Background Laser excision is used routinely in the treatment of sarcoids but may be ineffective in cases where complete excision cannot be achieved. A multimodal approach is warranted in these cases. 5-FU may improve the lethal effect of cryotherapy as an adjunct to laser excision. Objectives To compare two treatment protocols for equine sarcoids: laser excision alone versus a combination protocol of laser excision, cryotherapy, and 5-FU chemotherapy. Factors associated with sarcoid recurrence are also investigated. Study Design Retrospective case controlled study. Results Eighty-four horses with 168 histologically confirmed sarcoids were included, with a median follow up time of 39 months (IQR 21-62 months). Sarcoid recurrence at the treated site was reported in 38% of cases and in 23% of any individual sarcoids. No significant difference was demonstrated between treatment categories in either rate of sarcoid recurrence (p=0.45 for any treated horse, p=0.63 for individual sarcoids) or time to sarcoid recurrence (p=0.73). Sarcoid recurrence was higher in horses with a greater number of sarcoids (OR 1.2 (1.0-1.5), p=0.03); when treatment had been received prior to admission (OR 7.6 (2.0-33), p=0.004); for individual sarcoids ≥100mm in diameter (OR 5.6 (1.1-30), p=0.03); and for treatment under general anaesthesia (OR 5.0 (1.4-19), p=0.01). Horses with urogenital sarcoids and >1 mixed sarcoid experienced more rapid recurrence (HR 3.6 (1.3-10), p=0.02 and HR 9.9 (3.3-30), p<0.001) and recurrence was less rapid following the treatment of a horse’s first sarcoid (HR 0.3 (0.1-0.7), p=0.009). Main Limitations Significant differences in case populations in each treatment category. Treatment selection was neither blinded nor randomised and missing data and recall bias limit the study’s power. Sarcoid recurrence was owner reported. Conclusions When assessing the likelihood of sarcoid recurrence, characteristics of the individual patient and sarcoid(s) are likely to be more significant than selection of any individual treatment protocol.

A 15-year-old Warmblood gelding was presented with macroscopic hematuria and stranguria symptoms for two months. Cystoscopy revealed a pedunculated cauliflower-like mass, flowing from the right ureteral orifice into the bladder. Ureteroscopy showed a right dilated ureter (2.3 mm). The ureteral lumen mucosa was smooth and the mass had its origin approximately 10 cm cranial from the orifice. The right kidney was macroscopically on ultrasound within normal range. The mass was removed transendoscopically by means of a cautery snare leaving a small part at the base. Histopathological analysis identified it as a mucosal polyp. Recovery was uncomplicated and the gelding was discharged three days after surgery. A follow up 5 months later showed no signs of inflammation and the remaining small stalk in the right ureter.

Buyers expect much from the veterinarian examining a prospective horse for purchase. To compound this, the veterinarian is the gatekeeper in a highly unregulated transaction. The examining veterinarian must determine precisely what the buyer’s expectations are for the examination and their prospective new horse. How we communicate our findings to them is critical for helping them make an informed purchasing decision.

Background: The importance of intra-articular corticosteroid treatment for osteoarthritis with its possible adverse effects requires a comprehensive review. Objectives: This review answers the following questions: 1) What evidence is available regarding the symptom-modifying and disease-modifying changes related to a single intra-articular corticosteroid injection for treating osteoarthritis? Moreover, 2) What evidence suggests corticosteroids are detrimental to equine joint health? Study design: Systematic review. Methods: A systematic search was conducted in June/2022 in PubMed, CAB, and the Web of Science. Inclusion criteria were applied to titles and abstracts. For each question, further criteria were applied. The risk of bias was assessed according to the study design. Results: We generated 6,417 titles, and 23 articles fit all inclusion criteria for single-injection corticosteroid treatments; 21 were included regarding corticosteroid effects on joint health. Studies were usually rated as having an unclear risk of bias. Single-injection protocols lead to short-term symptom-modifying osteoarthritic changes with conflicting results regarding disease-modifying osteoarthritis. Healthy joints demonstrated disturbances in metabolism and tissue changes, with dose-dependent effects found in vitro. Main limitations: There is a lack of studies regarding the topics–primarily for equine species. Conclusions: Symptom-modifying osteoarthritic changes after a single injection are short-term; however, a consistent disease-modifying osteoarthritis effect is yet to be established. Joint health appears to be disturbed by corticosteroids as their effects on normal joints show adverse changes in tissues and metabolism.

