Anton Fürst

Bite and kick injuries in horses: Prevalence, risk factors and prevention

REASON FOR PERFORMING STUDY Studies on the prevalence and predisposing factors of bite and kick injuries in horses have not been reported in a population-based data sample. OBJECTIVES To investigate the prevalence of bite and kick injuries in horses and associated risk factors in a representative sample of horses in Switzerland. METHODS A questionnaire on the incidence of disease and injury, which included the frequency of bite and kick injuries and their association with breed, housing, use and feeding regime, was sent to 2559 horse owners randomly selected throughout Switzerland. RESULTS The data of 2912 horses with 897 disorders diagnosed by a veterinarian were analysed. There were 231 injuries, 50 (21.6%) caused by a bite or kick from another horse; this number corresponded to 5.6% of all diseases and injuries and concerned only 1.7% of all the horses evaluated. Warmblood, Thoroughbred and Arabian horses had a 4.3 times higher risk of bite or kick injuries than horses of other breeds. Eighteen per cent of injuries were associated with a change in housing management and occurred regardless of whether horses were kept in groups permanently or sporadically. CONCLUSIONS AND POTENTIAL RELEVANCE A stable group hierarchy and a housing system that provides adequate space and is adapted to horse-specific behaviour are important factors in prevention and kick and bite injuries.

Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy

The objective of the present clinical report was to investigate the short- and long-term outcomes of chronic proximal suspensory desmitis (PSD) treated with Extracorporeal Shockwave Treatment (ESWT). Fifty-two horses with chronic PSD in the forelimb (34 cases) or hindlimb (22 cases) were included in the study. Three horses had lesions in both hindlimbs and one in both forelimbs. The origin of the suspensory ligament was treated every three weeks for a total of three treatments using 2000 impulses applied by a focused ESWT device (Equitron) at an energy flux density of 0.15 mJ/ mm2. This treatment regime was followed by box rest and a controlled exercise program of 12 weeks duration. The horses were assessed 3, 6, 12, 24 weeks and one year after the first treatment. Of the 34 cases with forelimb PSD, 21 (61.8%) had returned to full work by six months after diagnosis and 19 cases (55.9%) were still in full work one year after ESWT. Of the 22 horses with hindlimb PSD, 9 (40.9%) had returned to full work by six months and 4 (18.2%) were still in full work one year after diagnosis. There was no association (chi-square test) between the outcome and the severity of the initial ultrasonographic and/or radiographic findings. Compared with the results of other clinical studies, these findings suggest that in horses with PSD of fore- and hindlimb, the prognosis for returning to full work six months after diagnosis can be improved when ESWT and a controlled exercise program are used. However, a high rate of recurrence occurred in the hindlimb despite treatment.

Surgical management of complete diaphyseal third metacarpal and metatarsal bone fractures: Clinical outcome in 10 mature horses and 11 foals

REASONS FOR PERFORMING STUDY Osteosynthesis of third metacarpal (McIII) and third metatarsal (MtIII) bone fractures in horses is a surgical challenge and complications surrounding the repair are common. Retrospective studies evaluating surgical repair, complications and outcome are necessary to increase knowledge and improve success of long bone fracture repair in the horse. OBJECTIVES To evaluate clinical findings, surgical repair, post operative complications and outcome of 10 mature horses and 11 foals with McIII or MtIII fractures that were treated with open reduction and internal fixation (ORIF). METHODS Medical records were reviewed and follow-up information obtained by means of radiographs and/or telephone questionnaire. RESULTS Survival was achieved in 62% of the horses (3 mature/10 foals). On long-term evaluation (> 6 months) 11 horses (2 mature/9 foals) were fit for their intended activity, one mature horse had a chronic low grade lameness, and one foal was lost to follow-up because it was sold. The main fracture types were simple transverse (333%) or simple oblique (28.6%) and 71.4% of the fractures were open, 3 Type I (one mature/2 foals) and 12 type II (7 mature/5 foals). The preoperative assessment revealed inadequate emergency treatment in 10 horses (5 mature/5 foals; 47.6%). Survival rate of horses with open fractures was 12.5% (1/8) in mature and 85.7% (6/7) in foals. Post operative incisional infection (4 mature, 3 foals) was only managed successfully in 2 foals. Fracture instability related to inadequate fracture fixation technique occurred in 4 horses (all mature) and was always associated with unsuccessful outcome. CONCLUSIONS Age, bodyweight and infection are strongly associated with outcome in treatment of complete McIII/MtIII fractures. CLINICAL RELEVANCE Rigid fixation using plates and screws can be successful in treatment of closed or open, complete diaphyseal McIII/MtIII fractures in mature horses and foals. Instable fixation, infection and a bodyweight > 320 kg are major risk factors for unsuccessful outcome.

