The management of equine acute laminitis

Radiographic assessment of normal parameters of forelimb distal phalanx in Turkmen horses

The Turkmen horse is one of the oldest breeds in the world with unique characteristics in agility, endurance and jump, being publicly acclaimed. Laminitis affects the limbs and decreases athletic performance. Radiographic evaluation is essential to confirm the sinking diagnosis in every breed of a horse suffering from laminitis. Since no information about distal phalanx radiographic measurements in this breed has been reported, the current study was designed and conducted. In the present study, 24 clinically sound registered Turkmen horses of both sexes (15 mares and nine stallions) were selected. Lateromedial radiographic views of both front distal phalanges were taken, focusing on the distal phalanx. After magnification correction, images were used to measure founder distances (FD) and other distal phalanx radiographic measurements using an image processing program. There was no significant difference between radiographic measurements of the left and right front feet. The FD had a significant positive correlation with weight. The horses under 3 years of age had a significantly greater U angle than the horses over the age of three. Also, palmarocortical length (PCL) in the Turkmen stallions was significantly higher than mares. In this investigation, PCL in horses under the age of three was significantly lower than horses over 3 years of age. The values determined in this study can be used as baseline data of front feet in Turkmen horses.

Topical Dimethyl Sulfoxide for Congested Nipple-areolar Complexes in Breast Surgery: A Pilot Study

Necrosis of the nipple-areolar complex (NAC) is a major complication of breast surgery that most commonly results from venous congestion. Several conservative rescue therapies have been proposed for relieving NAC congestion, but each carries certain drawbacks, including cost and side effect profile. In this study, we evaluated the effectiveness of topical dimethyl sulfoxide (DMSO), an inexpensive compound with vasodilatory, free radical scavenging, and antiinflammatory properties in rescuing congested NACs.

METHODS

We conducted a review of all 15 patients treated with DMSO for NAC congestion at our institution between May 2019 and October 2020. DMSO was applied in liquid form on a soaked gauze pad in the hospital; patients were instructed to apply a DMSO cream to the NAC twice a day following discharge. Patient characteristics and data related to DMSO treatment and NAC healing were compared via univariate analysis.

RESULTS

Eighteen congested NACs from 15 patients who underwent mastectomy, breast reduction, mastopexy, or breast reconstruction were treated with DMSO. Of the 18 treated NACs, 15 healed with DMSO treatment alone. The average length of DMSO treatment was 9.4 ± 8.5 days (mean ± standard deviation); NAC healing took place over 9.9 ± 9.6 days. There were no complications related to DMSO treatment.

CONCLUSIONS

This pilot study shows that DMSO may be an effective topical treatment for NAC congestion following breast surgery. Given its low cost, ease of application, and lack of side effects, future studies should prospectively compare DMSO against other topical treatments, like nitroglycerin ointment.

Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Background

Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined.

Objectives

To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis.

Animals

Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion).

Methods

This prospective cohort study collected data on veterinary‐diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non‐endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow‐up data were collected at regular intervals to determine whether the laminitis recurred in the 2‐year period after diagnosis.

Results

The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2‐year study period increased with basal, fasted serum insulin concentration (P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0‐20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely (P = .05) to recur sooner.

Conclusions and clinical importance

Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.

Comparison of first and second acupuncture treatments in horses with chronic laminitis

BACKGROUND

Laminitis is a common but critical disease that causes severe pain and disability in horses. The etiology and pathogenesis of laminitis remain inconclusive and a multimodal therapeutic approach is generally indicated. Acupuncture has been used as a treatment option; however, the required number of treatments is still controversial due to the lack of objective scientific evidence.

AIMS

The objective of this study was to determine if the response to a second acupuncture treatment differed from the response to the first acupuncture treatment in horses with chronic laminitis.

METHODS

Fourteen horses with chronic laminitis were identified. Acupuncture points were determined based on the results of a diagnostic acupuncture palpation examination. The second acupuncture treatment and lameness examination were conducted one week after the first treatment. Ten minutes after each acupuncture treatment, a lameness examination was performed and included an objective examination using a body-mounted inertial sensor system called "Lameness Locator" and a routine lameness examination following the "American Association of Equine Practitioners" (AAEP) lameness scale. The level of lameness was statistically analyzed using paired t-test and Wilcoxon signed rank test with p-values <0.05 considered significant.

RESULTS

Both objective (P=0.042) and routine lameness examinations (P=0.027) showed that the level of lameness significantly decreased after the second acupuncture treatment compared to the response to the first treatment.

CONCLUSION

The results of this study suggest that continued acupuncture treatments will result in increasing levels of pain relief, showing the advantage of performing more than one acupuncture treatment in horses with chronic laminitis.