presenting signs. Delay in case identification and treatment results in rapid deterioration of the patient. Treatment of recumbent equine botulism cases presents challenges due to patient size and requires intensive nursing care. This...
Current and Emerging Biologic Therapies for Equine Tendon and Ligament Injuries. This review explores the use of biologics in the treatment of tendon and ligament injuries in horses, focusing on current and emerging therapies aimed at enhancing tissue repair and regeneration. It discusses the role of scaffold-based therapies, growth factors, blood-derived and tissue-derived biologics, and gene therapy as biologic regenerative therapies for improving healing outcomes. The review evaluates the mechanisms, efficacy, and challenges of biologics in clinical applications, highlighting recent advances and clinical studies. It provides an overview of current trends and future dire...
Diagnosis and Minimally Invasive Surgical Treatment for Enhancing Intrathecal/Intrasynovial Tendon Injuries. Intrathecal and intrasynovial tendon and ligament injuries can result in extrusion of tendon/ligament fibers, granuloma, and adhesion formation that not only impairs healing of the original injury but can create new injuries that negatively affect adequate healing and return to athletic work. In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the an...
Adjunct Therapies for Tendon/Ligament Healing: Therapeutic Laser and Extracorporeal Shockwave Therapy. High-power laser therapy and extracorporeal shock wave therapy (ESWT) can be safely used to treat tendon and ligament injuries in horses, and the potential beneficial effects have been described. The power of low level lasers is not sufficient for treatment of tendon and ligament injuries in horses. ESWT is used more often to treat tendon and ligament injuries than it is for any other type of condition in horses, but there is limited supporting scientific evidence. Further research should focus on establishing dosage and treatment protocols for both laser therapy and ESWT in horses with clinic...
Suspensory Ligament Injuries: Diagnosis and Treatment. The location of a suspensory ligament (SL) injury heavily influences the clinical presentation, prognosis, and treatment options. Diagnostic imaging is necessary to provide an accurate diagnosis and is critical to ensure the institution of the most appropriate treatment. The hindlimb proximal SL in particular can be challenging to diagnosis, carries a guarded prognosis, and typically requires aggressive treatment to achieve soundness.
Guidelines for Formulating Rehabilitation Strategies for Equine Tendon and Ligament Injuries. Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Good response to oxymetholone in adult aplastic anemia. In Thailand, stem cell transplantation and horse antithymocyte globulin (ATG) are not accessible for most adult aplastic anemia (AA) patients. Alternative therapies are required. We conducted a cohort study of 110 adult AA patients treated with oxymetholone alone for at least 30 days from 2013 to 2023. Response at month 6 and prognostic factors were evaluated. The mean age was 63.4 years old and 58.2% were female. Severe and very severe AA (SAA/VSAA) comprised 64.5% and 3.6%, respectively. The initial oxymetholone daily dose was 150 mg in 66.4%. The overall response was 56.4% (50.7% for SAA/V...
Nebulization of an mRNA-encoded monoclonal antibody for passive immunization of foals against Rhodococcus equi. Inhalation of Rhodococcus equi causes severe pneumonia in humans and animals worldwide, most commonly affecting horse foals. The standard for preventing R. equi pneumonia in foals is transfusion of hyperimmune plasma, which is expensive and carries the risk of adverse effects. Our goal was to passively immunize foals against R. equi by nebulizing mRNA encoding an equine monoclonal antibody (mAb) against the virulence-associated protein A (VapA) directly into the lungs. VapA-specific memory B cells from an immunized horse were used to identify and select the sequence for an equine immunoglobuli...
Cellular and Matrix Dynamics of the Equine Tendon. Our understanding of tendon homeostasis and repair following injury has made great strides through basic science, clinical veterinary medicine, and preclinical translational research. We have now gleaned a greater understanding of the cellular and matrix dynamics that are being orchestrated within the tendon, which provide therapeutic opportunities. This article will focus on how utilizing the horse and equine tissues have advanced our understanding of tendinopathy and the cellular and matrix dynamics at play while also identifying continued gaps in our knowledge where the horse as a veterinar...
