EVJ 2020 Flashcards
ACVS Phase 2 Exam
Mendez-Angulo
EVJ 2020
“IVRLP lidocaine or mepivacaine”
-Nociceptive thresholds for lidocaine, mepivacaine and perineural anaesthesia trials were significantly increased compared with saline and baseline values at 10, 20 and 30 minutes,
-horses had lower heart rates than IVRLP with saline. After tourniquet release at 30 minutes, nociceptive thresholds for lidocaine and mepivacaine trials gradually re- turned to baselines, whereas perineural anaesthesia trial remained unchanged out to an hour.
-Amikacin was not included in the perfusate.
-IVRLP with lidocaine or mepivacaine provides anti-nociception to the distal limb in standing sedated horses while a tourniquet is applied with concentrations remaining below toxic levels
Hector et al.
EVJ 2020
“recovery quality after single dose alpha 2”
-To determine whether dexmedetomidine improves recovery quality from sevoflurane anaesthesia compared to a previously studied dose of romifidine.
-There were no significant differences between groups except end-tidal sevoflurane (FE ́Sevo) concentration and post-induction extra ketamine dosing.
- Including FE ́Sevo and additional ketamine in the analysis as covariates, VAS scores and time to standing were not significantly different between groups.
-Increased age, not receiving a nerve block, increased duration of hypotension, and having a nervous tempera- ment were significant predictors of VAS score.
Bergmann et al
EVJ 2020
“Cervical spine OCD”
-About 20.6% of facets revealed OC. There was no predilection site. Prevalence decreased with age up to 1 year (odds ratio [OR] 0.997; (95% CI 0.975- 0.998)) but not up to 5 months. Severity increased with age in all age ranges
-Highest prevalence was in cranial facets of the cervical and cervical-thoracic joints and in caudal facets of the thoracic joint up to 1 year and up to 1 month
-Articular process joint OC in Warmblood foals is common and is not more prevalent at CVM predilection sites, suggesting that abnormalities of enchon- dral ossification may not be major contributors to CVM.
Ramzan et al
EVJ 2020
“TB racehorse, MCP chips, surgical versus non”
-To compare racing career outcomes of Thoroughbred racehorses with nonsurgically (non-SX) or surgically (SX) managed MCP/MTP dorsal osteochondral chip fracture alongside a cohort of horses with no dorsal osteochondral chip fracture (unexposed).
- There was no significant difference among non-SX, SX, and unexposed horses in respect of total career starts, or likelihood of ever winning, placing, or earning money in a race (P > .05). SX horses had a significantly higher rate of wins/start than non-SX horses (rate ratio 1.6, CI 1.1-2.4, P = .02) and unexposed horses
-Total career earn ings for the SX horses were 4.1 times that of the unexposed horses (95% CI 1.2-14.5, P = .03), although total career earnings did not differ significantly between non-SX and unexposed horses (P = .8).
O’neill et al
EVJ 2020
“alternative, LFT joint”
-Entry and examination of both pouches of the caudal lateral femorotibial joint was consistently achieved using an arthroscopic portal immediately cranial to the lateral collateral ligament in both cadaver and clinical limbs, with no adverse effects noted in the latter.
-Contrary to published descriptions, the division of the pouches was principally formed by a meniscopopliteal septum derived from the joint capsule in all cases, rather than the popliteus muscle
McCoy et al
EVJ 2020
“regression of internal umbilical remnants”
*Exam committee
-Structure diameter decreased linearly over time. The largest measurements were at 24 hours of age with a median umbilical vein diameter of 0.83 cm (IQR 0.77- 1.02 cm), median umbilical artery diameter of 0.61 cm (IQR 0.56-0.70 cm) and median urachal diameter of 1.07 cm
-There was a significant reduction in diameter for all structures (16.0%-21.9%; corrected P < .001) within the first week of life.
Kennedy et al.
EVJ 2020
Long term post extraction complications
-Post-extraction complications were recorded following 58/428 extractions giving an overall complication rate of 13.6%, that caused a longer term clinical problem in 34/428 (7.9%) cases, with complications being asymptomatic or quickly self- resolving in the other 24 cases (5.6%).
-The most frequent complication was alveolar bone sequestration, including alveolar infection. Risk of developing a post-extraction
-alveolar disorder managed by the authors (n = 53) increased following extraction of the mandibular 06s, 07s or 08s compared with all other cheek teeth combined (P = .001); for cheek teeth with apical infections (P = .002) compared with those without; and following repulsion or minimally invasive transbuccal extraction
Hill et al
EVJ 2020
“BMI and incision”
- In all, 287 horses fit inclusion criteria. Incisional complication prevalence was 23.7%. Horses with incisional complications had a higher BMI (median 203.6 kg/m2, IQR = 191.5-217.4) compared with those without (median 199.1 kg/m2, IQR = 184.7- 210.2) (P = .03).
-Breed had an association with BMI (P < .01), but not with incisional complication risk.
Crandall et al
EVJ 2020
“Mepivacaine versus lidocaine, testicle block”
-Cremaster relaxation scores were significantly better for the mepivacaine group over the lidocaine group on a 1-3 scoring system (1 being most relaxed, 3 being least).
-The average cremaster relaxation score on both testicles treated with mepivacaine was 1 compared to the lidocaine treatment averaging 2 [P = .03 first testicle; P = .04 second testicle].
-The lidocaine group had an increased number of horses requiring additional ketamine (25% of horses) compared to the mepivacaine group (16% of horses).
Isgren et al.
