A 17-year-old Quarter Horse broodmare was taken to surgery for signs of colic unresponsive to medical management. The small colon was strangulated by a pendulous ovarian pedicle. The strangulation was freed, and the affected ovary was removed. The mare developed signs of a small colon obstruction 4 days after surgery. The mare was euthanized 6 days after surgery for signs of a GI rupture. A post-mortem examination revealed necrosis of the affected portion of small colon.

An 8-year-old Thoroughbred gelding presented for evaluation and investigation for recurrent unilateral epistaxis. Computer tomography (CT) confirmed the presence of an invasive and expansive progressive ethmoid hematoma (PEH) located in the right paranasal sinuses. The mass invaded the right paranasal sinuses compartments causing moderate leftward displacement of the nasal septum with subsequent collapse of the left nasal passages, complete obliteration of the right ethmoid turbinate, right infraorbital canal, and nasolacrimal duct. Also, impingement of the axial margin of the right orbit. A large frontonasal maxillary bone flap was performed standing under sedation and local anesthesia and the PEH was removed successfully with minimal surgical complications. The gelding made an unremarkable recovery from surgery and progressed well after recovering from post operative pleuropneumonia. Follow-up (25 months post operative) confirmed the reoccurrence of the PEH, but the horse remained healthy in pasture turn out.

Background: Colic is the commonest emergency in first opinion equine practice. Early referral is important for horses requiring surgery. Fast localised abdominal ultrasonography of horses (FLASH) is frequently used as a diagnostic tool in the investigation of colic at referral hospitals, but its use in first opinion practice has not been evaluated. Objective: To assess the value of FLASH scanning in the primary assessment of horses with colic in the field, using a portable wireless ultrasound system. Study design: Prospective study (2018-2021). Methods: Any horse examined for colic as an emergency in a first opinion ambulatory practice was eligible for inclusion in the study. A FLASH examination was performed using a wireless handheld ultrasound scanner, with the images displayed on a smartphone or tablet. The findings on FLASH scans and outcome of the case (recovered, referred for surgery or euthanised without referral) were recorded. Results: 135 equids with acute colic were evaluated. Of the 135 horses, 49 (36%) had an abnormal finding on FLASH scanning, including distended loops of small intestine (n=34), thickened small intestinal walls (n=23) and/or distension of the stomach (n=7). Reduced small intestinal motility was recorded in 52 animals (38%). Follow-up information was available in all animals: 50 (37%) were euthanised due to clinical deterioration and the owners’ decision not to undertake surgery; 85/135 (63%) survived, including 5/85 (6%) that underwent surgery and 80/85 (94%) that resolved with medical management. Main limitations: Small number of cases. Lack of results of post-mortem examination of horses that were euthanised. Potential selection bias. Conclusion: The FLASH technique can be valuable in the primary assessment of horses with colic in first opinion ambulatory practice. Further evaluation with more cases is required.

Laminitis associated with hyperinsulinemia a significant cause of morbidity and mortality in horses with equine metabolic syndrome. The diagnosis and management of insulin dysregulation are therefore critical to prevent the development of hyperinsulinemia-associated laminitis. This review article aims to help primary care clinicians manage patients with insulin dysregulation by providing an overview of diagnostics, management strategies and new therapies that are available.