Current and Emerging Quantitative Imaging Modalities for Diagnosing and Monitoring Equine Tendon and Ligament Injuries. Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Techniques for Equine Tendon Tenorrhaphy. Equine tendon lacerations are not uncommon secondary to traumatic wounds and degloving lacerations. These wounds are often contaminated and, therefore, basic principles of wound assessment and management are critical to identify the extent of an injury. Ancillary tools to aid physical examination include radiography, ultrasonography, and synoviocentesis (eg, if involving a joint and/or tendon sheath). Prolonged convalescence period, continued external coaptation, and controlled exercise are mainstays of treatment following tenorrhaphy. A poor prognosis for return to full athletic function is e...
Current Practices and Considerations in Therapeutic Farriery for Equine Tendon and Ligament Injuries. The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Diagnosis and Strategies for the Treatment of Infectious Equine Tendon and Ligament Disorders. Diagnostic and treatment strategies for infectious equine tendon and ligament disorders are continually evolving where recent progress is focused on advanced imaging and evidence supporting endoscopic lavage and regional antimicrobial therapy.
Structure Function Relationships in the Aging Superficial Digital Flexor Tendon: Implications for Injury. The high stresses and strains experienced by the superficial digital flexor tendon (SDFT) make it prone to age-related injury. The SDFT exhibits cellular and structural specializations, localized to the interfascicular matrix (IFM), enabling it to resist its extreme mechanical environment. With aging, these specializations are lost, impacting the ability of the tendon to withstand repeated loading. Within the IFM, there is loss of mechanical properties and organization accompanying cell senescence and a decreased resolution of inflammation. Developing therapeutics to reverse these changes may,...
Navigated minimally invasive puncture of the trigeminal cistern in horses-a cadaveric study in preparation for a controlled rhizotomy. Trigeminal-mediated headshaking is a neuropathic disorder in horses, characterized by signs of regional pain similar to trigeminal neuralgia in humans. The injection of glycerol into the trigeminal cistern to ablate pain-conducting nerve fibers within the trigeminal ganglion -known as glycerol rhizotomy- is a well-established treatment in human medicine. This study compares two approaches to the equine trigeminal cistern using a navigation system for guiding needle placement, a previously described ventral and a newly developed transmandibular lateral approach. The surgical accuracy and risk o...
[Off-label use of antibiotics in equine medicine – an online survey in Germany]. Since 28.01.2022, veterinary medicinal products must be used in accordance with the conditions of authorization (Regulation (EU) 2019/6, Article 106). This entails further restrictions on therapeutic freedom, e. g., with regard to dose deviations. To date, there is no data available in equine medicine on the scope of off-label use as any use deviating from the expert information for antibiotics, on the basis of which the feasibility of implementing the new regulations in Germany can be assessed.To collect data on the off-label use of antibiotics, a Germany-wide anonymous online survey was th...
Metabolic heterogeneity exists across equine distal limb tendons and ligaments in healthy, metabolically normal horses. To (1) identify tissue-specific metabolic profiles of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) and (2) evaluate metabolic profile differences in the SDFT, DDFT, and SL between the equine forelimb and hindlimb. Unassigned: 2 SDFT, DDFT, and SL specimens were collected from the forelimbs and hindlimbs of 10 horses of mixed breed, age, and sex that were euthanized for other reasons. One specimen was processed for histology to confirm that there were no underlying soft-tissue pathologies. One specimen was processed for 2 forms of...
[Sonographic diagnosis of lingual abscess formation in 2 horses with feeding difficulties]. Feeding disorders in horses may have various underlying causes. A thorough clinical examination of the oral cavity is essential for clarification and is often supplemented by imaging techniques such as oral endoscopy, radiography, and computed tomography (CT) of the head. Sonographic examinations of the head and oral cavity are less commonly described diagnostic methods for the investigation of feeding disorders. This case report describes 2 horses presented to the clinic due to impaired feed intake. In both cases the radiographic examination of the head did not reveal any abnormalities relate...
[Diagnostic imaging of the equine cervical spine and clinical significance of findings – review of literature – Part two: Ultrasonography, myelography, computed tomography, magnetic resonance tomography, and nuclear medicine]. Diagnostic imaging is an important part of the diagnostic approach in equine spinal ataxia especially with the cervical spine being commonly involved. The spinal cord may be affected by a variety of conditions including cervical vertebral malformations, osteoarthritis of the articular process joints or less commonly neoplasia. Advanced imaging techniques such as myelography are more accurate in diagnosing spinal cord compression and may be performed under general anesthesia in neutral, flexed and extended positions of the cervical spine. The use of ultrasound is non-invasive and allows ultraso...
