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EQUINE VETERINARY EDUCATION


Equine vet. Educ. (2019) 31 (5) 226-227 doi: 10.1111/eve.13079


Highlights of recent clinically relevant papers


Predicting strangulating intestinal lesions This prospective study by Isabelle Kilcoyne and colleagues in the USA assessed the ability of plasma and peritoneal creatine kinase (CK) to predict the presence of a strangulating lesion in horses presented for colic. Creatine kinase activity was measured in the peritoneal


fluid and plasma of 10 healthy horses and 61 horses presenting for colic (40 with nonstrangulating lesions and 21 with strangulating lesions). Details of other blood and peritoneal fluid variables, signalment, physical examination results, outcome, requirement for surgery and lesion location and type were retrieved from the medical records. A peritoneal CK cutoff level of 16 IU/L yielded a sensitivity


of 95.2% and a specificity of 84.6% (positive predictive value [PPV] = 76.9% and negative predictive value [NPV] = 97% respectively) for predicting a strangulating lesion. A peritoneal lactate cutoff level of 3.75 mmol/L yielded a sensitivity of 81% and a specificity of 92% (PPV = 85% and NPV = 90% respectively) for predicting a strangulating lesion. Peritoneal CK concentration was a sensitive indicator of the


presence of a strangulating lesion in horses presenting with colic, whereas peritoneal lactate concentration was a more specific indicator. Measuring CK in peritoneal fluid may be a useful addition to clinical case presentation to accelerate the diagnosis and treatment of horses presenting with strangulating intestinal lesions, thereby improving their outcome.


Hypoglycin A in sycamore seedlings This study by Sonia Gonz


Self-selected horse/pony owners in GB submitted initial


baseline and follow-up health and management questionnaires for 1070 horses/ponies over a 29-month period. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary- diagnosed episodes of active laminitis using a previously validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with a previous case- control study, a prior history of laminitis (particularly nonveterinary-diagnosed episodes), soreness after shoeing/ trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel and require further investigation to explore their relationship with laminitis and their applicability as potential interventions. These results serve as a sound evidence base towards the development of strategic recommendations for the horse/ pony-owning population to reduce the rate of laminitis in GB.


Ultrasonography to identify manica flexoria tears alez-Medina and colleagues in the


UK investigated various pasture management strategies employed to avoid hypoglycin A (HGA) intoxication in horses. Sycamore seedlings from nine locations were either


mowed (n = 6) or sprayed with a herbicide (dimethylamine- based, n = 2; picolinic acid-based, n = 1). Seedlings were analysed for HGA concentration prior to and at 48 h, 1 and 2 weeks after intervention. Cut grass in the vicinity of mowed seedlings was also analysed prior to and 1 week after intervention. Seeds and seedlings maintained for 6 months in processed grass forage (hay and silage) were also analysed. There was no significant decline in HGA content in


mowed or sprayed seedlings, with mowing inducing a temporary significant rise in HGA in the seedlings. HGA was still present in sycamore material after 6–8 months storage within either hay or silage. These findings show that neither mowing nor herbicidal spraying reduces HGA concentration in sycamore seedlings up to 2 weeks after intervention. Pastures contaminated with sycamore material should not be used to produce processed hay or silage.


Factors associated with equine laminitis


In this study, Danica Pollard and colleagues in the UK aimed to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors identified in a previous case- control study.


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Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study by Rita Martins Garcia da Fonseca and colleagues in Portugal, Belgium and Italy described the


ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of amanica flexoria tear. Six horses had a partial manica flexoria tear, one a


complete rupture. The ultrasonographic examination included a static examination on the weightbearing and nonweightbearing limb and a dynamic limb assessment


during flexion and extension. The main ultrasonographic finding at the static weightbearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon (SDFT) or an incomplete visualisation of the manica flexoria in the case of complete rupture. The split edges of the complete ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the SDFT slid


abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of


the SDFT, appearance of an anechoic gap between the flexor tendons or reduced SDFT sliding. As ultrasonographic diagnosis of manica flexoria tears is considered challenging, detection of these ultrasonographic


features is helpful to increase the likelihood of identifyingmanica flexoria tears prior to tenoscopy. The authors recommend static


ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination


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