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Rodden EBK, Suthers JM, Busschers E, Burford JH, Freeman SL. A scoping review on intraoperative and postoperative surgical castration complications in domesticated equids. Equine Vet J 2024. [PMID: 38993145 DOI: 10.1111/evj.14122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 06/02/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably. OBJECTIVES To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids. STUDY DESIGN Joanna Briggs Institute systematic scoping review. METHOD CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half-closed, and whether the parietal tunic was open or closed at the end of surgery. RESULTS The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty-five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery. MAIN LIMITATIONS Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic. CONCLUSION A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials.
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Affiliation(s)
- Elise B K Rodden
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | | | - Evita Busschers
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent, UK
| | - John H Burford
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Sarah L Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
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Rendle D, Hughes K, Bowen M, Bull K, Cameron I, Furtado T, Peachey L, Sharpe L, Hodgkinson J. BEVA primary care clinical guidelines: Equine parasite control. Equine Vet J 2024; 56:392-423. [PMID: 38169127 DOI: 10.1111/evj.14036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/16/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND There is a lack of consensus on how best to balance our need to minimise the risk of parasite-associated disease in the individual horse, with the need to limit the use of anthelmintics in the population to preserve their efficacy through delaying further development of resistance. OBJECTIVES To develop evidence-based guidelines utilising a modified GRADE framework. METHODS A panel of veterinary scientists with relevant expertise and experience was convened. Relevant research questions were identified and developed with associated search terms being defined. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Literature searches were performed utilising CAB abstracts and PubMed. Where there was insufficient evidence to answer the research question the panel developed practical guidance based on their collective knowledge and experience. RESULTS Search results are presented, and recommendation or practical guidance were made in response to 37 clinically relevant questions relating to the use of anthelmintics in horses. MAIN LIMITATIONS There was insufficient evidence to answer many of the questions with any degree of certainty and practical guidance frequently had to be based upon extrapolation of relevant information and the panel members' collective experience and opinions. CONCLUSIONS Equine parasite control practices and current recommendations have a weak evidence base. These guidelines highlight changes in equine parasite control that should be considered to reduce the threat of parasite-associated disease and delay the development of further anthelmintic resistance.
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Affiliation(s)
| | - Kristopher Hughes
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Mark Bowen
- Medicine Vet Referrals, Nottinghamshire, UK
| | - Katie Bull
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | - Tamzin Furtado
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Laura Peachey
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | - Jane Hodgkinson
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
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Xue C, Segabinazzi L, Hall A, Dzikiti TB, French H, Gilbert R. A retrospective comparison of postoperative outcomes in ovariectomised jennies (Equus asinus) treated with phenylbutazone or flunixin meglumine. Equine Vet J 2024. [PMID: 38500306 DOI: 10.1111/evj.