EVJ 2020
“sepsis calcanea bursa”
Survival to hospital discharge was 84.4%. Univariable survival analysis revealed that administration of systemic antimicrobials prior to referral was associated with reduced mortality (hazard ratio, [HR] 0.41, 95% CI 0.18–0.91, P = 0.03).
Increased mortality was associated with bone fracture/osteomyelitis (HR 2.43, 95% CI 1.12–5.26, P = 0.03), tendon involvement (≥30% cross sectional area) (HR 3.78 95% CI 1.78–8.04, P = 0.001), duration of general anaesthesia (HR 1.01, 95% CI 1.00–1.02, P = 0.04), post-operative synoviocentesis (HR 3.18, 95% CI 1.36–7.43, P = 0.006) and post-operative wound dehiscence
From 57 horses with athletic performance follow-up, 91.2% returned to the same/higher level of exercise, 5.3% to a lower level and 3.5% were retired due to persistent lameness of the affected limb.
-Increased mortality was associated with bone fracture/osteomyelitis, tendon involvement (≥30% cross sectional area), duration of general anaesthesia, post-operative synoviocentesis and post-operative wound dehiscence.
-The most common bacteria isolated were Staphylococcus spp. (36.0%, n = 9/ 25) followed by Streptococcus spp. (28.0%, n = 7/25) and Escherichia coli (20.0%, n = 5/25).
Verra, et al.
EVJ 2020
“C6, C7 signs and WB”
-Morphologic variation at C6 and C7 (n = 108/377 = 28.6%; Cases 58/245 = 23.7%; Control 50/132 = 38%) was less frequent in horses with clinical signs in univariable testing (OR 0.48, 95% CI 0.3–0.8, P = 0.001).
- Age, sex, breed and degenerative joint disease were not retained in the final multivariable logistic regression step whereas morphologic variation remained significantly less present in horses with clinical signs.
Radtke et al
EVJ 2020
“stifle block and distal limb pain”
-Overall, horses with hoof clamp-induced foot pain had a reduction in push-off lameness after IA stifle anaesthesia. The mean change in diffmax at 90 min was 4.3 mm (P = 0.005) for the experimental group vs. 2.3 mm (P = 0.2) for the control group.
-Lameness decreased over time, with an average improvement of 23% at 30 min, 33% at 60 min and 38% at 90 min.
There was high inter-horse variability; 3/9 horses improved by ~50% within 30 min, while 2/9 improved by ~30% and 4/9 had minimal (<10%) or no improvement in lameness. Improvement after IA stifle anaesthesia was not related to the severity of baseline lameness (P = 0.3–0.7).
-Intra-articular stifle anaesthesia reduces foot lameness in a third of horses by up to 50% within 30 min. Clinically, the results of IA stifle anaesthesia should be considered in the light of these findings before treatment recommendations are made, as additional diagnostics may be required to rule out pain originating in the distal limb.
Kent et al
EVJ 2020
“contrast radiology tendon sheath”
-Contrast tenography was a sensitive test for MF tears (92% confidence interval [CI] 88.4–94.4%; specificity 56%, CI 51.1–61.1%) and specific for diagnosing DDFT tears (73%, CI 68.6–76.8%; sensitivity 54%, CI 47.8–60.2%)
-Contrast tenography had a lower sensitivity (71%, CI 65.1–75.9% ) and specificity (45%, CI 39.1– 52.0%) for PAL constriction. It had good to substantial interobserver agreement for MF and DDFT tears (Krippendorff’s alpha 0.68 and 0.46 respectively).
-Ponies (57%) and cobs (58%) were significantly more likely to be affected with MF tears (other breeds 20–39%, P = 0.003) and Thoroughbreds (50%), warmbloods (45%) and draught breeds (48%) were more likely to have DDFT tears (other breeds 22–34%, P = 0.01).
-MF tears and PAL constriction were overrepresented in the hindlimbs compared to DDFT tears in forelimbs.
Graham et al.
EVJ 2020
“QH with osteochondral frags, carpus”
-Sixty-five percent (n = 289) and 27% (n = 118) of the lesions were bilateral in Quarter Horses and Thoroughbreds respectively (P<0.001). In both breeds, the most commonly affected bone was the dorsodistal radial carpal bone (n = 320/659; 48.6%).
-Overall, 82% (n = 686; n = 358 Quarter Horses, n = 328 Thoroughbreds) of horses raced post-surgery, with 69.5% (n = 476; n = 228 Quarter Horses, n = 248 Thoroughbreds) racing at the same or a higher level of competition.
-Factors associated with horses not returning to racing post-surgery were increasing horse age, female horses, and a lesion grade of 4, while racing pre-surgery was protective.
Caramello et al.
EVJ 2020
“cheek tooth extraction complications”
-The study included 137 horses and 162 cheek teeth extractions. Oral extraction was successful in 71% of patients in which it was attempted.
-Oral extraction (n = 55) had the lowest incidence of complications (20%) and repulsion by sinus bone flap (n = 20) the highest (80%).
-Complication rates for repulsion by maxillary (n = 19) and mandibular trephination (n = 28), and extraction by lateral buccotomy (n = 15) were 42, 54 and 53%, respectively.
-Cheek tooth repulsion by sinus bone flap significantly -increased the odds of damage to adjacent teeth, post-operative sinusitis, damage to alveolar bone, delayed alveolar granulation and orosinus fistulation.
-Repulsion by maxillary trephination significantly increased the odds of superficial incisional surgical site infection; and extraction by lateral buccotomy significantly increased the odds of facial nerve neuropraxia.
-Post-operative pyrexia was more common in all repulsion methods.