A 17-year-old Quarter Horse broodmare was taken to surgery for signs of colic unresponsive to medical management. The small colon was strangulated by a pendulous ovarian pedicle. The strangulation was freed, and the affected ovary was removed. The mare developed signs of a small colon obstruction 4 days after surgery. The mare was euthanized 6 days after surgery for signs of a GI rupture. A post-mortem examination revealed necrosis of the affected portion of small colon.

An 8-year-old Thoroughbred gelding presented for evaluation and investigation for recurrent unilateral epistaxis. Computer tomography (CT) confirmed the presence of an invasive and expansive progressive ethmoid hematoma (PEH) located in the right paranasal sinuses. The mass invaded the right paranasal sinuses compartments causing moderate leftward displacement of the nasal septum with subsequent collapse of the left nasal passages, complete obliteration of the right ethmoid turbinate, right infraorbital canal, and nasolacrimal duct. Also, impingement of the axial margin of the right orbit. A large frontonasal maxillary bone flap was performed standing under sedation and local anesthesia and the PEH was removed successfully with minimal surgical complications. The gelding made an unremarkable recovery from surgery and progressed well after recovering from post operative pleuropneumonia. Follow-up (25 months post operative) confirmed the reoccurrence of the PEH, but the horse remained healthy in pasture turn out.

Background: Colic is the commonest emergency in first opinion equine practice. Early referral is important for horses requiring surgery. Fast localised abdominal ultrasonography of horses (FLASH) is frequently used as a diagnostic tool in the investigation of colic at referral hospitals, but its use in first opinion practice has not been evaluated. Objective: To assess the value of FLASH scanning in the primary assessment of horses with colic in the field, using a portable wireless ultrasound system. Study design: Prospective study (2018-2021). Methods: Any horse examined for colic as an emergency in a first opinion ambulatory practice was eligible for inclusion in the study. A FLASH examination was performed using a wireless handheld ultrasound scanner, with the images displayed on a smartphone or tablet. The findings on FLASH scans and outcome of the case (recovered, referred for surgery or euthanised without referral) were recorded. Results: 135 equids with acute colic were evaluated. Of the 135 horses, 49 (36%) had an abnormal finding on FLASH scanning, including distended loops of small intestine (n=34), thickened small intestinal walls (n=23) and/or distension of the stomach (n=7). Reduced small intestinal motility was recorded in 52 animals (38%). Follow-up information was available in all animals: 50 (37%) were euthanised due to clinical deterioration and the owners’ decision not to undertake surgery; 85/135 (63%) survived, including 5/85 (6%) that underwent surgery and 80/85 (94%) that resolved with medical management. Main limitations: Small number of cases. Lack of results of post-mortem examination of horses that were euthanised. Potential selection bias. Conclusion: The FLASH technique can be valuable in the primary assessment of horses with colic in first opinion ambulatory practice. Further evaluation with more cases is required.

Laminitis associated with hyperinsulinemia a significant cause of morbidity and mortality in horses with equine metabolic syndrome. The diagnosis and management of insulin dysregulation are therefore critical to prevent the development of hyperinsulinemia-associated laminitis. This review article aims to help primary care clinicians manage patients with insulin dysregulation by providing an overview of diagnostics, management strategies and new therapies that are available.