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/25/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Clinically, flunixin meglumine (FM) and phenylbutazone (PBZ) are preferentially selected for the treatment of visceral and musculoskeletal pain, respectively, in horses. In donkeys, there is no information to support or refute this conventional conjecture. OBJECTIVES To compare postoperative outcomes in a group of jennies treated with intravenous FM or oral PBZ. ANIMALS Fourteen jennies unilaterally ovariectomised by standing left flank laparotomy. STUDY DESIGN Retrospective cohort study. METHODS Data from medical records of ovariectomised jennies (case details, weight, non-steroidal anti-inflammatory drug [NSAID] protocol, surgery duration, operative sequence, anaesthesia protocol, physical examination findings and outcomes) were collected. From collated data, postoperative adverse events were defined as fever, tachycardia, tachypnea, inappetence, altered mentation, abnormal oral mucous membranes, bruxism, colic, incisional complications (i.e., drainage, oedema, peri-incisional emphysema and pain) and non-survival, then further divided into occurrence during the early (≤24 h) or late (>24 h) postoperative period for data analysis using R software. Chi-squared test was used to compare individual adverse events between groups (PBZ vs. FM) and moments (early vs. late). Significance was set at p ≤ 0.05. RESULTS PBZ treatment (8/14) was associated with (odds ratio, 95% confidence interval) more total (2.93, 1.97-4.36), early (3.01, 1.87-4.84) and late (2.69, 1.28-5.63) adverse events than FM treatment (6/14). Tachycardia (37.83, 2.21-646.66), tachypnoea (0.29, 0.13-0.66), altered mentation (2.78, 1.01-7.67), altered mucous membranes (18.38, 1.04-325.23), incisional oedema (44.33, 2.60-754.5) and incisional pain (47.78, 2.81-811.61) were significantly different between groups. Early adverse events significantly different between groups included tachycardia (50.2, 2.9-877.0), altered mentation (3.33, 1.08-10.29) and incisional pain (21.0, 1.2-374.5), with late adverse events being tachypnea (0.07, 0.01-0.62), incisional oedema (32.92, 1.85-584.28) and incisional pain (28.92, 1.62-515.68). Colic (2/8) and non-survival (1/8) were rare events that only occurred in the PBZ cohort and could not be further evaluated for differences. MAIN LIMITATIONS Small sample size; retrospective study; treatment bias; varied administration routes. CONCLUSIONS Oral PBZ may be inappropriate to use following abdominal surgery in donkeys. CLINICAL RELEVANCE More prospective and case-controlled studies are needed to evaluate the clinical efficacy of these two NSAIDs in donkeys.
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Affiliation(s)
- Cynthia Xue
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
| | - Lorenzo Segabinazzi
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
| | - Alexis Hall
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
| | - Tarisai Brighton Dzikiti
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
| | - Hilari French
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
| | - Robert Gilbert
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
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Menzies-Gow NJ, Banse HE, Duff A, Hart N, Ireland JL, Knowles EJ, McFarlane D, Rendle D. BEVA primary care clinical guidelines: Diagnosis and management of equine pituitary pars intermedia dysfunction. Equine Vet J 2024; 56:220-242. [PMID: 37795557 DOI: 10.1111/evj.14009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/19/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Pituitary pars intermedia dysfunction (PPID) is a prevalent, age-related chronic disorder in equids. Diagnosis of PPID can be challenging because of its broad spectrum of clinical presentations and disparate published diagnostic criteria, and there are limited available treatment options. OBJECTIVES To develop evidence-based primary care guidelines for the diagnosis and treatment of equine PPID based on the available literature. STUDY DESIGN Evidence-based clinical guideline using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. METHODS Research questions were proposed by a panel of veterinarians and developed into PICO or another structured format. VetSRev and Veterinary Evidence were searched for evidence summaries, and systematic searches of the NCBI PubMed and CAB Direct databases were conducted using keyword searches in July 2022 and updated in January 2023. The evidence was evaluated using the GRADE framework. RESULTS AND RECOMMENDATIONS The research questions were categorised into four areas: (A) Case selection for diagnostic testing, pre-test probability and diagnostic test accuracy, (B) interpretation of test results, (C) pharmacological treatments and other treatment/management options and (D) monitoring treated cases. Relevant veterinary publications were identified and assessed using the GRADE criteria. The results were developed into recommendations: (A) Case selection for diagnostic testing and diagnostic test accuracy: (i) The prevalence of PPID in equids aged ≥15 years is between 21% and 27%; (ii) hypertrichosis or delayed/incomplete hair coat shedding provides a high index of clinical suspicion for