C. M. Marr

What is the likelihood that Thoroughbred foals treated for septic arthritis will race

REASONS FOR PERFORMING STUDYnSeptic arthritis is a serious problem in the neonate, with a poor prognosis being reported for recovery. The impact of neonatal septic arthritis on the likelihood that Thoroughbred (TB) foals will start on a racecourse is not known.nnnHYPOTHESISnThe development of septic arthritis in a TB foal significantly reduces the likelihood that it will race when compared to foals from the same dam.nnnMETHODSnMedical records of 69 foals treated for septic arthritis were reviewed. The dams foaling records were reviewed and lifetime racing records were then retrieved for both the affected foals and at least one of their siblings (controls). Outcomes that were statistically evaluated included discharge from the hospital and whether the foal eventually raced. Univariate analyses of categorical variables were conducted for each outcome. The number of affected and unaffected foals that raced at least once were compared using regression analysis. Survival analysis was used to compare age at first race between the study and comparison groups.nnnRESULTSnFoals with septic arthritis were less likely to start on a racecourse compared to controls (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.12-0.62, P = 0.001), while those foals that were discharged from the hospital were also less likely to start on a racecourse compared to controls (OR 036; CI 0.15-0.83, P = 0.008). The presence of multisystem disease was associated with a decreased likelihood of surviving to be discharged (OR 0.13; 95% CI 0.02-0.90; P = 0.005), but did not affect the likelihood that they would start in at least one race if discharged successfully (OR 0.45; 95% CI 0.04-2.81; P = 0.34) compared to the other foals with septic arthritis. Log-rank comparison of survival curves confirmed that foals discharged following treatment for septic arthritis took significantly longer to start in their first race compared to the sibling population (mean age of study group 1757 days, CI 1604-1909; mean age of sibling group 1273 days, CI 1197-1349; P = 0.0006).nnnCONCLUSIONSnThe development of septic arthritis in a TB foal significantly reduces the likelihood that it will start on a racecourse when compared to controls.nnnPOTENTIAL RELEVANCEnAccurate figures allowing a realistic assessment of the athletic future of a foal following treatment for septic arthritis are of significance for both owner and treating veterinarian.

Repeatability of diagnostic ultrasonography in the assessment of the equine superficial digital flexor tendon

A quantitative investigation of the variation that can occur during the course of ultrasonography of the equine superficial digital flexor tendons (SDFT) was undertaken. The aim of this investigation was to use an objective measure, namely the measurement of CSA, to quantify the variability occurring during the course of the ultrasonographic assessment of the equine SDFT. The effects of 3 variables on the CSA measurements were determined. 1) Image acquisition operator (IAc): two different operators undertaking the ultrasonographic examination; 2) image analysis operator (IAn): two different operators undertaking the calculation of CSA values from previously stored images; and 3) analytical equipment (used during CSA measurement) (IEq): the use of 2 different sets of equipment during calculation of CSA values. Tendon cross-sectional area (CSA) measurements were used as the comparative variable of 3 potential sources: interoperator, during image acquisition; interoperator, during CSA measurement; and intraoperator, when using different analytical equipment. Two operators obtained transverse ultrasonographic images from the forelimb SDFTs of 16 National Hunt (NH) Thoroughbred (TB) racehorses, each undertaking analysis of their own and the other operators images. One operator undertook analysis of their images using 2 sets of equipment. There was no statistically significant difference in the results obtained when different operators undertook image acquisition (P>0.05). At all but the most distal level, there was no significant difference when different equipment was used during analysis (P>0.05). A significant difference (P<0.01) was reported when different operators undertook image analysis, one operator consistently returning larger measurements. Different operators undertaking different stages of an examination can result in significant variability. To reduce confounding during ultrasonographic investigations involving multiple persons, one operator should undertake image analysis, although different operators may undertake image acquisition.

Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk?

