EVJ 2021 Flashcards
ACVS Phase II Large Animal
Ayodele, B. et al
EVJ 2021
“microstructure, TB, sesamoids”
-Bone volume fraction (BVTV) and bone material density (BMD) of the whole bone and four regions (apical, midbody dorsal, midbody palmar and basilar) were determined.
-The mean sesamoid BVTV was 0.79 ± 0.08 and BMD was 806.02 ± 24.66 mg HA/ccm.
-BVTV was greater in medial sesamoids compared with lateral sesamoids (0.80 ± 0.07 vs 0.79 ± 0.08; P < .001) predominantly due to differences in the apical region
-BVTV was greater in sesamoids with more microcracks on their articular surface, greater extent of bone resorption on their abaxial surface, in horses with a low or mid handicap rating compared with high rating, in 2- to 5-year-old horses compared with younger or older horses and in horses that commenced their racing career at less than 4 years of age.
-Lower sesamoid BVTV was associated with longevity and better performance.
Elzer et al
EVJ 2021
“short frontal plane, P1, racing performance”
-Of 81 treated horses, 74 (91%) raced post-operatively. Treated horses had fewer post-operative starts compared with controls (median 12, 95% CI 9-16 vs median 19, 95% CI 15-23; P < .001), but there was no difference in post-operative earnings
-Treatment of frontal plane fractures of the proximal phalanx by arthroscopic debridement results in racing performance comparable to uninjured controls with respect to longevity and earnings.
Freeman, S. et al
EVJ 2021
“Wound management, PICO format”
**Yvonne Elce on paper
A Woundlavageandtopicaltreatments:(i)Tapwatershouldbeconsideredinstead
of saline for lavage;
(ii) Povidone iodine lavage should be considered for contaminated wounds (There was limited evidence in the human literature that povidone-iodine is an effective cleansing solution for contaminated wounds.);
(iii) Topical silver sulfadiazine may not be suitable for acute wounds;
(iv) Optimal lavage pressures are around 13 psi (based on the human literature, a pressure of 13 psi (12 mL syringe with 22 g needle) is effective at re- ducing infection and inflammation in lacerations and traumatic wounds.)
B Wound debridement and closure: (i) Debridement pads should be considered for wound preparation (The review concluded that the Debrisoft pad should be considered as part of management of acute and chronic wounds, and is cost saving compared to the use of hydrogel, gauze or bagged larvae.);
(ii) Larvae debridement should be considered in selected cases (necrotic hoof defects and deep-seated abscesses on the trunk.);
(iii) Hydrosurgery should be considered in acute contaminated wounds, limited evidence.
C Therapeutics for wound healing:
(i) Honey may reduce duration of some phases of wound healing (evidence that manuka honey improves the speed of healing was moderate quality and for the early phase (up to 21 days) only. There was a lack of good quality evidence that manuka honey improves the overall duration of wound healing or the final cosmetic appearance.)
insufficient evidence to draw conclusions on the use of chemical debride- ment, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions.
Gustafsson, K. et al
EVJ 2021
“medical grade honey incisional infection”
Eighty-nine horses were included in the study. No adverse effects associ- ated with treatment were observed. Horses in the treatment group had a lower rate of incisional infection compared with the control group (8.2% vs. 32.5%, P = .02).
The protective effect of MGH had a calculated adjusted odds ratio (OR) of 0.2 (95% CI:0.07-0.8, P = .03). The number of patients required to receive treatment to pre- vent one case of incisional infection (NNEB) was 4.7.
Risk factors associated with infection included: younger age (OR = 27, 95% CI: 2.3 to 306, P = .008) and diarrhoea 48 hours post-operatively (OR = 20, 95% CI: 1.5 to 277, P = .02).
Haseler et al.
EVJ 2021
“triamcinolone joint injection, laminitis”
-The incidence of laminitis over the 4-month study period in both groups was identical: 3/966 horses (0.31%), equivalent to 0.93 cases per 100 horses per year (P > .9).
-intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
James et al.
EVJ 2021
“arthroscopic evaluation of fetlock with P1 parasagittal fractures”
-81 MCP/MTP joints in 78 horses underwent arthroscopic evaluation concurrent to parasagittal fracture repair. Tears of the joint capsule and dorsal synovial plica were noted in 43 cases.
-Arthroscopy identified articular incongruity in three horses where fracture displacement was not predicted at all on pre-operative radiographs, and incongruity in additional plane(s) to the radiographic displacement in 14 horses.
-Concurrent osteochondral fragmentation and disruption of cartilage were present in some cases.
You should scope these fractures as you do your repair.