PPID; (iii) the combination of clinical signs and age informs the index of clinical suspicion prior to diagnostic testing; (iv) estimated pre-test probability of PPID should be considered in interpretation of diagnostic test results; (v) pre-test probability of PPID is low in equids aged <10 years; (vi) both pre-test probability of disease and season of testing have strong influence on the ability to diagnose PPID using basal adrenocorticotropic hormone (ACTH) or ACTH after thyrotropin-releasing hormone (TRH) stimulation. The overall diagnostic accuracy of basal ACTH concentrations for diagnosing PPID ranged between 88% and 92% in the autumn and 70% and 86% in the non-autumn, depending on the pre-test probability. Based on a single study, the overall diagnostic accuracy of ACTH concentrations in response to TRH after 30 minutes for diagnosing PPID ranged between 92% and 98% in the autumn and 90% and 94% in the non-autumn, depending on the pre-test probability. Thus, it should be remembered that the risk of a false positive result increases in situations where there is a low pre-test probability, which could mean that treatment is initiated for PPID without checking for a more likely alternative diagnosis. This could compromise horse welfare due to the commencement of lifelong therapy and/or failing to identify and treat an alternative potentially life-threatening condition. (B) Interpretation of diagnostic tests: (i) There is a significant effect of breed on plasma ACTH concentration, particularly in the autumn with markedly higher ACTH concentrations in some but not all 'thrifty' breeds; (ii) basal and/or post-TRH ACTH concentrations may also be affected by latitude/location, diet/feeding, coat colour, critical illness and trailer transport; (iii) mild pain is unlikely to have a large effect on basal ACTH, but caution may be required for more severe pain; (iv) determining diagnostic thresholds that allow for all possible contributory factors is not practical; therefore, the use of equivocal ranges is supported; (v) dynamic insulin testing and TRH stimulation testing may be combined, but TRH stimulation testing should not immediately follow an oral sugar test; (vi) equids with PPID and hyperinsulinaemia appear to be at higher risk of laminitis, but ACTH is not an independent predictor of laminitis risk. (C) Pharmacologic treatments and other treatment/management options: (i) Pergolide improves most clinical signs associated with PPID in the majority of affected animals; (ii) Pergolide treatment lowers basal ACTH concentrations and improves the ACTH response to TRH in many animals, but measures of insulin dysregulation (ID) are not altered in most cases; (iii) chasteberry has no effect on ACTH concentrations and there is no benefit to adding chasteberry to pergolide therapy; (iv) combination of cyproheptadine with pergolide is not superior to pergolide alone; (v) there is no evidence that pergolide has adverse cardiac effects in horses; (vi) Pergolide does not affect insulin sensitivity. (D) Monitoring pergolide-treated cases: (i) Hormone assays provide a crude indication of pituitary control in response to pergolide therapy, however it is unknown whether monitoring of ACTH concentrations and titrating of pergolide doses accordingly is associated with improved endocrinological or clinical outcome; (ii) it is unknown whether monitoring the ACTH response to TRH or clinical signs is associated with an improved outcome; (iii) there is very weak evidence to suggest that increasing pergolide dose in autumn months may be beneficial; (iv) there is little advantage in waiting for more than a month to perform follow-up endocrine testing following initiation of pergolide therapy; there may be merit in performing repeat tests sooner; (v) timing of sampling in relation to pergolide dosing does not confound measurement of ACTH concentration; (vi) there is no evidence that making changes after interpretation of ACTH concentrations measured at certain times of the year is associated with improved outcomes; (vii) evidence is very limited, however, compliance with PPID treatment appears to be poor and it is unclear whether this influences clinical outcome; (viii) evidence is very limited, but horses with clinical signs of PPID are likely to shed more nematode eggs than horses without clinical signs of PPID; it is unclear whether this results in an increased risk of parasitic disease or whether there is a need for more frequent assessment of faecal worm egg counts. MAIN LIMITATIONS Limited relevant publications in the veterinary scientific literature. CONCLUSIONS These findings should be used to inform decision-making in equine primary care practice.