Background: The conjunctiva of the eye is a mucosal surface that is colonized by various bacteria. Following surgeries, trauma, or other underlying conditions the normal flora of these bacteria may cause some eye infections such as conjunctival, corneal infections, or endophthalmitis. Objectives: This study aimed to investigate the bacterial population and antibiotic resistance of the conjunctiva in healthy horses. Study design: Random sampling of ocular samples from 20 horse during the winter (2019). Methods: Swab samples were collected from the eyes of 20 healthy horses of different breeds, ages, and sexes in Tehran province, Iran. The swabs were cultured on blood agar and MacConkey agar and incubated at 37°C for 24-48 hours. The isolated bacteria were characterized using cellular morphology, gram-staining, and biochemical tests. Sensitivity and resistance to 10 different antibiotics were measured using an antibiogram test. Results: Results showed that the bacterial population consisted of various species, with Bacillus cereus being the most frequent. There were no significant differences in the frequency of isolated bacteria between sexes and age groups. There were no significant differences in the sensitivity of bacterial flora of the eyes to Colistin, ceftiofur, florfenicol, amoxicillin, and ampicillin between neither different age groups nor different sexes of the horses (P>0.05). However, sensitivity to enrofloxacin and ciprofloxacin was significantly correlated with the age groups of the horses (P>0.05). Significant difference in sensitivity to trimethoprim-sulfamethoxazole between various sexes of horses was observed. Main limitations: The non-uniformity of the follow-up examination reliance owners or caregiver of the horse for follow-up information and Lack of adequate financial resources to study more horses. Conclusions: The study suggests that the frequency of bacterial flora in horses’ eyes is influenced by housing and management conditions rather than age and sex. Keywords: Microbial flora, Conjunctiva, Eyes, Horse, Mucosal surface.

The inclusion of thoracolumbar radiographs in a pre-purchase examination (PPE) is a topic of current and intense debate, subsequent to a statement from the Federation of European Equine Veterinary Associations (FEEVA) advocating the exclusion of spinous process radiography from the PPE. This review will consider the reasons behind the addition of such radiographs into PPEs, the limitations of radiography in ambulatory practice and therefore the diagnostic limitations to the practitioner, the diagnostic benefit of a complete radiographic examination, and discussion of common and less-frequent thoracolumbar pathologies. We will focus on laterolateral radiographs of the spinous processes as these are most commonly acquired during the PPE. The lack of consistent and repeatable grading systems highlights the subjective nature and variability in assessing this region radiographically. Coupled with the sparse evidence of correlation between clinical symptoms and radiographic abnormalities of the thoracolumbar spine leads us to conclude that taking radiographs of the back during PPEs should not be performed unless the clinical examination indicates otherwise.

This report describes the successful treatment of a cutaneous hemangiosarcoma of a 12 years old horse presented for evaluation of a cutaneous mass on the left gluteal region. Hemangiosarcoma is a rare life-threatening neoplasia that can be successfully managed when diagnosed and treated at early stages. Unfortunately, they are often diagnosed at later stages, leading to a poor outcome and low survival rates. In this report, the horse has been treated with a complete large surgical excision of the neoplastic tissue. A good cosmetic outcome as well as a short recovery time has been achieved with an autologous skin grafting split thickness modified meek technique. A long-term follow-up of the patient showed no reoccurrence of the hemangiosarcoma, and successful return to athletic performance. In the authors knowledge, this is the first equine primary cutaneous hemangiosarcoma treated with complete excision and subsequently autologous skin grafting with a long-term follow-up and good outcome despite the poor prognosis.

Whilst there are limited data on the environmental impact of administering parasiticide drugs to horses, evidence from other species treated with identical drugs indicates significant negative ecological effects. Anthelmintic drugs may be excreted unchanged or metabolised to other active and/or toxic metabolites that enter the environment through direct excretion during grazing. These chemicals can have significant toxic effects on non-target insects, such as dung beetles, earthworms and aquatic animals. Of the anthelmintics frequently used in horses, ivermectin appears to be the most ecotoxic; available evidence indicates that moxidectin is less toxic. Fenbendazole appears to have little impact on dung-colonising insects but may be toxic to aquatic organisms and fungi. There is very little data regarding the ecotoxicity of pyrantel and praziquantel, although their ecotoxic effects are thought to be low. Pasture hygiene reduces pharmaceutical contamination and also helps to break the endoparasitic cycle of infectivity, thus reducing reliance on anthelmintics. Judicious use of endoparasiticides, along with pasture hygiene measures, will limit the ecotoxic effects of these drugs and reduce the selection pressure that drives anthelmintic resistance. Anthelmintics may also impact the equine gastrointestinal microbiota.Following topical treatment with ectoparasiticides (such as fipronil, permethrin or cypermethrin), there is a risk of contamination of both the immediate environment and water courses. The half-life of fipronil in the environment is variable, but it degrades into compounds which are more toxic; it is highly toxic to bees, and is reported to bioaccumulate in fish and can be toxic to birds. Of the synthetic pyrethroids, permethrin degrades at a faster rate than cypermethrin and may therefore have a lower ecotoxic effect. The ecotoxic effects of injectable doramectin are likely to be similar to oral ivermectin, although persistence in faeces may be significantly prolonged compared to the oral treatment route.