Jarosinski et al
EVJ 2021
“US guided injection of centrodistal joint”
-The CD joint was successfully injected in 17/24 joints, representing a 70.8% accuracy.
Johnston et al
EVJ 2021
“stress fracture TB Hong Kong”
Eighty-seven horses sustained a NS-diagnosed fracture within their first year in Hong Kong (incidence risk 1.7%
Humerus and tibia were most common stress fracture sites
Cases missed median of 63 days
Cases had a median of 4 fewer starts
Louro et al
EVJ 2021
“Epidural opioid recovery form GA”
-Records from 149 horses, undergoing 170 general anesthetics were included. Multivariable logistic regression analysis showed that opioid epidural analgesia was associated with good quality of recovery.
-Cob breeds, age (in years), increasing intraoperative dosages (in mg/kg) of thiopental (OR 0.64, 95% CI 0.46 to 0.90, P = .01) or ketamine (OR 0.42, 95% CI 0.18 to 0.98, P = .04) were associated with poor quality of recovery.
-Opioid epidural analgesia is significantly associated with good quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis.
Joyner et al.
EVJ 2021
“intraocular pressure, sedation protocols”
-detomidine and 0.01 mg/kg of butorphanol (SED2) had greatest change in IOP therefore lowers intraocular pressure at 60 min timepoint.
-sed3 (10 μg/kg detomidine) were higher than other treatments
-IOPs of head down were higher compared to head elevated
Michanek et al.
EVJ 2021
“infrared light and red monochromatic light on equine wound healing”
-The wound area (P = .2-.9) and degree of swelling (P = .2-1.0) did not differ between treated and control groups on any day.
-There was a significant difference (P = .03) in healing time between control (49.0, 95% CI = 35.4-62.6 days) and treated wounds (51.8, 95% CI = 38.7-64.8 days).
-Time to complete healing was significantly shorter for untreated control wounds (49.0 [95% CI = 35.4-62.6] days) compared with treated wounds (51.8 [95% CI = 38.7-64.8] days) (P = .03).
O’Brien et al
EVJ 2021
“racing performance TB septic arthritis”
-78% foals discharged alive
-Foals <26 days old at the time of admission were five times less likely (P = .003) and foals with concurrent multisystemic disease were six times less likely (P = .02) to be discharged alive.
-67% discharged alive started a race
-there was no difference in the proportion of foals that started in a race or racing performance between foals treated for septic arthritis and their maternal siblings.
Oliveira et al
EVJ 2021
“pain expression in post-op donkeys”
-When compared with presurgical baseline behaviours (M0), after surgery (M1) donkeys raised their pelvic limbs more (P = .003).
-The dirty stall increased tail (53 vs 80; P = .03), head (16 vs 30; P = .03) and ear movements (50 vs 78; P = .04).
-lifting pelvic limbs is primary sign of pain, but The dirty stall and presence of insects possibly contributed to the expression of behaviours unrelated to pain.
Nogues et al
EVJ 2021
“medial femoral condyle lucency’s repository radiographs”
-A MFC lucency ≤3 mm in depth was diagnosed in at least one radiographic sales set in 248 horses (6.4%).
-The right femur was more commonly affected (73.9%) than the left.
-Radiographic lucencies in the left femur were significantly smaller (P = .02) than lucencies in the right femur.
-Radiographic lucencies resolved in 6.1% of cases, 3.6% of cases developed into a cyst, 40.7% of cases were unchanged in size, 23.6% of lucencies decreased in size and 8.2% increased in size.
-Cysts >3 mm deep regressed into smaller lesions ac- counting for 4.9% of the lucencies, and 12.9% of lucencies developed from a normal or flat medial femoral condyle contour.
-Horses with a medial femoral condyle lucency had significantly less starts as a 2-year-old vs. their maternal siblings (P < .01).
Renaudin et al
EVJ 2021
“Granulosa cell tumors diagnostic challenge”
-The clinical form and ultrasonographic appearance may also vary with time from an initially enlarged/anovulatory follicular structure that later develops a multicystic ‘honeycomb’ appearance. Mares with GCTs can also present with persistent anovulatory follicles or apparent luteal tissue that are unresponsive to treat- ment.
-If both ovaries are of relatively normal size and symmetry, but hormonal biomark- ers are markedly increased (AMH >10 ng/mL, inhibin B and/or testosterone >100 pg/ mL; 0.37 nmol/L), it is likely that a functional GCT is present. Still, it can be a challenge to decide which ovary to remove. Post-surgical endocrine testing can be helpful, especially if histopathology is not performed or a GCT is not found.