Background: The conjunctiva of the eye is a mucosal surface that is colonized by various bacteria. Following surgeries, trauma, or other underlying conditions the normal flora of these bacteria may cause some eye infections such as conjunctival, corneal infections, or endophthalmitis. Objectives: This study aimed to investigate the bacterial population and antibiotic resistance of the conjunctiva in healthy horses. Study design: Random sampling of ocular samples from 20 horse during the winter (2019). Methods: Swab samples were collected from the eyes of 20 healthy horses of different breeds, ages, and sexes in Tehran province, Iran. The swabs were cultured on blood agar and MacConkey agar and incubated at 37°C for 24-48 hours. The isolated bacteria were characterized using cellular morphology, gram-staining, and biochemical tests. Sensitivity and resistance to 10 different antibiotics were measured using an antibiogram test. Results: Results showed that the bacterial population consisted of various species, with Bacillus cereus being the most frequent. There were no significant differences in the frequency of isolated bacteria between sexes and age groups. There were no significant differences in the sensitivity of bacterial flora of the eyes to Colistin, ceftiofur, florfenicol, amoxicillin, and ampicillin between neither different age groups nor different sexes of the horses (P>0.05). However, sensitivity to enrofloxacin and ciprofloxacin was significantly correlated with the age groups of the horses (P>0.05). Significant difference in sensitivity to trimethoprim-sulfamethoxazole between various sexes of horses was observed. Main limitations: The non-uniformity of the follow-up examination reliance owners or caregiver of the horse for follow-up information and Lack of adequate financial resources to study more horses. Conclusions: The study suggests that the frequency of bacterial flora in horses’ eyes is influenced by housing and management conditions rather than age and sex. Keywords: Microbial flora, Conjunctiva, Eyes, Horse, Mucosal surface.

The inclusion of thoracolumbar radiographs in a pre-purchase examination (PPE) is a topic of current and intense debate, subsequent to a statement from the Federation of European Equine Veterinary Associations (FEEVA) advocating the exclusion of spinous process radiography from the PPE. This review will consider the reasons behind the addition of such radiographs into PPEs, the limitations of radiography in ambulatory practice and therefore the diagnostic limitations to the practitioner, the diagnostic benefit of a complete radiographic examination, and discussion of common and less-frequent thoracolumbar pathologies. We will focus on laterolateral radiographs of the spinous processes as these are most commonly acquired during the PPE. The lack of consistent and repeatable grading systems highlights the subjective nature and variability in assessing this region radiographically. Coupled with the sparse evidence of correlation between clinical symptoms and radiographic abnormalities of the thoracolumbar spine leads us to conclude that taking radiographs of the back during PPEs should not be performed unless the clinical examination indicates otherwise.

This report describes the successful treatment of a cutaneous hemangiosarcoma of a 12 years old horse presented for evaluation of a cutaneous mass on the left gluteal region. Hemangiosarcoma is a rare life-threatening neoplasia that can be successfully managed when diagnosed and treated at early stages. Unfortunately, they are often diagnosed at later stages, leading to a poor outcome and low survival rates. In this report, the horse has been treated with a complete large surgical excision of the neoplastic tissue. A good cosmetic outcome as well as a short recovery time has been achieved with an autologous skin grafting split thickness modified meek technique. A long-term follow-up of the patient showed no reoccurrence of the hemangiosarcoma, and successful return to athletic performance. In the authors knowledge, this is the first equine primary cutaneous hemangiosarcoma treated with complete excision and subsequently autologous skin grafting with a long-term follow-up and good outcome despite the poor prognosis.

Whilst there are limited data on the environmental impact of administering parasiticide drugs to horses, evidence from other species treated with identical drugs indicates significant negative ecological effects. Anthelmintic drugs may be excreted unchanged or metabolised to other active and/or toxic metabolites that enter the environment through direct excretion during grazing. These chemicals can have significant toxic effects on non-target insects, such as dung beetles, earthworms and aquatic animals. Of the anthelmintics frequently used in horses, ivermectin appears to be the most ecotoxic; available evidence indicates that moxidectin is less toxic. Fenbendazole appears to have little impact on dung-colonising insects but may be toxic to aquatic organisms and fungi. There is very little data regarding the ecotoxicity of pyrantel and praziquantel, although their ecotoxic effects are thought to be low. Pasture hygiene reduces pharmaceutical contamination and also helps to break the endoparasitic cycle of infectivity, thus reducing reliance on anthelmintics. Judicious use of endoparasiticides, along with pasture hygiene measures, will limit the ecotoxic effects of these drugs and reduce the selection pressure that drives anthelmintic resistance. Anthelmintics may also impact the equine gastrointestinal microbiota.Following topical treatment with ectoparasiticides (such as fipronil, permethrin or cypermethrin), there is a risk of contamination of both the immediate environment and water courses. The half-life of fipronil in the environment is variable, but it degrades into compounds which are more toxic; it is highly toxic to bees, and is reported to bioaccumulate in fish and can be toxic to birds. Of the synthetic pyrethroids, permethrin degrades at a faster rate than cypermethrin and may therefore have a lower ecotoxic effect. The ecotoxic effects of injectable doramectin are likely to be similar to oral ivermectin, although persistence in faeces may be significantly prolonged compared to the oral treatment route.