Evaluation of a Motorized Morcellator for Laparoscopic Removal of Granulosa‐Theca Cell Tumors in Standing Mares

OBJECTIVE To describe a motorized morcellator technique for laparoscopic removal of granulosa-theca cell tumors (GCT) in standing mares and to evaluate long-term outcome. STUDY DESIGN Case series. ANIMALS Mares (n=7) aged 4-15 years, with unilateral GCT. METHODS Tumor size was determined by transrectal palpation and ultrasonography. Standing sedated mares had 3 laparoscopic portal sites in the paralumbar fossa. After laparoscopic observation of the GCT, the mesovarium was desensitized, the ovarian pedicle transected with a LigaSure device, and the ovary grasped with forceps and cut in cylindrical tissue blocks using a motorized morcellator. Tissue blocks were removed through the laparoscopic sleeve. Outcome was determined by telephone interview of owners 6-40 months after surgery. RESULTS Estimated ultrasonographic median GCT diameter was 17 cm (range, 10-22 cm). Surgical time was 2-4.5 hours. There were no surgical complications. Two mares had mild subcutaneous emphysema at the portals after surgery. Convalescence was short, owners were satisfied with cosmetic outcome, and clinical signs associated with GCT did not recur. CONCLUSION The motorized morcellator allows piecemeal removal of large GCT through a relatively small laparoscopic portal. Surgical complications were rare and the cosmetic outcome is favorable. CLINICAL RELEVANCE A motorized morcellator is a safe and minimally invasive technique for laparoscopic removal of GCT in mares.

Effect of age on bone mineral density and micro architecture in the radius and tibia of horses: an Xtreme computed tomographic study.

BackgroundThe effect of age on the bone mineral density and microarchitecture of the equine radius and tibia was investigated. Fifty-six bones from 15 horses aged four to 21 years were used. There were nine geldings and six mares, and none of the horses had any disease influencing bone properties. Xtreme computed tomography was used to evaluate a 9-mm segment of the diaphysis and metaphysis of each bone. The following variables were determined: length of the bone, circumference and diameter in the frontal and sagittal planes in the middle of the bone.Diaphysis: total volume, bone volume, bone volume ratio, slice area, bone area, marrow area, cortical and marrow thickness, bone mineral density, polar moment of inertia of the cortex.Metaphysis: total area, bone area, cortical bone area, cortical thickness, bone mineral density, bone mineral density in the cortex, bone mineral density in the trabecular region, trabecular number, trabecular thickness, trabecular separation, polar moment of inertia of the metaphysis, polar moment of inertia of the cortex of the metaphysis.ResultsBone density and microarchitecture were not affected by breed or gender. However, the microarchitecture varied with the age of the horse; the number of trabeculae decreased significantly and the distance between trabeculae increased significantly with increasing age. There were no significant differences between bones of the left and right limbs or between the radius and tibia.ConclusionThe variables investigated did not differ between geldings and mares. However, there were age-related changes in the microstructure of the bones. Further experimental studies are necessary to determine whether these changes reduce bone strength. Age-related changes in the bones were seen and may explain the higher incidence of fractures and fissures in older horses.

Schlagverletzungen an Tierärzten während der Untersuchung und Behandlung von Pferden: Eine retrospektive Studie in der Schweiz

The risk of injury to veterinarians treating horses is high, particularly when performing painful procedures. The present retrospective study investigated this risk, including the frequency and severity of kick injuries, by submitting questionnaires to 700 veterinary practitioners in Switzerland. Evaluation of 216 completed questionnaires revealed that the frequency of kick injuries was affected by the professional experience of the veterinarian, veterinarians being an owner of a horse, the season, the type of procedure, the percentage of equine patients in the practice population, the treatment location (stall, pasture) and chemical restraint of the patient. Severe injuries incurred by veterinarians in recent years were few in number and the result of a number of unfortunate circumstances, which included hurried procedures due to time restraints and unforeseen events that frightened the patient. The risk factors derived from the full statistical model are the percentage of equine patients in the practice population, the treatment location, the type of procedure and chemical restraint of the patient. Using this information, it should be feasible to reduce the risk of injuries. Sedation of horses undergoing painful procedures, choosing a safe treatment location and caution on the part of the veterinarian are advised to reduce the number of injuries.

