394


EQUINE VETERINARY EDUCATION


Equine vet. Educ. (2019) 31 (8) 394-395 doi: 10.1111/eve.13139


Highlights of recent clinically relevant papers


Honey and wound healing This prospective, randomised clinical study by Hadar Mandel and colleagues in Israel aimed to evaluate the effect of intralesional medical grade honey (MGH) on wound infection and dehiscence following closure. A total of 127 horses were included in the study and


randomly allocated into the treatment (MGH; 69 horses) or control (58 horses) group. Neonatal foals, horses with major systemic illness, penetrating wounds requiring hospitalisation and eyelid lacerations were excluded from the study. All wounds were first cleaned thoroughly with diluted


chlorhexidine or diluted povidone iodine followed by a balanced sterile electrolyte solution. The MGH group had sterile MGH (L-Mesitran gel) applied directly onto the subcutaneous tissue prior to skin closure or after partial wound closure. Data relating to wound healing was subsequently collected from the 11 participating practitioners through questionnaires and telephone conversations. No adverse effects of the MGH were recorded in any of


the horses participating in the study. MGH-treated horses were significantly more likely to heal completely, to have no signs of infection and for the veterinarians to report some degree of satisfaction compared to control cases. The authors concluded that intralesional application of


MGH to lacerations prior to wound closure may help prevent wound infection and therefore dehiscence.


Per rectum fluid therapy


This randomised controlled crossover study by Adeel Khan and colleagues in Australia and the UK compared the use of rectally administered fluids with nasogastric and intravenous administration. Six healthy horses each received each of three different


fluid treatment protocols (intravenous Hartmann’s, nasogastric polyionic solution and rectally administered tap water) at 5 mL/kg bwt/h and also underwent a control protocol (no treatment) while feed and water was withheld for 6 h. A minimum 2-week washout period was observed between each treatment. Prior to administering rectal fluids the rectum was manually


evacuated and a 24 Fr flush enema tube inserted approximately 50 cm into the rectum and secured to the tail. Fluid was delivered continuously by gravity flow. Packed cell volume (PCV), total solids (TS), albumin, electrolytes, lactate, urine specific gravity, vital parameters, gastrointestinal borborygmi and central venous pressure were measured every 2h.


Rectal administration of fluid was well tolerated in all


horses. PCV decreased over time with all fluid treatments but not with the control, and TS decreased with intravenous and rectally administered fluid. There was an increase in gastrointestinal borborygmi with rectally administered fluid. Rectal fluid administration may offer an effective,


inexpensive alternative or adjunct to intravenous fluid therapy, particularly when administration via nasogastric tube is not possible or contraindicated.


© 2019 EVJ Ltd Chemotherapy for lymphoma


In this retrospective study Daniela Luethy and colleagues in the USA, Australia and Canada reported the long-term outcome of 15 horses with lymphoma treated with chemotherapy. Fifteen cases with adequate data were identified through


a search of medical records and an email call for cases on the ACVIM listserv for horses treated with chemotherapy for lymphoma. Complete remission was achieved in five horses (33.3%),


partial response was achieved in nine equids (60%), and stable disease was achieved in one horse. Overall response rate was 93.3% (14/15). Overall median survival time was 8 months (range, 1–46 months). Nine horses experienced a total of 14 adverse effects attributable to chemotherapy. Adverse effects were graded according to the Veterinary Cooperative Oncology Group common terminology criteria for adverse events grading system (grade 1 alopecia, n = 2; grade 1 neutropenia, n = 2; grade 1 lymphopenia, n = 3; grade 1 lethargy, n = 1; grade 2 neurotoxicity, n = 1; grade 2 colic, n = 1; grade 1 hypersensitivity, n = 1; grade 2 hypersensitivity, n = 2; grade 5 hypersensitivity, n = 1). Higher grade adverse effects most commonly were associated with doxorubicin administration (n = 4), including one horse that died 18 h post-administration. The authors concluded that chemotherapy can be used


successfully for treatment of horses with lymphoma. Adverse effects, most commonly mild, occurred in approximately two- thirds of treated horses.


Saddle fitting


This pilot study by Kathryn Nankervis and colleagues in the UK assessed the reliability of saddle fitters (SFs) to determine the position of the last thoracic vertebra of horses using palpation techniques. According to published guidelines an English saddle tree


should not extend beyond the 18th thoracic vertebra (T18). This study aimed to assess reliability of SFs to identify the T18 spinous process (SP). Part 1 investigated agreement between T18 (T18SF) as identified by three SFs using palpation and a veterinary surgeon (VS) using radiography (T18VS) in seven horses. SF1 and SF2 palpated the lumbosacral joint and counted cranially six SPs, whereas SF3 followed the rib curvature toward the dorsal midline. In part 2, SF1 and SF2 identified T18 by counting cranially five SPs in seven horses on two occasions. Agreement between SFs and VS was assessed using t tests and Bland-Altman plots. Interrater and intrarater reliability were estimated using intraclass correlation


coefficients. In part 1, SF1 and SF2 found T18SF 4.3 cm (4.1 and 4.0 cm, respectively) cranial to T18VS. Mean difference between T18SF3 and T18VS was 0.1 4.9 cm (95% CI:


9.5 cm, 9.6 cm). When counting cranially five SPs, mean difference between T18SF1 and T18VS was 1.5 3.4 cm (95% CI: 8.3 cm; 5.1 cm) and T18SF2 and T18VS was


0.3 cm 4.5 cm (95% CI: 8.8 cm; 8.5 cm). Interrater reliability was ‘good’ (ICC = 0.798). Intrarater reliability was

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88