Management and treatment of the recumbent horse

Neurological Examination of Horses

The neurological examination is undertaken to determine whether any deficit is due to a lesion in the nervous system and, if so, where within the nervous system any possible lesion or lesions are located. The examination of horses has challenges not encountered when doing the equivalent examination in dogs and cats, principally that spinal reflexes and postural reactions are impossible/difficult to assess in most animals. The anatomy book can be consulted later but at the end of the neurological examination the clinician then should be able to determine broadly which area of the neuromuscular systems is affected.

Postpartum Polyneuropathy in a Mare: A Case Report

Obstetric paralysis is a generic term used to describe postpartum locomotor alterations resulting from nerve damage, widely reported in cattle, but rare in equines. The aim of this study is to report a case of a peripheral polyneuropathy in a primiparous mare, 3 years old, of Mangalarga Marchador breed, after a dystocia lasting approximately 12 hours. At the time of delivery, the head of the fetus was exposed in the vulva and there was flexion of the thoracic limbs. These events culminated in a framework of extreme abduction of the pelvic limbs, thus generating functional impotence and leading the animal to adopt a frog anddecubitus position. After three days of treatment with no improvement in the clinical framework, the animal was euthanized. In the postmortem examination, perineural hemorrhagic lesions were observed in the obturator and sciatic nerves, characterizing the diagnosis of obstetric paralysis. It is possible the outcome of the case would have been satisfactory if there had been an early fetotomy or postpartum treatment had been more prolonged; however, these measures depend on the availability of equipment, conditions of care, and consideration of the owner.

Factors associated with survival in 148 recumbent horses

REASONS FOR PERFORMING STUDY

There are currently few data available on the prognosis and outcome of recumbent horses.

OBJECTIVES

To investigate the outcome of hospitalised horses that had been recumbent in the field or hospital and factors affecting their survival within the first 3 days of hospitalisation and survival after 3 days to hospital discharge.

STUDY DESIGN

Retrospective analysis of clinical records.

METHODS

Records of 148 horses admitted to the William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis from January 1995 to December 2010 with a history of recumbency or horses that became recumbent while hospitalised were evaluated. Exact logistic regression was used to assess the association between clinical parameters and survival within the first 3 days of hospitalisation and survival to hospital discharge after 3 days.

RESULTS

There were 109 nonsurvivors and 39 survivors. Multivariate analysis showed variables associated with an increased odds of death within the first 3 days of hospitalisation included duration of clinical signs prior to presentation, with horses showing clinical signs for over 24 h having increased odds of death (P = 0.043, odds ratio [OR] 4.16, 95% confidence interval [95% CI] 1.04-16.59), the presence of band neutrophils (P = 0.02, OR 7.94, 95% CI 1.39-45.46), the horse not using the sling (P = 0.031, OR 4.22, 95% confidence interval 1.14-15.68) and horses that were unable to stand after treatment (P<0.0001, OR 231.15, 95% CI 22.82-2341.33). Increasing cost was associated with lower odds of death (P = 0.017, OR 0.96, for each additional $100 billed, 95% CI 0.93-0.99).

CONCLUSIONS

This study demonstrates that the duration of clinical signs, response to treatment and the ability of horses to use a sling are associated with survival to hospital discharge for recumbent horses.