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Affiliation(s)
| | - Heidi E Banse
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Aimi Duff
- Rainbow Equine Hospital, North Yorkshire, UK
| | | | - Joanne L Ireland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Wirral, UK
| | | | - Dianne McFarlane
- College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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De Laat M, Hart K, Menzies-Gow NJ. Clinical insights: Advances in equine endocrinology. Equine Vet J 2024; 56:216-219. [PMID: 38327248 DOI: 10.1111/evj.14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024]
Affiliation(s)
- Melody De Laat
- Earth, Environmental and Biological Sciences School, Science and Engineering Faculty, Gardens Point, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kelsey Hart
- Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Nicola J Menzies-Gow
- Department of Clinical Sciences and Services, Royal Veterinary College, Hertfordshire, UK
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Marr CM. A pyramid needs a foundation: Exploding some myths about what EVJ's editors are looking for from authors? Equine Vet J 2023; 55:931-937. [PMID: 37827177 DOI: 10.1111/evj.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
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Colgate VA, Sepulveda Caviedes MF. World Equine Veterinary Association Congress moves to Chile: A collection of articles for the South American practitioner. Equine Vet J 2023; 55:940-943. [PMID: 37827176 DOI: 10.1111/evj.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 10/14/2023]
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Reed RA, Krikorian AM, Reynolds RM, Holmes BT, Branning MM, Lemons MB, Barletta M, Quandt JE, Burns CC, Dantino SC, Sakai DM. Post-anesthetic CPS and EQUUS-FAP scores in surgical and non-surgical equine patients: an observational study. FRONTIERS IN PAIN RESEARCH 2023; 4:1217034. [PMID: 37502312 PMCID: PMC10369185 DOI: 10.3389/fpain.2023.1217034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
Background Equine pain scoring may be affected by the residual effect of anesthetic drugs. Objectives 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. Study design Clinical observational study. Methods 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 following anesthetic recovery to standing, every hour for 5 h (T1-T5). Data were analyzed using a generalized linear mixed effects model. A post-hoc Dunnett's test for multiple comparisons was performed for variables where an effect was detected. Results Mean (95% confidence interval) CPS scores for T0-T5 were 1.6 (1.2-2.0), 6.8 (6.0-7.6), 5.1 (4.3-5.9), 4.3 (3.4-5.2), 3.7 (2.8-4.6), and 2.8 (2.0-3.6) and EQUUS-FAP scores were 0.6 (0.3-0.9), 3.0 (2.5-3.5), 1.9 (1.6-2.2), 1.1 (0.8-1.4), 0.6 (0.4-0.8), and 0.7 (0.4-1.0), respectively. For the CPS, scores greater than 5, and for the EQUUS-FAP scores greater than 3, are consistent with minor pain. There was no effect of type of procedure (surgical vs non-surgical) on CPS or EQUUS-FAP scores. There was an effect of time with CPS scores significantly greater than baseline at T1-T5 and EQUUS-FAP scores significantly greater than baseline at T1 and T2. Main limitations Discomfort caused by hoisting was not quantified and it was difficult to ascertain if this affected the results. Conclusions Post-anesthetic pain scores may be influenced by the residual effect of anesthetic agents for as long as 5 h and 2 h for the CPS and EQUUS-FAP, respectively.
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Affiliation(s)
- Rachel Anne Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Anna M. Krikorian
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Rose M. Reynolds
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Brittany T. Holmes
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Megan M. Branning
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Margaret B. Lemons
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jane E. Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Charlotte C. Burns
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Stephanie C. Dantino
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Daniel M. Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Bookbinder L, Prisk A. Updates on Diagnosis and Management of Colic in the Field and Criteria for Referral. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00013-5. [PMID: 37121785 DOI: 10.1016/j.cveq.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Gastrointestinal colic is the most common primary care equine emergency and affects nearly one of four horses per year. Colic is a significant welfare concern for equine patients and a financial and emotional burden for owners. The primary care practitioner is instrumental in identifying critical cases quickly and making appropriate management recommendations to improve patient outcomes.
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Affiliation(s)
- Lauren Bookbinder
- Large Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI, USA.