This case report describes successful conservative management of a comminuted fracture of the atlas. To the authors knowledge, fracture of the atlas in the horse and intrathecal corticosteroid injection in the standing sedated patient has not been previously reported. Clinical signs included acute onset ataxia, proprioceptive deficits and neck stiffness; which developed immediately post trauma during assisted recovery from general anaesthesia. Radiographic examination was not diagnostic immediately post trauma and computed tomographic (CT) imaging subsequently identified a fracture of the atlas. Treatment included ultrasound guided intrathecal medication of the cerebrospinal fluid and intra-articular medication of the atlantooccipital joint under standing sedation. Medication resulted in a marked improvement in clinical signs (grade 4 ataxia to grade 1 ataxia).

Introduction: A closed inguinal castration technique was compared with field castrations based on the post-operative (p.o.) inflammatory marker Serum Amyloid A (SAA). Third day p.o. SAA, which has been related to trauma, has been reported after field castrations in four different studies in literature between 500 mg/l and 700 mg/l. These values were compared with SAA values measured on day three after routine castration using a closed inguinal approach applied under general anaesthesia under strict aseptic conditions. Materials and Methods: 51 Male horses were presented for routine castration. Serum was collected pre-operatively and on day 3 post operatively. Castration was performed using a closed inguinal approach in dorsal recumbence under general anaesthesia. The vaginal process was retrieved by blunt dissection over an inguinal skin incision. The closed proximal vaginal process was crushed by a Sand emasculator and ligated at this site. Vaginal Process with content was cut off 10 mm distal to the ligated site. Skin incisions were closed intra cutaneously. Antibiotics or anti-inflammatory drugs were not applied. Results: 48 horses tested negative (SAA< 3mg/l) pre-operatively. Two ponies and one standardbred showed pre-operative 5mg/l, 7mg/l and 75mg/l respectively. Mean SAA value of all 51 horses, three days post operatively, measured 94mg/l. 27 Horses showed no elevation in SAA (<3mg/l). Only 8 horses showed SAA values >100mg/l, of which 4 horses > 500mg/l, (514mg/l, 747mg/l, 1110 mg/l and 1160 mg/l) possibly related to additional trauma. Excluding these 4 cases results in a mean SAA value of 27mg/l. Conclusion: Castrations, using a closed inguinal approach, in which proper surgical standards can be maintained, proved to be far less traumatic than field castrations.

Twin pregnancies in Arabian horses is a major cause of abortion. In all cases when the abortion occurs, it occurs for both fetuses. Unusually in the case described here, which we believe has not previously been documented in Arabian horses, one fetus aborted in undersized and representing an age of 4 months. The other fetus completed the gestation and reached full term followed by birth. The authors postulated that one fetus underwent a stage of diapause like marsupials in a blastocyst stage then re-grew again, followed by abortion. The parentage analysis confirmed that both feti are derived from the same dam and sire stallion.