A seven year old Slovak warmblood gelding, used as a police horse, initially presented to the refferal clinic when it was five years old, with an itching keloid on the distal limb, requiring surgical removal. After surgical removal of the keloid and successful closure of the skin, it was necessary to maintain bandaging the healed wound to prevent self mutilation as the healed surgical site remained pruritic post operatively. After two years, the horse presented to the clinic again with pruritic and alopetic regions of the head, neck, limbs and base of the tail. Attempts to find the cause of dermal iritation included dermatological, parazitological, microbiological and ultrasonographic examination. Treatment with corticosteroids, antiparasitics and antibiotics were not succesfull. Further investigation due to the horse's worsening general status led to the finding of marked pleural effusion. Cytology of the pleural fluid confirmed there was, as suspected, neoplastic changes in the thoracic cavity. Furthermore there were gross pathological changes of the lymphatic tissue of the cranial mediastinum, surroundings of the aorta in the thoracic cavity and lymph nodes of the abdominal cavity. Histolology of the lymphatic nodes found poorly differentiated round cell tumours. Histopathological findings confirmed there was a very aggressive form of lymphoma. The pruritus, generalised moth-eaten alopecia and self-mutilation were the first symptoms of the terminal disease in this case.

This case report describes successful conservative management of a comminuted fracture of the atlas. To the authors knowledge, fracture of the atlas in the horse and intrathecal corticosteroid injection in the standing sedated patient has not been previously reported. Clinical signs included acute onset ataxia, proprioceptive deficits and neck stiffness; which developed immediately post trauma during assisted recovery from general anaesthesia. Radiographic examination was not diagnostic immediately post trauma and computed tomographic (CT) imaging subsequently identified a fracture of the atlas. Treatment included ultrasound guided intrathecal medication of the cerebrospinal fluid and intra-articular medication of the atlantooccipital joint under standing sedation. Medication resulted in a marked improvement in clinical signs (grade 4 ataxia to grade 1 ataxia).

Introduction: A closed inguinal castration technique was compared with field castrations based on the post-operative (p.o.) inflammatory marker Serum Amyloid A (SAA). Third day p.o. SAA, which has been related to trauma, has been reported after field castrations in four different studies in literature between 500 mg/l and 700 mg/l. These values were compared with SAA values measured on day three after routine castration using a closed inguinal approach applied under general anaesthesia under strict aseptic conditions. Materials and Methods: 51 Male horses were presented for routine castration. Serum was collected pre-operatively and on day 3 post operatively. Castration was performed using a closed inguinal approach in dorsal recumbence under general anaesthesia. The vaginal process was retrieved by blunt dissection over an inguinal skin incision. The closed proximal vaginal process was crushed by a Sand emasculator and ligated at this site. Vaginal Process with content was cut off 10 mm distal to the ligated site. Skin incisions were closed intra cutaneously. Antibiotics or anti-inflammatory drugs were not applied. Results: 48 horses tested negative (SAA< 3mg/l) pre-operatively. Two ponies and one standardbred showed pre-operative 5mg/l, 7mg/l and 75mg/l respectively. Mean SAA value of all 51 horses, three days post operatively, measured 94mg/l. 27 Horses showed no elevation in SAA (<3mg/l). Only 8 horses showed SAA values >100mg/l, of which 4 horses > 500mg/l, (514mg/l, 747mg/l, 1110 mg/l and 1160 mg/l) possibly related to additional trauma. Excluding these 4 cases results in a mean SAA value of 27mg/l. Conclusion: Castrations, using a closed inguinal approach, in which proper surgical standards can be maintained, proved to be far less traumatic than field castrations.