REASONS FOR PERFORMING STUDYnPost operative complications following exploratory laparotomy can be potentially life-threatening, increase post operative morbidity and result in an increase in the length of hospitalisation of the affected individual. No study has evaluated the efficacy of specific strategies to reduce the incidence of post operative incisional complications.nnnHYPOTHESISnThe use of an abdominal bandage following colic surgery through a celiotomy incision would significantly reduce the prevalence of post operative incisional complications.nnnMETHODSnA controlled, randomised clinical trial to test the hypothesis was devised. Horses eligible for inclusion in the study were assigned randomly either to the study or control group following recovery from general anaesthesia. Any post operative incisional complications occurring during hospitalisation were recorded. Long-term follow-up was obtained via telephone questionnaires. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. Multivariable analyses were conducted for all outcomes of interest.nnnRESULTSnThere was an ARR of the likelihood of developing a post operative incisional complication of 45% when using compared to not using an abdominal bandage in the post operative period. Therefore, it would be necessary to treat 2.2 horses with an abdominal bandage in order to prevent one horse developing any post operative incisional complications.nnnCONCLUSIONSnAlthough incisional complications continue to be a problem following an exploratory celiotomy for colic, the proportion of horses affected was significantly reduced by use of a bandage.nnnPOTENTIAL RELEVANCEnUsing an abdominal bandage following an exploratory laparotomy may help reduce the prevalence of post operative incisional complications, and prevent the development of potentially life-threatening complications.

What is the likelihood that a horse treated for septic digital tenosynovitis will return to its previous level of athletic function

REASONS FOR PERFORMING STUDYnSeptic digital tenosynovitis is a serious problem in the horse, with a poor prognosis being reported for recovery.nnnHYPOTHESISnThe occurrence of septic digital tenosynovitis would significantly reduce the likelihood of a horse returning to its previous level of athletic function.nnnMETHODSnMedical records of 90 horses treated for septic digital tenosynovitis were reviewed. Data retrieved included age, sex, location of inciting cause of sepsis, time from onset of clinical signs to presentation for treatment, and whether the horse survived to be discharged. Long-term outcome was determined through telephone questionnaires. Univariate analyses of categorical variables were conducted for each outcome.nnnRESULTSnOverall, 87.8% of horses (79/90) survived to be discharged from the hospital. Only one factor examined was shown to have a significant effect on outcome. A delay of 1-7 days between onset of clinical signs and presentation for treatment reduced significantly the likelihood of the horse surviving to be discharged from the hospital. Of the horses discharged from the hospital, long-term follow-up was available for 72 horses, with 54.2% (39/72) returning to their previous level of athletic function.nnnCONCLUSIONSnOnly approximately 50% of horses treated for septic digital tenosynovitis returned to their previous level of athletic function following resolution of synovial sepsis.nnnPOTENTIAL RELEVANCEnAccurate figures allowing a realistic assessment of the athletic future of a horse following treatment for septic digital tenosynovitis are of value to both the owner and treating veterinarian.

The effect of mare obesity and endocrine function on foal birthweight in Thoroughbreds

BACKGROUNDnBirthweight of Thoroughbred foals has increased in recent years. It is unknown whether this is associated with increased broodmare obesity or endocrine dysfunction.nnnOBJECTIVESnTo determine insulin, leptin and triglyceride concentrations in Thoroughbred mares throughout gestation and investigate their association with obesity and foal birthweight.nnnSTUDY DESIGNnCohort study.nnnMETHODSnA total of 66 mares were included from 40 days post-breeding. Body condition score (BCS), weight and blood samples were obtained every 60 days throughout gestation. Serum/plasma insulin, leptin and triglyceride concentrations and foal birthweight were recorded. Associations between hormone/triglyceride concentration with BCS, stage of gestation and birthweight were analysed using a linear mixed effects model.nnnRESULTSnSerum insulin concentrations were greater at 1-60 days (4.31 μiu/mL) compared with 241-300 days (3.13 μiu/mL) and 61-120 days (5.33 μiu/mL) compared with 181-240, 241-300 and 301-360 days (3.78, 3.13, 3.37 μiu/mL) gestation (P<0.05). There was no significant hyperinsulinaemia and no association of insulin concentration with BCS. Leptin concentration was greater at 181-240 days (2.28 μg/L, P<0.0001) compared with all other time points and correlated with BCS (P<0.0003). Triglyceride concentration was greater at 241-300 days (0.245 mmol, P<0.02) compared with earlier time points, but was not associated with BCS. Foal birthweight was weakly positively correlated with BCS (r = 0.13, P<0.001) and inversely correlated with leptin concentrations at 61-120 and 241-300 days gestation (r = -0.64, P<0.05).nnnMAIN LIMITATIONSnReduction in sample size over the study and tight clustering of BCS.nnnCONCLUSIONSnMare BCS correlated with foal birthweight; obese mares had heavier foals. Significant hyperinsulinaemia was not identified in this population. Increased leptin concentration in early and late gestation was associated with decreased foal birthweight. Further work is required to establish whether leptin concentration in late gestation could predict foal birthweight.