Zuclopenthixol decanoate is a dopamine antagonist licensed for human use to manage schizophrenia and paranoid psychosis. It is in the same drug class (thioxanthene) as fluphenazine decanoate, a drug with reported use in horses to provide long-acting sedation. This case study describes severe extrapyramidal signs seen in a thoroughbred colt after zuclopenthixol decanoate administration. The colt was presented to a referral hospital for an unusual manifestation of colic signs. On admission, the colt began to show clear extrapyramidal neurological signs. Initial suspicion was of fluphenazine decanoate toxicity, therefore treatment as reported in the literature for this syndrome was commenced. The limited available literature regarding treatment options includes use of intravenous formulations of diphenhydramine hydrochloride and benztropine mesylate, which were unavailable without an import licence in the UK at the time of publication. The closest alternative option, oral diphenhydramine (Nytol) 1mg/kg was administered alongside intravenous atropine (0.01mg/kg) and pergolide (2mcg/kg/q 24 hours). Improvements in the colt’s demeanour and neurological status was noted within 24 hours. Ongoing supportive treatment was continued and slowly tapered in line with clinical improvement. The colt was hospitalised for a total of 26 days and at time of discharge was clinically normal. Follow-up communication 3 months after discharge confirmed that the colt had remained neurologically normal. Crucially, toxicology testing submitted to Cornell University was negative for common toxins, including fluphenazine decanoate. Specific secondary testing was performed after suspicion of the use of zuclopenthixol decanoate was raised, and this was positive for this compound. Routine drug testing would therefore not identify the use of this behaviour modifying drug. Clinical data regarding the use of zuclopenthixol in animals is limited to its use in translocation of wildlife to relieve stress and aid acclimatisation. To our knowledge there is no available literature describing administration of zuclopenthixol decanoate in equine patients.

Background: Workforce shortages are key challenges facing veterinary practice. Anecdotal evidence suggests that veterinary students are less interested in entering equine practice than previously. Objectives: To investigate veterinary students’ perceptions about their equine veterinary education and about working in equine practice. Study Design: On-line survey. Methods: Survey distributed via social media to veterinary students at UK veterinary schools. Questions to document intended career path of students and evaluate perceptions about careers in equine practice. Results: 744 students completed the survey - from all 10 veterinary schools. 88.8% intended to work in clinical practice (32.9% mixed; 25.3% small animal; 20.2% equine; 10.9% farm; 10.7% other/undecided). Factors considered most important for their first job included: mentoring and support (47.0%), team and practice culture (26.2%), working hours (including out-of-hours) (9.2%), location (6.6%), salary and benefits (5.7%) and familiarity with the practice (3.1%). 55.2% felt there were barriers to entering equine practice. 46.9% had ridden a horse regularly; 14.2% had never ridden. Respondents in clinical years rated their university training in equine practice as ‘Excellent’ (10.0%), ‘Good’ (45.9%), ‘OK’ (35.3%), ‘Poor’ (7.0%) and ‘Rubbish’ (1.8%). 48.9% respondents felt EMS had contributed most to their equine training. Statistical associations were identified between the following variables and intention to work in equine practice: owning a horse, having ever ridden a horse, confidence in handling horses, student membership of BEVA, and desire to undertake an internship. Main Limitations: Potential selection bias. Conclusions: 20% of students reporting an intention in equine work does not explain problems with recruitment of equine vets. Potential mismatch between numbers of students interested in equine practice and availability of equine jobs for new graduates. Students with pre-existing equine interest /experience were more likely to want to enter equine practice. EMS appears important for students’ training in equine medicine.

A 20-year-old Warmblood broodmare was presented to the primary veterinarian for bilateral nasal discharge, which had been treated with sulfamethoxazole without complete resolution. The mare was referred to Cornell’s Equine Hospital after she began dropping feed without losing weight. Oral exam, radiography, computed tomography (CT) of the head, and upper airway endoscopy were performed, revealing a left sided nasal abscess filled with feed material due to an associated oronasal fistula between the left maxillary premolars (207 and 209) with reactive bone extending past 210. The abscess was debrided, and drainage was established via a transnasal standing approach under endoscopic guidance, with conservative management of the affected teeth. Repeated follow-up evaluations included upper respiratory endoscopic and oral endoscopic exams to monitor abscess resolution and to evaluate the compromised periodontal attachment of the affected teeth. This case highlights 1) the importance of advanced imaging in cases of equine nasal and sinus disease and 2) the success of conservative dental management when faced with a case of severe periodontitis with subsequent oronasal fistulation.