Mechanical Stimulation of Equine Bone Marrow Mesenchymal Stromal Cell-Derived Cartilage-Like In Vitro Model Triggers Osteoarthritis Features. Osteoarthritis (OA) affects millions of people globally, causing irreversible cartilage damage, chronic inflammation, and progressive joint dysfunction. Similarly, horses can develop OA spontaneously or due to their athletic careers, influenced by mechanical and biochemical factors. Current treatments primarily focus on symptom relief without promoting cartilage regeneration. In line with the 3Rs principles (refine, reduce, replace), the development of OA models is essential for advancing new therapeutic approaches against OA. In response to this need, the present study aimed to develop an m...
Perioperative factors and outcomes associated with antimicrobial therapy duration in horses undergoing exploratory celiotomy. The objective was to compare perioperative factors that may influence clinician decisions regarding antimicrobial therapy duration and outcomes in horses undergoing exploratory celiotomy. Unassigned: Horses > 1 mo of age undergoing exploratory celiotomy for colic that survived without repeat celiotomy for ≥ 5 d. Unassigned: Retrospective cohort study. Cases were grouped by duration of antimicrobial therapy: G1, ≤ 24 h; G2, 1 to 3 d; G3, > 3 d. Admission, surgical, and postoperative data from the medical records and long-term outcome assessed telephone follow-up were compared among g...
PRP and hyaluronic acid reduce synovitis in horses after arthroscopic OCD removal in Andalusian horses. This study was performed to evaluate the efficacy of intra-articular (IA) injections of a combination of platelet rich plasma (PRP) and hyaluronic acid (HA) on joint effusion following arthroscopic removal of OCD in the tarso-crural joint (TCJ) in young Andalusian horses. Methods: Forty Andalusian horses diagnosed with OCD of the distal intermediate ridge of the tibia (DIRT) were included in the study. Horses enrolled in this study had persisting synovial effusion after arthroscopic removal of OCD in the TCJ. A subjective semi-quantitative effusion score was adopted in the study to define the ...
Lag screw compression effectively treats proximal subchondral bone cysts and fissures in the first phalanx of mature performance horses. To determine the outcome of skeletally mature performance horses with subchondral bone cysts and fissures in the proximal aspect of the first phalanx treated by lag screw compression. Unassigned: Case records of horses that underwent lag screw compression to treat subchondral bone lesions in the proximal aspect of the first phalanx were reviewed. Performance horses > 5 years old with lameness referrable to the fetlock region; radiographic or other advanced imaging evidence of subchondral bone lesions, with no other concurrent cause for lameness; and at least 6 months of follow-up data were inc...
Metabolic, pathological, and genetic analyses of foals neonatal foals that died in Noma horses. We evaluated metabolic abnormalities in six neonatal Noma foals (Nos. 54-57, 62, and 66) that died shortly after birth, using laboratory tests, pathological examinations, serum amino acid (AA) analyses, gas chromatography/mass spectrometry (GC/MS), and genetic analyses. Nonspecific clinical symptoms, such as poor suckling and weakness, were commonly observed at birth. Sepsis caused by various bacterial infections was detected in foal Nos. 54, 62, and 66, while a heart malformation was identified in foal No. 57. Laboratory tests showed high aspartate transaminase, lactate dehydrogenase, and cre...
Sudden death in a Thoroughbred stallion: cardiac tamponade due to transverse aortic rupture with bone metaplasia and calcification. A 17-year-old Thoroughbred stallion died suddenly after grazing. Necropsy revealed massive hemorrhage in the pericardial sac, suggesting cardiac tamponade. Aortic perforation was observed at the aortic origin, and hemorrhage was observed in and around the epicardium. Superficial observation of the aortic lumen revealed a transverse tear of the aortic wall at the bases of the right semilunar valve and septal semilunar valve. Fibro-osseous changes with calcification were histopathologically observed at the site of the rupture. A nodular goiter was observed in the left thyroid gland. The horse di...
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