| | - Amanda Prisk
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, USA
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Loomes K, Louro L. Is general anaesthesia avoidable for limb fracture repair in horses? EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Luís Louro
- Veterinary Anaesthesia Consultancy Services Barnsley UK
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Freeman SL. Study design synopsis: Evidence syntheses-What are they and why do we need them? Equine Vet J 2022; 54:1011-1012. [PMID: 36196748 DOI: 10.1111/evj.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Louise Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
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Flood J, Stewart AJ. Non-Steroidal Anti-Inflammatory Drugs and Associated Toxicities in Horses. Animals (Basel) 2022; 12:2939. [PMID: 36359062 PMCID: PMC9655344 DOI: 10.3390/ani12212939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 07/30/2023] Open
Abstract
Effective pain management in horses can be a challenge despite the understanding that appropriate analgesia improves animal welfare and increases treatment success. The administration of NSAID drugs, particularly phenylbutazone and flunixin, are common practice in equine veterinary patients. Known for their analgesic and anti-inflammatory properties, NSAIDs are used for the treatment of a variety of conditions in horses, from gastrointestinal to orthopedic pain. Despite extensive usage, NSAIDs have a narrow margin of safety and the body of literature documenting the efficacy and side effects of different NSAIDs is broad. The three main side effects associated with excessive or prolonged NSAID usage in horses include gastroduodenal ulceration, right dorsal colitis (RDC) and renal papillary necrosis. The use of cyclooxygenase-2 selective NSAIDS, such as firocoxib, are theoretically safer. The aim of this paper is to review the current literature on the use and efficacy of different NSAIDs, summarise the associated side effects of NSAID usage and evaluate the current state of knowledge for the diagnosis and treatment of such toxicities.
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Gibbs R, Duz M, Shipman E. A survey of non‐steroidal anti‐inflammatory drug use in the post‐operative period following equine colic surgery. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rachel Gibbs
- School of Veterinary Medicine and Science University of Nottingham Leicestershire UK
| | - Marco Duz
- School of Veterinary Medicine and Science University of Nottingham Leicestershire UK
| | - Emma Shipman
- School of Veterinary Medicine and Science University of Nottingham Leicestershire UK
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Lemonnier LC, Thorin C, Meurice A, Dubus A, Touzot-Jourde G, Couroucé A, Leroux AA. Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses. Animals (Basel) 2022; 12:ani12040526. [PMID: 35203234 PMCID: PMC8868280 DOI: 10.3390/ani12040526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Pain management following surgical intervention is key. In horses, several anti-inflammatories (flunixin meglumine, meloxicam and ketoprofen) are available for the management of pain following castration. However, their analgesic efficacy remains unclear for mild visceral pain. The aim of this study was to compare the analgesic efficacy of the above-mentioned anti-inflammatory drugs, following a simple surgery (inguinal castration). Horses were administered a randomly assigned anti-inflammatory drug before and after surgery. A pain score was recorded using a previously described pain assessment scale (PASPAS) before administration, and after the first and second administrations by a senior clinician and a veterinary student. Thirty horses were evaluated, and there was no significant effect of the drug administered on the pain score. Horse welfare was not compromised regardless of drug assigned. Horses showed mild pain post-operatively, which decreased significantly within 24 h. Pain scores were significantly different when assessed by a veterinary student and a senior clinician. The authors found that the anti-inflammatory drug studied provided a similar level of analgesia for the management of mild visceral pain in horses, but that the pain scale used is not suitable for junior evaluators or, by extension, owners. Abstract The analgesic efficacy of meloxicam and ketoprofen against equine visceral pain is unclear. The aim of this study was to compare the analgesic efficacy of meloxicam (M) and ketoprofen (K) to flunixin meglumine (F) following inguinal castration. Horses undergoing inguinal castration under general anesthesia were randomly assigned F (1.1 mg/kg), M (0.6 mg/kg) or K (2.2 mg/kg) intravenously two hours pre-operatively and 24 h later. A pain score (out of 31) was recorded blindly by a senior clinician and veterinary student before NSAIDs administration (T0), and after the first (T1) and second (T2) administrations, using a modified post-abdominal surgery pain assessment scale (PASPAS). Pain was classified as mild (score ≤ 7), moderate (score = 8–14) or severe (score > 14). Thirty horses (12 F, 10 M, 8 K) aged 6.2 ± 4.9 years, mostly warmbloods, were included. Horse welfare was not compromised regardless of the drug assigned. There was no statistically significant effect of NSAIDs on pain score. Mean pain scores were significantly higher at T1 than T0 for each NSAID (F: 5.08 ± 2.50 vs. 1.58 ± 1.38 (p < 0.001); M: 4.60 ± 2.32 vs. 1.10 ± 1.20 (p < 0.001); K: 5.25 ± 1.39 vs. 1.50 ± 1.51 (p < 0.0001)) and lower at T2 than T1 for F (2.92 ± 2.423 vs. 5.08 ± 2.50 (p < 0.001)) and M (2.90 ± 1.37 vs. 4.60 ± 2.32 (p < 0.0325)). At T1, senior pain scores were significantly different than for junior (5.56 ± 0.54 vs. 3.22 ± 0.62, p = 0.005). This study indicates that meloxicam and ketoprofen provide a similar level of analgesia to flunixin meglumine for the management of mild visceral pain in horses. PASPAS is not reliable for junior evaluators.