Results and complications of a novel technique for primary castration with an inguinal approach in horses

REASONS FOR PERFORMING STUDY Complications associated with equine castration can have medical and financial consequences. This retrospective study investigated a novel method of castration via an inguinal approach in mature stallions and compared the incidence of complications with other methods. HYPOTHESIS Castration via an inguinal approach has a low complication rate at the site of surgery compared with other castration techniques. METHODS Mature stallions (n = 238) were castrated under general anaesthesia in dorsal recumbency using an inguinal approach. The vaginal process was incised, the spermatic cord ligated twice and the testis removed. After suturing, the vaginal process and one or 2 layers of fascia, the subcutis and cutis were closed in a simple continuous pattern. RESULTS Five of 238 (2.1%) horses had post operative haemorrhage and a haematoma in the scrotal region, which required additional treatment. All horses made a full recovery. Five of 238 (2.1%) of the horses had a post operative respiratory infection, which resolved with antibiotic therapy. Sixteen of 238 (8.8%) had transient signs of colic shortly after surgery. CONCLUSION This technique of castration with an inguinal approach had a low incidence of complications at the site of surgery compared with other methods. An inguinal approach and leaving the vaginal tunic in situ may cause less soft tissue trauma than a scrotal approach.

Computed tomographic features of apical infection of equine maxillary cheek teeth: A retrospective study of 49 horses

REASONS FOR PERFORMING STUDY Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. OBJECTIVES To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. STUDY DESIGN Retrospective case-control study. METHODS Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. RESULTS Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. CONCLUSIONS Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality.

Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing

OBJECTIVE To describe short incomplete sagittal fractures of the proximal phalanx (type Ia P1 fractures) in horses not used for racing and report outcome. STUDY DESIGN Retrospective study. ANIMALS Horses (n=10) with type Ia P1 fractures. METHODS Retrieved data of horses with type Ia P1 fractures were signalment, history and results of orthopedic examination. Radiographs were re-evaluated for position and length of the fracture line, presence of osteoarthritis or subchondral cystic lesions (SCL), periosteal new bone formation and subchondral sclerosis. Conservative treatment (n=4) included box confinement for 2 months followed by 1 month of hand walking. Surgical therapy (n=6) consisted of internal fixation by screws inserted in lag fashion in 5 horses. Concurrent SCL were debrided by curettage via a transcortical drilling approach. In 1 horse, only SCL curettage but not internal fixation was performed. Outcome was assessed on a clinical and radiographic follow-up examination in all horses. RESULTS Mean follow-up time was 27 months (median, 13.5 months; range, 9 months to 9 years). All horses treated with internal fixation were sound at follow-up and had radiographic fracture healing. Of the 4 horses managed conservatively, 3 remained lame and only 1 horse had radiographic evidence of fracture healing. Catastrophic fracture propagation occurred in 2 horses not treated by internal fixation, 20 and 30 months after diagnosis, respectively. CONCLUSIONS Horses with a type Ia P1 fracture treated surgically had a better outcome than those managed conservatively and lack of fracture healing seemingly increases the risk of later catastrophic fracture. CLINICAL RELEVANCE Surgical repair of type Ia P1 fractures should be considered to optimize healing and return to athletic use.

Group housing of horses: veterinary considerations with a focus on the prevention of bite and kick injuries

Although group housing of horses has become common practice, the risk of equine injury is substantial. The veterinary community is challenged to reduce this risk, particularly with regard to injuries caused by kicking and biting. Preventive measures should focus on the disposition of horses within the group, the introduction of new horses to the group and the design of the housing facility. Feeding methods as well as the structure of the environment should meet the physiological requirements for horses; there should be adequate space for exercise, extended foraging and the possibility of benign social interactions. Veterinarians need to educate horse owners and builders of equine facilities about the husbandry, feeding, use, behaviour and health of horses.