Background: Alpha tocopherol is one of the non-enzymatic lipophilic antioxidants. Butylated hydroxytoluene (BHT) is a synthetic analog that possesses similar modes of actions in protecting the cryopreserved sperms. Objectives: This study hypothesized that a certain concentration of any antioxidant is suitable for improving the post-thaw semen quality of stallions. Study Design: Case control study. Methods: To determine this concentration, a synthetic antioxidant similar to vitamin E in potency and scavenging oxidative stress power in concentrations of 0.0, 0.25, 0.50, 1.0, 2.0, 4.0 mM/ml were added to semen extender. The post-thaw sperm progressive motility at 0, 1h, 2h, 3h, the sperm viability index, the plasma membrane integrity tested by the hypo-osmotic selling test (HOST), the acrosome integrity, non-fragmented DNA, % of DNA in the comet head, % of DNA in the comet tail, comet tail length, and comet tail moment were compared. Results: According to our hypothesis, 1.0 mM BHT was the most suitable concentration that preserved the highest (P<0.0001) post-thaw sperm progressive motility at 0.0, 1h, 2h, 3h., the highest viability index (P<0.0001), plasma membrane and acrosome integrities (P<0.0001), non-fragmented DNA (P<0.001), and % of DNA in the comet head (P<0.001), the lowest DNA % in the comet tail (P<0.001) and comet tail moment (P<0.0001), and the shortest (P<0.0001) comet tail length. Main limitations: Collection of semen for research from registered Arabian Horse was the main obstacle for conducting this research. In conclusion, the concentrations of BHT around 1.0 mM/ml (0.5, 2.0mM/ml) proved better post-thaw semen characteristics, but BHT in concentrations >2.0mM/ml indicated the worst of all concentration which kept the lowest semen quality than non-supplemented control.

Cranial mid-body fractures of the axis in horses result from hyperflexion of the neck and are most commonly associated with lateral bending falls over showjumping or steeple chase fences. In the authors' experience, conservative treatment of mild to moderately displaced cranial mid-body axis fractures has been unsuccessful. This case report describes surgical management of a cranial mid-body fracture of the axis in an eight-year-old warmblood gelding that sustained the injury during a showjumping course. Following reduction, a five hole 4.5mm equine compression T-plate was contoured to fit the ventral aspect of the axis and used as an internal fixator. The horse was turned out starting 2 months after surgery and training was gradually resumed. No lameness, ataxia or decrease in cervical range motion were reported after surgery. Check-up radiographs at 5 months post-op showed complete healing of the fracture. T-LCP fixation is a promising treatment option for cranial mid-body fractures of the axis with a good prognosis for athletic function.

Background: Endoscopy, including tracheal mucus score (TMS) and bronchoalveolar lavage (BAL) fluid cytology, are commonly used to diagnose equine asthma (EA). Large-scale studies comparing clinical signs, TMS and BAL cytology are warranted. Objectives: Investigate associations between clinical signs of EA, tracheal mucus score and BAL cytology. Study design: cross-sectional study Methods: Data from 604 horses, each horse having one BAL cytology sample evaluated at the laboratory service at the Large Animal Teaching Hospital in Denmark, with further information provided by an owner questionnaire and veterinarian performing the endoscopy and BAL. Results: Tracheal mucus score increased significantly with EA severity, BAL neutrophilia and owner reported coughing, but not with BAL mastocytosis. Owner complaint of coughing was associated with an increasing amount of BAL neutrophils, but not with an increase in BAL mast cells. Poor performance was not correlated to BAL neutrophils, mast cells or TMS. Percentage of BAL aspirated was found lower in the SEA group compared to the non-asthmatic and MEA groups. Main limitations: Several different veterinarians performed the BAL sampling, BAL samples were shipped and a 24 hour delay in processing of the sample. Not able to adjust for season as these data was not recorded. Conclusion: this large-scale study showed a correlation between TMS and increasing severity of lower airway inflammation, confirming TMS as a reliable diagnostic factor for EA. Owner complaint of coughing, was found to be associated with TMS and BAL neutrophilia, and poor performance without coughing is not a reliable parameter for EA.