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Affiliation(s)
- Louise C. Lemonnier
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- Correspondence: ; Tel.: +33-(0)2-40-68-76-64
| | - Chantal Thorin
- Nutrition PhysioPathologie et Pharmacologie, University of Nantes, Oniris, F-44000 Nantes, France;
| | - Antoine Meurice
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
| | - Alice Dubus
- Clinique Vétérinaire de Bel Air, Allée Marcel Doret, F-41000 Blois, France;
| | - Gwenola Touzot-Jourde
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- UMR Inserm U1229–Regenerative Medecine and Skeleton, Department of Veterinary Clinical Sciences, University of Nantes, Oniris, F-44000 Nantes, France
| | - Anne Couroucé
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- Biotargen, Normandie University, Unicaen, F-14000 Caen, France
| | - Aurélia A. Leroux
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- l’Institut du Thorax, Université de Nantes, CHU Nantes, CNRS, INSERM, F-44000 Nantes, France
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15
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Kuroda T, Minamijima Y, Nomura M, Yamashita S, Yamada M, Nagata S, Mita H, Tamura N, Fukuda K, Kuwano A, Kusano K, Toutain PL, Sato F. Medication control of flunixin in racing horses: Possible detection times using Monte Carlo simulations. Equine Vet J 2021; 54:979-988. [PMID: 34719043 PMCID: PMC9546317 DOI: 10.1111/evj.13532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/24/2021] [Accepted: 10/16/2021] [Indexed: 12/01/2022]
Abstract
Background For medication control in several jurisdictions, withdrawal time is the period of refrain from racing after drug administration. It is set by adding a safety period to an experimental detection time. However, there are no reports of statistical analyses of detection time for the determination of withdrawal time in flunixin meglumine‐treated horses. Objective To analyse the population pharmacokinetics of flunixin in horses through the generation of a dataset for detection time statistical analysis and predictions via Monte Carlo simulation. Study design Experimental study. Methods Drug plasma and urine concentrations following single intravenous administration of flunixin 1.1 mg/kg bodyweight (BW) in 10 horses and multiple administration of q 24 hours for 5 days in 10 horses were measured using liquid chromatography with tandem mass spectrometry (LC‐MS/MS). Data were modelled using a nonlinear mixed effect model followed by Monte Carlo simulation. Irrelevant plasma concentration (IPC) and irrelevant urine concentration (IUC) were calculated using the Toutain approach. Detection times were obtained considering the time after the last administration for selected quantiles of 5000 hypothetical horses under the international screening limit (ISL) proposed by the International Federation of Horseracing Authorities (plasma: 1 ng/mL, urine; 100 ng/mL). Results For a regimen of 1.1 mg/kg BW q 24 hours, the IPC and IUC values were 2.0 and 73.0 ng/mL respectively. Detection times in plasma above the ISL for 90% of simulated horses were estimated as 74 hours after a single 1.1 mg/kg dose administration, 149 and 199 hours after multiple doses over 5 days at either 24‐ or 12‐hour intervals respectively. Corresponding detection times in urine were 46, 68 and 104 hours respectively. Main limitation Only female horses were investigated. Conclusions Statistical detection times for different flunixin meglumine regimens indicated a delay of detection time in plasma after multiple administrations under ISL.
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Affiliation(s)
- Taisuke Kuroda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
| | - Yohei Minamijima
- Drug Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Japan
| | - Motoi Nomura
- Equine Department Main office, Japan Racing Association, Minato-ku, Japan
| | - Shozo Yamashita
- Drug Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Japan
| | - Masayuki Yamada
- Drug Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Japan
| | - Shunichi Nagata
- Drug Analysis Department, Laboratory of Racing Chemistry, Utsunomiya, Japan
| | - Hiroshi Mita
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
| | - Norihisa Tamura
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
| | - Kentaro Fukuda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
| | - Atsutoshi Kuwano
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
| | - Kanichi Kusano
- Equine Department Main office, Japan Racing Association, Minato-ku, Japan
| | - Pierre-Louis Toutain
- Comparative Biomedical Sciences, The Royal Veterinary College, London, UK.,Intheres, Ecole Nationale Vétérinaire de Toulouse, Toulouse, France
| | - Fumio Sato
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Japan
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16
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Tallon R, McMillan M, Ho N, Dunkel B. Presumed generalised seizure following caudal epidural administration of morphine and detomidine in a pony. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Tallon
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - M. McMillan
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - N. Ho
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - B. Dunkel
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
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17
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Rhodes DM, Madrigal R. Management of Colic in the Field. Vet Clin North Am Equine Pract 2021; 37:421-439. [PMID: 34243880 DOI: 10.1016/j.cveq.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Colic is one of the most frequent emergencies necessitating veterinary attention. Referral is not an option in many cases; therefore, the ability to diagnose and treat colic in an ambulatory setting is paramount. Portable imaging and point-of-care testing has improved the ability to identify lesions and assess the patient's status. In cases when field management is the only option, practitioners should be aware of the various treatment options available.
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Affiliation(s)
- Diane M Rhodes
- Loomis Basin Equine Medical Center, 2973 Penryn Road, Penryn, CA 95603, USA.
| | - Rodolfo Madrigal
- Loomis Basin Equine Medical Center, 2973 Penryn Road, Penryn, CA 95603, USA
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18
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Mackenzie C. Clinical insights: Equine analgesia. Equine Vet J 2021; 53:407-409. [PMID: 33834534 DOI: 10.1111/evj.13421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
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19
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Use of Omics Data in Fracture Prediction; a Scoping and Systematic Review in Horses and Humans. Animals (Basel) 2021; 11:ani11040959. [PMID: 33808497 PMCID: PMC8065418 DOI: 10.3390/ani11040959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Despite many recent advances in imaging and epidemiological data analysis, musculoskeletal injuries continue to be a welfare issue in racehorses. Omics studies describe the study of protein, genetic material (both DNA and RNA, including microRNAs—small non-coding ribonucleic acids) and metabolites that may provide insights into the pathophysiology of disease or opportunities to monitor response to treatment when measured in bodily fluids. As these fields of study are scientifically complex and highly specialised, it is timely to perform a review of the current literature to allow for the design of robust studies that allow for repeatable work. Systematic reviews have been introduced into the medical literature and are a methodological way of searching for relevant papers followed by critical review of the content and a detection of biases. The objectives of the current systematic review were to identify and critically appraise the literature pertaining to microRNA (miRNA) and their target genes that are correlated with stress fractures in racehorses and humans. The object was to define a panel of miRNAs and their target genes as potential biomarkers in either horses or human subjects. The online scientific databases were searched and a reviewed was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MicroRNA profiling studies in horses continue to emerge, but as of yet, no miRNA profile can reliably predict the occurrence of fractures. It is very important that future studies are well designed to mitigate the effects of variation in sample size, exercise and normalisation methods. Abstract Despite many recent advances in imaging and epidemiological data analysis, musculoskeletal injuries continue to be a welfare issue in racehorses. Peptide biomarker studies have failed to consistently predict bone injury. Molecular profiling studies provide an opportunity to study equine musculoskeletal disease. A systematic review of the literature was performed using preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P) guidelines to assess the use of miRNA profiling studies in equine and human musculoskeletal injuries. Data were extracted from 40 papers between 2008 and 2020. Three miRNA studies profiling equine musculoskeletal disease were identified, none of which related to equine stress fractures. Eleven papers studied miRNA profiles in osteoporotic human patients with fractures, but differentially expressed miRNAs were not consistent between studies. MicroRNA target prediction programmes also produced conflicting results between studies. Exercise affected miRNA profiles in both horse and human studies (e.g., miR-21 was upregulated by endurance exercise and miR-125b was downregulated by exercise). MicroRNA profiling studies in horses continue to emerge, but as yet, no miRNA profile can reliably predict the occurrence of fractures. It is very important that future studies are well designed to mitigate the effects of variation in sample size, exercise and normalisation methods.
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21
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Skrzypczak H, Reed R, Barletta M, Quandt J, Sakai D. A retrospective evaluation of the effect of perianesthetic hydromorphone administration on the incidence of postanesthetic signs of colic in horses. Vet Anaesth Analg 2020; 47:757-762. [PMID: 32830037 DOI: 10.1016/j.vaa.2020.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the incidence of postanesthetic signs of colic (PASC) in horses and determine if perianesthetic administration of hydromorphone was associated with an increased risk of PASC. STUDY DESIGN Retrospective, cohort study. ANIMALS A total of 409 horses. METHODS Anesthesia and clinical records of horses admitted for various procedures from July 2018 to September 2019 were reviewed. Signs of colic and interventions were recorded up to 48 hours after anesthesia. A binomial logistic regression model was used to evaluate the association between the type of surgery, administration of hydromorphone, the duration of anesthesia and the incidence of PASC. RESULTS Overall, 25 (6.1%) horses developed PASC within 48 hours of general anesthesia. Of 60 horses that underwent colic surgery, 16 (26.7%) developed PASC. Of 349 horses that underwent noncolic procedures, nine (2.6%) developed PASC. Thus, the incidence of PASC was higher in horses that underwent colic surgery than in horses that underwent noncolic procedures [odds ratio (OR) = 13.74 (5.73-32.95)]. No effect of hydromorphone on the incidence of PASC was identified [OR = 1.61 (0.71-3.62)]. Longer procedures (>2 hours) were identified as an independent risk factor for PASC [OR = 4.13 (1.52-11.22)]. CONCLUSIONS No association between hydromorphone and an increase in the incidence of PASC was identified. Anesthesia for colic surgery and duration of anesthesia were associated with an increased risk of PASC. CLINICAL RELEVANCE Hydromorphone did not increase the incidence of PASC in this population.
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Affiliation(s)
- Heather Skrzypczak
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Rachel Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jane Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Daniel Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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22
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Freeman SL, Ashton NM, Elce YA, Hammond A, Hollis AR, Quinn G. BEVA primary care clinical guidelines: Wound management in the horse. Equine Vet J 2020; 53:18-29. [PMID: 32463930 DOI: 10.1111/evj.13289] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND There are currently no evidence summaries on wounds in the horse. OBJECTIVES To develop evidence-based guidelines on wound management in the horse. STUDY DESIGN Evidence review using the GRADE framework. METHODS Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence. RESULTS AND RECOMMENDATIONS The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13 psi. Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions. MAIN LIMITATIONS Low quality evidence in veterinary literature; majority of recommendations were based on human evidence. CONCLUSIONS These findings should be used to inform decision-making in equine primary care practice.
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Affiliation(s)
- Sarah L Freeman
- University of Nottingham, School of Veterinary Medicine and Science, Loughborough, Leicestershire, UK
| | | | - Yvonne A Elce
- Equine Referral Hospital, Langford Vets, Langford, Bristol, UK
| | - Anna Hammond
- Equine Referral Hospital, Langford Vets, Langford, Bristol, UK
| | - Anna R Hollis
- Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, UK
| | - Greg Quinn
- Waikato Equine Veterinary Centre, Cambridge, New Zealand
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Woodford N. Guide to performing equine castration. IN PRACTICE 2020. [DOI: 10.1136/inp.m1882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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24
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Erratum. Equine Vet J 2020; 52:477. [DOI: 10.1111/evj.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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